Basil Fomanka
NPI 1013621010 · Psychiatric/Mental Health Nurse Practitioner · Riverdale, MD
Enrolled with Medicare as Practitioner - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Basil Fomanka is a Psychiatric/Mental Health Nurse Practitioner provider in Riverdale, MD (NPI 1013621010).
Provider details
- NPI number
- 1013621010
- Entity type
- Individual
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- R198010 (MD)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2023-01-13
- Last updated
- 2025-09-18
- Certified
- 2025-09-18
Frequently asked questions
- What is Basil Fomanka's NPI number?
- Basil Fomanka's National Provider Identifier (NPI) is 1013621010, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Basil Fomanka's specialty?
- Basil Fomanka is listed in the NPPES registry with a primary specialty of Psychiatric/Mental Health Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Basil Fomanka located?
- Basil Fomanka's practice location on file with NPPES is 6200 Baltimore Ave, Riverdale, MD 20737-1054.
- What is Basil Fomanka's phone number?
- The practice phone number listed in the NPPES registry for Basil Fomanka is (443) 520-8138.
- Does Basil Fomanka accept Medicare?
- Basil Fomanka is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Basil Fomanka's NPI active?
- Yes — Basil Fomanka's NPI (1013621010) is active in the NPPES registry as of the last update on 2025-09-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.