TERMINAL · ENTITY CARD · PERSON

ELIS OLSON

Canonical entity in the resolved graph · CA · methodology entity-graph/v1 · 3314457f-629a-4f62-9d46-d7c86c42f7e5

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	1285629923	nppes_providers	deterministic_pk	1.000	2026-06-11	evidence recorded: 2026-06-11 methodology: entity-graph/v1 evidence: {"rule":"D-NPI","source_pk":"1285629923","entity_type_code":"1"}
pac_id	0648269282	pecos_providers	exact_npi_in_pecos	1.000	2026-06-12	evidence recorded: 2026-06-12 methodology: entity-graph/v1 evidence: {"npi":"1285629923","rule":"D-PECOS","enrlmt_id":"I20040510000749","pecos_asct_cntl_id":"0648269282"}
pecos_enrlmt_id	I20200604003368	pecos_providers	exact_npi_in_pecos	1.000	2026-06-15	evidence recorded: 2026-06-15 methodology: entity-graph/v1 evidence: {"npi":"1285629923","rule":"D-PECOS","enrlmt_id":"I20200604003368"}
pecos_enrlmt_id	I20240828001193	pecos_providers	exact_npi_in_pecos	1.000	2026-06-16	evidence recorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1285629923","rule":"D-PECOS","enrlmt_id":"I20240828001193"}
pecos_enrlmt_id	I20241023001441	pecos_providers	exact_npi_in_pecos	1.000	2026-06-16	evidence recorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1285629923","rule":"D-PECOS","enrlmt_id":"I20241023001441"}
pecos_enrlmt_id	I20241104003281	pecos_providers	exact_npi_in_pecos	1.000	2026-06-16	evidence recorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1285629923","rule":"D-PECOS","enrlmt_id":"I20241104003281"}
pecos_enrlmt_id	I20250321001158	pecos_providers	exact_npi_in_pecos	1.000	2026-06-16	evidence recorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1285629923","rule":"D-PECOS","enrlmt_id":"I20250321001158"}
pecos_enrlmt_id	I20040510000749	pecos_providers	exact_npi_in_pecos	1.000	2026-06-12	evidence recorded: 2026-06-12 methodology: entity-graph/v1 evidence: {"npi":"1285629923","rule":"D-PECOS","enrlmt_id":"I20040510000749"}

Graph edges

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

Current record

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

provider · 1285629923 JSON

Current claims for provider 1285629923
Metric	Value	Asserted	Source
credential	MD	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
enumeration_date	2005-09-19	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
first_name	ELIS	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
last_name	OLSON	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	CA	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	207PP0204X	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
years_active	20 years	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 1285629923: 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

On file

A hard exclusion is in force on 2 lists. Screening aid — re-confirm against the primary source before acting.

Excluded by: MD Medicaid, NC Medicaid (DHHS)
Screened 26 integrity lists.

Source:OIG LEIE +25 moreChecked 2026-08-04

14-tuple provenance (26)

OIG LEIE

source: HHS Office of Inspector General (LEIE)

dataset_id: oig-leie

snapshot: —

methodology: v2026.05.0

last_checked: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: present, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: present, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: indeterminate, not_reconciled_to_attested_artifact, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: not_flagged, snapshot_date_unavailable

pipeline_version: 0236392

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: not_flagged, snapshot_date_unavailable

pipeline_version: 0236392

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 2026-08-04

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: not_present, snapshot_date_unavailable

pipeline_version: 0236392

doi: —

license: US-Government-Works

coverage_start: 2013-08-01

coverage_end: ongoing

slsa_provenance_url: —

upstream source

Order & referring eligibility

On file

On 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

Source:CMS Order and ReferringChecked 2026-08-04

14-tuple provenance (1)

CMS Order and Referring

source: Centers for Medicare & Medicaid Services (CMS)

dataset_id: cms-order-referring

snapshot: 2026-06-12

methodology: cms-order-referring/v1

last_checked: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: present

pipeline_version: 0236392

doi: —

license: US-Government-Works

coverage_start: 2026-06-12

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 2026-08-04

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: not_present, snapshot_date_unavailable

pipeline_version: 0236392

doi: —

license: US-Government-Works

coverage_start: 1998-01-01

coverage_end: ongoing

slsa_provenance_url: —

upstream source

Revalidation

On file

5 Medicare enrollment records on file.

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

Source:CMS Medicare Revalidation Due Date ListChecked 2026-08-04

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: 2026-08-04T19:12:24.446Z

confidence: 1

data_availability: present, snapshot_date_unavailable

pipeline_version: 0236392

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=…