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.
| Scheme | Value | Source table | Link method | Confidence | Since | Provenance |
|---|---|---|---|---|---|---|
| npi | 1043722960 | nppes_providers | deterministic_pk | 1.000 | 2026-06-10 | evidencerecorded: 2026-06-10 methodology: entity-graph/v1 evidence: {"rule":"D-NPI","source_pk":"1043722960","entity_type_code":"2"} |
| pac_id | 6204195613 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1043722960","rule":"D-PECOS","enrlmt_id":"O20180110001961","pecos_asct_cntl_id":"6204195613"} |
| pecos_enrlmt_id | O20180110001961 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1043722960","rule":"D-PECOS","enrlmt_id":"O20180110001961"} |
Graph edges
One-hop relationships — ownership, chain membership, operation — each backed by a federal source row.
| Relationship | Entity | Confidence | Source table | Provenance |
|---|---|---|---|---|
| ← owns | OWNER PAC 0042738403 (NJ) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"04/30/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"0042738403","source_pk":175353,"type_owner":"O","enrollment_id":"O20180110001961","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | SORA KOHN FAM TR UAD 120120 (NJ) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"12/31/2021","percentage_ownership":22.5} evidence: {"rule":"D-OWNER","owner_pac":"0446642912","source_pk":175354,"type_owner":"O","enrollment_id":"O20180110001961","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":22.5,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | SAMMY HAMID (PA) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"01/04/2018","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"0648231183","source_pk":175356,"type_owner":"I","enrollment_id":"O20180110001961","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | OWNER PAC 1052839412 (NJ) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"04/29/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"1052839412","source_pk":175358,"type_owner":"O","enrollment_id":"O20180110001961","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | RELIANT PRO REHAB LLC (TX) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"10/11/2021","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"1759768047","source_pk":175359,"type_owner":"O","enrollment_id":"O20180110001961","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | PROVIDENCE LEASEHOLD LLC (NJ) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"05/05/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"1951829316","source_pk":175361,"type_owner":"O","enrollment_id":"O20180110001961","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | UKR CONSULTING LLC (NJ) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"34","association_date":"01/04/2018","percentage_ownership":10} evidence: {"rule":"D-OWNER","owner_pac":"2062657570","source_pk":175362,"type_owner":"O","enrollment_id":"O20180110001961","role_code_owner":"34","role_text_owner":"5% OR GREATER DIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":10,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | ERICA MOSS | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"11/08/2021","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"2769488717","source_pk":175364,"type_owner":"I","enrollment_id":"O20180110001961","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | SK 2013 DELTA TRUST (IL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"12/31/2021","percentage_ownership":22.5} evidence: {"rule":"D-OWNER","owner_pac":"2769816339","source_pk":175368,"type_owner":"O","enrollment_id":"O20180110001961","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":22.5,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | OWNER PAC 2860910221 (PA) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"11/02/2017","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"2860910221","source_pk":175370,"type_owner":"O","enrollment_id":"O20180110001961","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | MARQUIS LIMITED LLC (NJ) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"01/01/2021","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3173053527","source_pk":175371,"type_owner":"O","enrollment_id":"O20180110001961","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | OWNER PAC 3971021338 (NJ) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"04/28/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3971021338","source_pk":175373,"type_owner":"O","enrollment_id":"O20180110001961","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | JONATHAN PAPADA | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"63","association_date":"11/18/2022","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"4385057165","source_pk":175374,"type_owner":"I","enrollment_id":"O20180110001961","role_code_owner":"63","role_text_owner":"MANAGING CONTROL - GOVERNING BODY","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | MINDEE POSEN | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"40","association_date":"01/04/2018","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"4789085465","source_pk":175376,"type_owner":"I","enrollment_id":"O20180110001961","role_code_owner":"40","role_text_owner":"CORPORATE OFFICER","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | OWNER PAC 4880112242 (NJ) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"04/30/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"4880112242","source_pk":175378,"type_owner":"O","enrollment_id":"O20180110001961","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | QUINTO HOLDINGS LLC (NJ) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"34","association_date":"01/04/2018","percentage_ownership":90} evidence: {"rule":"D-OWNER","owner_pac":"4981849494","source_pk":175379,"type_owner":"O","enrollment_id":"O20180110001961","role_code_owner":"34","role_text_owner":"5% OR GREATER DIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":90,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | RSBRMK HOLDINGS LLC (NJ) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"12/31/2021","percentage_ownership":22.5} evidence: {"rule":"D-OWNER","owner_pac":"5496146615","source_pk":175381,"type_owner":"O","enrollment_id":"O20180110001961","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":22.5,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | OWNER PAC 5698293058 (CT) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"04/30/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"5698293058","source_pk":175383,"type_owner":"O","enrollment_id":"O20180110001961","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | TRYKO HOLDINGS, LLC (NJ) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"01/04/2018","percentage_ownership":67.5} evidence: {"rule":"D-OWNER","owner_pac":"6204962327","source_pk":175384,"type_owner":"O","enrollment_id":"O20180110001961","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":67.5,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | NFR 2020 IRRV TR (NJ) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"12/31/2021","percentage_ownership":22.5} evidence: {"rule":"D-OWNER","owner_pac":"6305237520","source_pk":175386,"type_owner":"O","enrollment_id":"O20180110001961","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":22.5,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | YR 2013 DELTA TR UA 03252013 (NJ) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"12/31/2021","percentage_ownership":22.5} evidence: {"rule":"D-OWNER","owner_pac":"7315371986","source_pk":175388,"type_owner":"O","enrollment_id":"O20180110001961","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":22.5,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | CIBC BANK USA (IL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"37","association_date":"01/04/2018","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"8426229584","source_pk":175390,"type_owner":"O","enrollment_id":"O20180110001961","role_code_owner":"37","role_text_owner":"5% OR GREATER SECURITY INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | UAK 2020 IRRV TR (NJ) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"12/31/2021","percentage_ownership":9.9} evidence: {"rule":"D-OWNER","owner_pac":"9032514625","source_pk":175391,"type_owner":"O","enrollment_id":"O20180110001961","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":9.9,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
| ← owns | NUTRACO LLC (FL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"02/09/2021","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"9436436987","source_pk":175393,"type_owner":"O","enrollment_id":"O20180110001961","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"PROVIDENCE OPERATOR LLC"} |
Current record
Current claims returned for this entity, grouped by provenance subject. The table exposes the source identifier recorded for each claim.
org · 1043722960 JSON
| Metric | Value | Asserted | Source |
|---|---|---|---|
| dba_name | <UNAVAIL> | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| enumeration_date | 2017-11-01 | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| legal_business_name | PROVIDENCE OPERATOR LLC | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| practice_state | PA | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| primary_taxonomy | 314000000X | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
Provider screening signals
NPI-keyed source families read directly for 1043722960: 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 staleExclusion 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.
14-tuple provenance (26)
Industry payments
None on file0 CMS Open Payments records on file for this NPI.
14-tuple provenance (1)
Order & referring eligibility
None on fileNo CMS Order and Referring record on file for this NPI.
14-tuple provenance (1)
Medicare opt-out
None on fileNo CMS Medicare opt-out affidavit on file for this NPI.
14-tuple provenance (1)
Revalidation
On file1 Medicare enrollment record on file.
- Due date: TBD upstream — not due within the ensuing six months.
14-tuple provenance (1)
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=…