Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Form Health Associates MA, PC

Organization Family Medicine Physician · NPI 1386260594

Form Health Associates MA, PC is a Family Medicine Physician in Boston, Massachusetts. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
2
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

109 State Street 5th Fl
Boston, MA 02109-2906
Phone: (617) 505-1520
Fax: (617) 928-8401
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Endocrinology, Diabetes & Metabolism Physician (primary) Taxonomy 207RE0101X
Family Medicine Physician Taxonomy 207Q00000X

Record details

NPI number1386260594
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Nam Kim — President · (617) 505-1520
NPI enumeratedJune 23, 2020
Last updated in NPPESMarch 18, 2026
Certification dateMarch 18, 2026
Mailing address109 State St, 5th Fl, Boston, MA 02109-2906

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