Forward Care Family Practice, PLLC
NPI 1205435880ActiveOrganization· Physician Assistant· Glendale, AZ
Physician Assistant in Glendale, Arizona, registered in NPPES in October 2020. The authorized official on file is Ellana Davidov, Authorized Official/Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1205435880 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 23, 2020 |
| Last updated in NPPES | Oct 26, 2020 |
| Certified by provider | Oct 26, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AZ) |
|---|
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