Teresa D. Formo, APRN, CNP
NPI 1225648736ActiveIndividual· Nurse Practitioner, Family· Valley City, ND
Nurse Practitioner, Family (APRN, CNP) with Sanford Medical Center Fargo, practicing in Valley City, North Dakota. 276 Medicare patients in 2024, $32,161 paid; nearly all of their 1,073 Part D prescriptions were generic (94%). Phathom Pharmaceuticals, Inc. was the largest of 3 companies reporting payments in 2025, $70.61 in all, mostly food and beverage. Lists Chi Mercy Health and 3 other hospitals as hospital affiliations.
Overview
| NPI | 1225648736 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | APRN, CNP |
| Sole proprietor | No |
| NPI issued | Aug 10, 2020 |
| Last updated in NPPES | May 21, 2024 |
| Certified by provider | May 21, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | R23725 | ND |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (ND) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 276 |
|---|---|
| Services billed | 1,142 across 79 procedure codes |
| Paid by Medicare | $32,161 |
Part D prescriptions in 2024
| Prescriptions (claims) | 1,073 · 1,588 30-day fills |
|---|---|
| Patients | 331 |
| Total drug cost | $24,538 |
| Generic share | 94% of claims |
Education and affiliations
| Graduation year | 2020 |
|---|---|
| Medicare specialty | Nurse Practitioner |
Medical group
- Sanford Medical Center FargoWest Fargo, ND · 1,225 clinicians
Hospital affiliations
- Chi Mercy HealthValley City, ND
- Jamestown Regional Medical CenterJamestown, ND
- Lisbon Area Health ServicesLisbon, ND
- Sanford Medical Center FargoFargo, ND
Industry payments (Open Payments)
- 2025$70.61 · 5 payments from 3 companies
- 2024$13.39 · 1 payment from 1 company
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Phathom Pharmaceuticals, Inc. | $40.03 | 3 |
| Takeda Pharmaceuticals U.S.A., Inc. | $15.54 | 1 |
| Collegium Pharmaceutical, Inc. | $15.04 | 1 |
What the 2025 payments were for
- Food and Beverage$70.61 · 5 payments
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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