Teresa D Formo, APRN, CNP - Medicare Nurse Practitioner in Valley City, ND

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Teresa D Formo, APRN, CNP is a medicare enrolled "Nurse Practitioner - Family" in Valley City, North Dakota. She graduated from nursing school in 2020 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Innovis Health Llc and her current practice location is 520 Chautauqua Blvd, Valley City, North Dakota. You can reach out to her office (for appointments etc.) via phone at (701) 845-6000.

Teresa D Formo is licensed to practice in North Dakota (license number R23725) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1225648736.

Contact Information

Teresa D Formo, APRN, CNP
520 Chautauqua Blvd,
Valley City, ND 58072-3145
(701) 845-6000
Not Available

Map and Direction




Provider's Profile

Full NameTeresa D Formo
GenderFemale
SpecialityNurse Practitioner
Experience5 Years
Location520 Chautauqua Blvd, Valley City, North Dakota
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Teresa D Formo graduated from nursing school in 2020
  NPI Data:
  • NPI Number: 1225648736
  • Provider Enumeration Date: 08/10/2020
  • Last Update Date: 05/21/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 6709203904
  • Enrollment ID: I20200902002898

Medical Identifiers

Medical identifiers for Teresa D Formo such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1225648736NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family R23725 (North Dakota)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Essentia HealthFargo, NDHospital
Jamestown Regional Medical CenterJamestown, NDHospital
Chi Mercy HealthValley city, NDHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Innovis Health Llc9931298155478

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Teresa D Formo allows following entities to bill medicare on her behalf.
Entity NameInnovis Health Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1215125463
PECOS PAC ID: 9931298155
Enrollment ID: O20071211000158

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Teresa D Formo is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Teresa D Formo, APRN, CNP
Po Box 5074,
Sioux Falls, SD 57117-5074

Ph: (605) 328-9419		Teresa D Formo, APRN, CNP
520 Chautauqua Blvd,
Valley City, ND 58072-3145

Ph: (701) 845-6000

Reviews and Comments


Nurse Practitioner Nurses in Valley City, ND

Kari Marie Kietzman, CNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 520 Chautauqua Blvd, Valley City, ND 58072
Phone: 701-845-6000    Fax: 701-845-6150
Sarah Ellen Hansen,
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 132 4th Ave Ne, Valley City, ND 58072
Phone: 701-845-8060    
Stacie Cleveland, FNP-C
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 367 2nd St Nw, Valley City, ND 58072
Phone: 701-845-6550    
Trent William Bitz, FNP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 132 4th Ave Ne, Valley City, ND 58072
Phone: 701-845-8060    
Leah Kathryn Swenson, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 132 4th Ave Ne, Valley City, ND 58072
Phone: 701-845-8060    Fax: 701-845-8067
Dr. Joann Delane Trader, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 520 Chautauqua Blvd, Valley City, ND 58072
Phone: 701-845-6000    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.