TERMINAL · ENTITY CARD · ORGANIZATION

IMR OAK CREEK OPCO, LLC

Canonical entity in the resolved graph · WI · methodology entity-graph/v1 · 07924520-eae9-44ed-929b-4752d9248cc5

active

Cross-source identifiers

Every current identifier attachment, with the link method and confidence carried verbatim — deterministic links are 1.000; probabilistic links surface their real matcher confidence, never rounded up.

Current identifier attachments with link confidence
Scheme	Value	Source table	Link method	Confidence	Since	Provenance
npi	1235762881	nppes_providers	deterministic_pk	1.000	2026-06-10	evidence recorded: 2026-06-10 methodology: entity-graph/v1 evidence: {"rule":"D-NPI","source_pk":"1235762881","entity_type_code":"2"}
pac_id	2961830179	pecos_providers	exact_npi_in_pecos	1.000	2026-06-16	evidence recorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1235762881","rule":"D-PECOS","enrlmt_id":"O20200323001984","pecos_asct_cntl_id":"2961830179"}
pecos_enrlmt_id	O20200323001984	pecos_providers	exact_npi_in_pecos	1.000	2026-06-16	evidence recorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1235762881","rule":"D-PECOS","enrlmt_id":"O20200323001984"}

Graph edges

One-hop relationships — ownership, chain membership, operation — each backed by a federal source row.

Current 1-hop graph edges
Relationship	Entity	Confidence	Source table	Provenance
← owns	TODD A STERN	1.000	snf_all_owners	evidence recorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"10/17/2018","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"2264341924","source_pk":200141,"type_owner":"I","enrollment_id":"O20200323001984","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"IMR OAK CREEK OPCO LLC"}
← owns	PRESTIGE WORLDWIDE OAK CREEK LLC (IL)	1.000	snf_all_owners	evidence recorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"12/01/2019","percentage_ownership":13.72} evidence: {"rule":"D-OWNER","owner_pac":"2466880679","source_pk":200142,"type_owner":"O","enrollment_id":"O20200323001984","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":13.72,"enrollment_organization_name":"IMR OAK CREEK OPCO LLC"}
← owns	BARRY CARR	1.000	snf_all_owners	evidence recorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"10/17/2018","percentage_ownership":15.68} evidence: {"rule":"D-OWNER","owner_pac":"2567417249","source_pk":200143,"type_owner":"I","enrollment_id":"O20200323001984","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":15.68,"enrollment_organization_name":"IMR OAK CREEK OPCO LLC"}
← owns	BENJAMIN ISRAEL	1.000	snf_all_owners	evidence recorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"34","association_date":"10/17/2018","percentage_ownership":15.3} evidence: {"rule":"D-OWNER","owner_pac":"4183884968","source_pk":200145,"type_owner":"I","enrollment_id":"O20200323001984","role_code_owner":"34","role_text_owner":"5% OR GREATER DIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":15.3,"enrollment_organization_name":"IMR OAK CREEK OPCO LLC"}
← owns	IGNITE TEAM PARTNERS LLC (IL)	1.000	snf_all_owners	evidence recorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"01/01/2020","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6204264419","source_pk":200147,"type_owner":"O","enrollment_id":"O20200323001984","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"IMR OAK CREEK OPCO LLC"}
← owns	BLUE PEARL FINANCIAL LLC (IL)	1.000	snf_all_owners	evidence recorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"12/01/2019","percentage_ownership":15.68} evidence: {"rule":"D-OWNER","owner_pac":"6305198656","source_pk":200148,"type_owner":"O","enrollment_id":"O20200323001984","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":15.68,"enrollment_organization_name":"IMR OAK CREEK OPCO LLC"}
← owns	RAPHAELA E STERN	1.000	snf_all_owners	evidence recorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"34","association_date":"10/17/2018","percentage_ownership":15.3} evidence: {"rule":"D-OWNER","owner_pac":"6901066786","source_pk":200149,"type_owner":"I","enrollment_id":"O20200323001984","role_code_owner":"34","role_text_owner":"5% OR GREATER DIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":15.3,"enrollment_organization_name":"IMR OAK CREEK OPCO LLC"}
← owns	IGNITE POST ACUTE SOLUTIONS LLC (IL)	1.000	snf_all_owners	evidence recorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"12/01/2019","percentage_ownership":19.6} evidence: {"rule":"D-OWNER","owner_pac":"8022360387","source_pk":200150,"type_owner":"O","enrollment_id":"O20200323001984","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":19.6,"enrollment_organization_name":"IMR OAK CREEK OPCO LLC"}
← owns	TIMOTHY FIELDS	1.000	snf_all_owners	evidence recorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"10/17/2018","percentage_ownership":19.6} evidence: {"rule":"D-OWNER","owner_pac":"8729384599","source_pk":200151,"type_owner":"I","enrollment_id":"O20200323001984","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":19.6,"enrollment_organization_name":"IMR OAK CREEK OPCO LLC"}
← owns	IGNITE OAK CREEK LLC (WI)	1.000	snf_all_owners	evidence recorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"34","association_date":"10/17/2018","percentage_ownership":49} evidence: {"rule":"D-OWNER","owner_pac":"8921436130","source_pk":200154,"type_owner":"O","enrollment_id":"O20200323001984","role_code_owner":"34","role_text_owner":"5% OR GREATER DIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":49,"enrollment_organization_name":"IMR OAK CREEK OPCO LLC"}
← owns	BERGER FAM TR UA 06252014 (IL)	1.000	snf_all_owners	evidence recorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"34","association_date":"10/17/2018","percentage_ownership":20.4} evidence: {"rule":"D-OWNER","owner_pac":"9830316710","source_pk":200155,"type_owner":"O","enrollment_id":"O20200323001984","role_code_owner":"34","role_text_owner":"5% OR GREATER DIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":20.4,"enrollment_organization_name":"IMR OAK CREEK OPCO LLC"}

Current record

Current claims returned for this entity, grouped by provenance subject. The table exposes the source identifier recorded for each claim.

org · 1235762881 JSON

Current claims for org 1235762881
Metric	Value	Asserted	Source
enumeration_date	2020-02-21	2026-06-10	Centers for Medicare & Medicaid Services NPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… Upstream source claim API: JSON
legal_business_name	IMR OAK CREEK OPCO, LLC	2026-06-10	Centers for Medicare & Medicaid Services NPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… Upstream source claim API: JSON
practice_state	WI	2026-06-10	Centers for Medicare & Medicaid Services NPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… Upstream source claim API: JSON
primary_taxonomy	314000000X	2026-06-10	Centers for Medicare & Medicaid Services NPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… Upstream source claim API: JSON

Provider screening signals

NPI-keyed source families read directly for 1235762881: federal and state integrity lists, CMS Open Payments, Order and Referring eligibility, Medicare opt-out, and enrollment revalidation. Cells expose the source and provenance fields supplied by the selected record. A screening aid — re-confirm any match against the primary source before acting; absence means nothing on file in the data Fonteum currently holds, never a guarantee none exists.

Sanctions & integrity

Coverage stale

Exclusion coverage is stale or cannot be reconciled to an attested source artifact. This result is indeterminate and must not be treated as a clearance; check the current issuing-agency lists.

Coverage status: indeterminate
Screened 26 integrity lists; no negative determination was made.

Source:OIG LEIE +25 moreChecked 2026-09-20

14-tuple provenance (26)

OIG LEIE

source: HHS Office of Inspector General (LEIE)

dataset_id: oig-leie

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: US-Government-Works

coverage_start: 1977-10-25

coverage_end: ongoing

slsa_provenance_url: —

upstream source

SAM.gov Exclusions

source: U.S. General Services Administration (GSA), System for Award Management (SAM.gov)

dataset_id: sam-gov-exclusions

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: US-Government-Works

coverage_start: 2012-07-30

coverage_end: ongoing

slsa_provenance_url: —

upstream source

NY Medicaid (OMIG)

source: NY Office of the Medicaid Inspector General (OMIG)

dataset_id: ny-omig-exclusions

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: NY-OMIG-public-records

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

OH Medicaid (ODM)

source: Ohio Department of Medicaid (ODM)

dataset_id: oh-odm-exclusions

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: OH-ODM-public-records

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

GA Medicaid (DCH OIG)

source: Georgia DCH Office of Inspector General

dataset_id: ga-dch-exclusions

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: GA-DCH-public-records

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

PA Medicaid (Medicheck)

source: Pennsylvania Department of Human Services (DHS)

dataset_id: pa-dhs-medicheck

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: PA-DHS-public-records

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

NC Medicaid (DHHS)

source: NC DHHS, Division of Health Benefits (NC Medicaid)

dataset_id: nc-dhhs-exclusions

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: NC-DHHS-public-records

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

MD Medicaid

source: Maryland Department of Health (MDH)

dataset_id: md-mdh-sanctioned

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: MD-public-records

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

WA Medicaid

source: Washington State Health Care Authority (HCA)

dataset_id: wa-hca-termination-exclusion

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: WA-public-records

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

IA Medicaid

source: Iowa Health and Human Services (Iowa Medicaid)

dataset_id: ia-medicaid-exclusions

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: IA-public-records

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

MS Medicaid

source: Mississippi Division of Medicaid (DOM)

dataset_id: ms-dom-sanctioned

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: MS-public-records

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

MT Medicaid

source: Montana Department of Public Health and Human Services (DPHHS)

dataset_id: mt-dphhs-exclusions

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: MT-public-records

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

CO Medicaid

source: Colorado Department of Health Care Policy & Financing (HCPF)

dataset_id: co-hcpf-terminations

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: CO-public-records

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

IN Medicaid

source: Indiana FSSA, Office of Medicaid Policy and Planning (OMPP)

dataset_id: in-ompp-terminations

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: IN-public-records

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

KS Medicaid

source: Kansas Department of Health and Environment, Division of Health Care Finance (KDHE-DHCF)

dataset_id: ks-kmap-terminations

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: KS-public-records

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

KY Medicaid

source: Kentucky CHFS, Department for Medicaid Services (DMS)

dataset_id: ky-dms-terminations

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: KY-public-records

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

NH Medicaid

source: New Hampshire Department of Health and Human Services (DHHS)

dataset_id: nh-dhhs-sanctions

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: NH-public-records

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

ND Medicaid

source: North Dakota Health and Human Services (HHS), Medicaid Program Integrity

dataset_id: nd-hhs-exclusions

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: ND-public-records

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

TN Medicaid

source: Tennessee TennCare, Office of Program Integrity

dataset_id: tn-tenncare-terminated

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: TN-public-records

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

MI Medicaid

source: Michigan Department of Health and Human Services (MDHHS), Medicaid Program Integrity

dataset_id: mi-mdhhs-sanctions

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: MI-public-records

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

LA Medicaid

source: Louisiana Department of Health (LDH), Program Integrity

dataset_id: la-ldh-adverse-actions

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: LA-public-records

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

SC Medicaid

source: South Carolina Department of Health and Human Services (SCDHHS), Program Integrity

dataset_id: sc-scdhhs-sanctioned

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: SC-public-records

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

MA Medicaid

source: Massachusetts MassHealth (EOHHS), Office of Program Integrity

dataset_id: ma-masshealth-exclusions

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: MA-public-records

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

MO Medicaid

source: Missouri Medicaid Audit and Compliance (MMAC), Department of Social Services

dataset_id: mo-mmac-sanctions

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: MO-public-records

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

OIG CIA

source: HHS Office of Inspector General — Corporate Integrity Agreements

dataset_id: oig-cia

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: not_flagged, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: US-Government-Works

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

CMS Penalties

source: Centers for Medicare & Medicaid Services (CMS) — Civil Money Penalties

dataset_id: cms-cmp

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: not_flagged, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: US-Government-Works

coverage_start: —

coverage_end: —

slsa_provenance_url: —

upstream source

Industry payments

None on file

0 CMS Open Payments records on file for this NPI.

Source:CMS Open PaymentsChecked 2026-09-20

14-tuple provenance (1)

CMS Open Payments

source: CMS Open Payments (Sunshine Act physician payment disclosures)

dataset_id: cms-open-payments

snapshot: —

methodology: open-payments/v1

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: not_present, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: US-Government-Works

coverage_start: 2013-08-01

coverage_end: ongoing

slsa_provenance_url: —

upstream source

Order & referring eligibility

None on file

No CMS Order and Referring record on file for this NPI.

Source:CMS Order and ReferringChecked 2026-09-20

14-tuple provenance (1)

CMS Order and Referring

source: Centers for Medicare & Medicaid Services (CMS)

dataset_id: cms-order-referring

snapshot: —

methodology: cms-order-referring/v1

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: not_present, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: US-Government-Works

coverage_start: —

coverage_end: ongoing

slsa_provenance_url: —

upstream source

Medicare opt-out

None on file

No CMS Medicare opt-out affidavit on file for this NPI.

Source:CMS Opt Out AffidavitsChecked 2026-09-20

14-tuple provenance (1)

CMS Opt Out Affidavits

source: Centers for Medicare & Medicaid Services (CMS)

dataset_id: cms-opt-out-affidavits

snapshot: —

methodology: cms-opt-out/v1

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: not_present, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: US-Government-Works

coverage_start: 1998-01-01

coverage_end: ongoing

slsa_provenance_url: —

upstream source

Revalidation

On file

1 Medicare enrollment record on file.

Due date: TBD upstream — not due within the ensuing six months.

Source:CMS Medicare Revalidation Due Date ListChecked 2026-09-20

14-tuple provenance (1)

CMS Medicare Revalidation Due Date List

source: Centers for Medicare & Medicaid Services (CMS)

dataset_id: cms-revalidation-due-dates

snapshot: —

methodology: v2026.05.0

last_checked: 2026-09-20T09:10:31.306Z

confidence: 1

data_availability: present, snapshot_date_unavailable

pipeline_version: b1fa680

doi: —

license: US-Government-Works

coverage_start: 2011-03-25

coverage_end: ongoing

slsa_provenance_url: —

upstream source

Point-in-time

Query retained claim coordinates under bitemporal-read/v1. Most facts have no superseded row; dates outside retained coverage may return no prior version, and diffs require both coordinates.

Pick a date to reconstruct, or two dates to diff. Equivalent JSON: /api/v1/history/{subject_type}/{subject_id}?at=… and …/diff?from=…&to=…