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 | 1366704553 | nppes_providers | deterministic_pk | 1.000 | 2026-06-11 | evidencerecorded: 2026-06-11 methodology: entity-graph/v1 evidence: {"rule":"D-NPI","source_pk":"1366704553","entity_type_code":"1"} |
| pac_id | 3173832359 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-12 | evidencerecorded: 2026-06-12 methodology: entity-graph/v1 evidence: {"npi":"1366704553","rule":"D-PECOS","enrlmt_id":"I20160728002488","pecos_asct_cntl_id":"3173832359"} |
| pecos_enrlmt_id | I20160728002488 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-12 | evidencerecorded: 2026-06-12 methodology: entity-graph/v1 evidence: {"npi":"1366704553","rule":"D-PECOS","enrlmt_id":"I20160728002488"} |
Graph edges
One-hop relationships — ownership, chain membership, operation — each backed by a federal source row.
| Relationship | Entity | Confidence | Source table | Provenance |
|---|---|---|---|---|
| owns → | EBENEZER SOCIETY (MN) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-14 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"01/01/2022","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3173832359","source_pk":103630,"type_owner":"I","enrollment_id":"O20110823000333","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pac_id","percentage_ownership_raw":null,"enrollment_organization_name":"EBENEZER SOCIETY"} |
| owns → | EBENEZER RIDGES (MN) | 1.000 | snf_all_owners | evidencerecorded: 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":"3173832359","source_pk":26439,"type_owner":"I","enrollment_id":"O20050303001030","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EBENEZER RIDGES"} |
| owns → | JONES HARRISON RESIDENCE CORPORATION (MN) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"10/01/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3173832359","source_pk":37679,"type_owner":"I","enrollment_id":"O20060317000544","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"JONES HARRISON RESIDENCE CORPORATION"} |
| owns → | SENIOR CARE FOREST LAKE, LLC (MN) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"05/01/2022","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3173832359","source_pk":50289,"type_owner":"I","enrollment_id":"O20070619000471","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"SENIOR CARE FOREST LAKE, LLC"} |
| owns → | EBENEZER SOCIETY (MN) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"01/01/2022","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3173832359","source_pk":103630,"type_owner":"I","enrollment_id":"O20110823000333","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EBENEZER SOCIETY"} |
| owns → | EBENEZER LAKES ASSISTED LIVING (MN) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"01/01/2022","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3173832359","source_pk":138272,"type_owner":"I","enrollment_id":"O20140702000102","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EBENEZER LAKES ASSISTED LIVING"} |
| owns → | EDINA SENIOR LIVING, LLC (MN) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"01/01/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3173832359","source_pk":160693,"type_owner":"I","enrollment_id":"O20161004003060","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"EDINA SENIOR LIVING LLC"} |
Current record
Current claims returned for this entity, grouped by provenance subject. The table exposes the source identifier recorded for each claim.
provider · 1366704553 JSON
Provider screening signals
NPI-keyed source families read directly for 1366704553: 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
On fileOn the CMS Order and Referring roster — eligible to order and refer in 5 of 5 Medicare benefit categories.
- Part B: Y
- DME: Y
- HHA: Y
- PMD: Y
- Hospice: Y
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=…