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 | 1649220906 | nppes_providers | deterministic_pk | 1.000 | 2026-06-10 | evidencerecorded: 2026-06-10 methodology: entity-graph/v1 evidence: {"rule":"D-NPI","source_pk":"1649220906","entity_type_code":"2"} |
| pac_id | 3678586880 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1649220906","rule":"D-PECOS","enrlmt_id":"O20060710000268","pecos_asct_cntl_id":"3678586880"} |
| pecos_enrlmt_id | O20060710000268 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1649220906","rule":"D-PECOS","enrlmt_id":"O20060710000268"} |
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 0648754754 | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"02/01/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"0648754754","source_pk":39820,"type_owner":"I","enrollment_id":"O20060710000268","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | CARY MASLOW | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"08/01/2019","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"0941213151","source_pk":39821,"type_owner":"I","enrollment_id":"O20060710000268","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | OWNER PAC 1557845658 | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"07/01/2019","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"1557845658","source_pk":39823,"type_owner":"I","enrollment_id":"O20060710000268","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | CARRIE SCHROEDER | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"11/07/2022","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"1759715022","source_pk":39824,"type_owner":"I","enrollment_id":"O20060710000268","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | P. G. - DON #3 TRUST (IL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"01/01/2012","percentage_ownership":5.42} evidence: {"rule":"D-OWNER","owner_pac":"1951558204","source_pk":39826,"type_owner":"O","enrollment_id":"O20060710000268","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":5.42,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | OWNER PAC 2264916360 (IL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"09/18/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"2264916360","source_pk":39827,"type_owner":"O","enrollment_id":"O20060710000268","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | THOMAS J MUSZYNSKI | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"40","association_date":"06/01/2022","percentage_ownership":0} evidence: {"rule":"D-OWNER","owner_pac":"2466734314","source_pk":39828,"type_owner":"I","enrollment_id":"O20060710000268","role_code_owner":"40","role_text_owner":"CORPORATE OFFICER","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":0,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | CC-DEVELOPMENT GROUP, INC. (IL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"34","association_date":"05/15/2006","percentage_ownership":100} evidence: {"rule":"D-OWNER","owner_pac":"2860462413","source_pk":39831,"type_owner":"O","enrollment_id":"O20060710000268","role_code_owner":"34","role_text_owner":"5% OR GREATER DIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":100,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | P. G. - DANIEL TRUST (IL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"01/01/2012","percentage_ownership":5.42} evidence: {"rule":"D-OWNER","owner_pac":"2961659214","source_pk":39832,"type_owner":"O","enrollment_id":"O20060710000268","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":5.42,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | JOHN POORMAN | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"40","association_date":"05/15/2006","percentage_ownership":0} evidence: {"rule":"D-OWNER","owner_pac":"3577533132","source_pk":39833,"type_owner":"I","enrollment_id":"O20060710000268","role_code_owner":"40","role_text_owner":"CORPORATE OFFICER","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":0,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | P. G. - JIM TRUST (IL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"01/01/2012","percentage_ownership":5.42} evidence: {"rule":"D-OWNER","owner_pac":"3870740129","source_pk":39835,"type_owner":"O","enrollment_id":"O20060710000268","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":5.42,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | TOMEK KOSZYLKO | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"10/15/2018","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"4587162730","source_pk":39836,"type_owner":"I","enrollment_id":"O20060710000268","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | TARA COPE | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"40","association_date":"06/01/2018","percentage_ownership":0} evidence: {"rule":"D-OWNER","owner_pac":"4688858756","source_pk":39838,"type_owner":"I","enrollment_id":"O20060710000268","role_code_owner":"40","role_text_owner":"CORPORATE OFFICER","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":0,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | BRIDGET WILLIAMS | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"12/01/2022","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"4981077294","source_pk":39840,"type_owner":"I","enrollment_id":"O20060710000268","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | MANSOOR SYED ALI | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"07/15/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"5092046805","source_pk":39842,"type_owner":"I","enrollment_id":"O20060710000268","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | P. G. - NICHOLAS TRUST (IL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"01/01/2012","percentage_ownership":5.99} evidence: {"rule":"D-OWNER","owner_pac":"5698922938","source_pk":39844,"type_owner":"O","enrollment_id":"O20060710000268","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":5.99,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | MARGOT AND TOM PRITZKER FOUNDATION (IL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"05/22/2025","percentage_ownership":10.24} evidence: {"rule":"D-OWNER","owner_pac":"5799283933","source_pk":39845,"type_owner":"O","enrollment_id":"O20060710000268","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":10.24,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | P. G. - LINDA TRUST (IL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"01/01/2012","percentage_ownership":5.42} evidence: {"rule":"D-OWNER","owner_pac":"6507013851","source_pk":39846,"type_owner":"O","enrollment_id":"O20060710000268","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":5.42,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | PRITZKER PUCKER FAMILY FOUNDATION NO. 2 (IL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"05/22/2025","percentage_ownership":8.63} evidence: {"rule":"D-OWNER","owner_pac":"6608374848","source_pk":39847,"type_owner":"O","enrollment_id":"O20060710000268","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":8.63,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | CLAUDIA ANTAL | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"01/30/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6800370917","source_pk":39848,"type_owner":"I","enrollment_id":"O20060710000268","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | MELISSA G EVRAETS | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"08/31/2020","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7113279084","source_pk":39849,"type_owner":"I","enrollment_id":"O20060710000268","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | P. G. - KAREN TRUST (IL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"01/01/2012","percentage_ownership":8.82} evidence: {"rule":"D-OWNER","owner_pac":"7315194669","source_pk":39851,"type_owner":"O","enrollment_id":"O20060710000268","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":8.82,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | P. G. - JOHNNY TRUST (IL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"01/01/2012","percentage_ownership":5.42} evidence: {"rule":"D-OWNER","owner_pac":"7416104765","source_pk":39852,"type_owner":"O","enrollment_id":"O20060710000268","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":5.42,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | OWNER PAC 7618451725 | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"06/01/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7618451725","source_pk":39853,"type_owner":"I","enrollment_id":"O20060710000268","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | GARY SMITH | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"40","association_date":"06/01/2022","percentage_ownership":0} evidence: {"rule":"D-OWNER","owner_pac":"8022088681","source_pk":39854,"type_owner":"I","enrollment_id":"O20060710000268","role_code_owner":"40","role_text_owner":"CORPORATE OFFICER","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":0,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | CLASSIC RESIDENCE MANAGEMENT LIMITED PARTNERSHIP (IL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"05/15/2006","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"8123098779","source_pk":39857,"type_owner":"O","enrollment_id":"O20060710000268","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | SARAH WATSON | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"07/29/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"8729562830","source_pk":39859,"type_owner":"I","enrollment_id":"O20060710000268","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | P. G. - TONY TRUST (IL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"01/01/2012","percentage_ownership":5.42} evidence: {"rule":"D-OWNER","owner_pac":"9133376486","source_pk":39861,"type_owner":"O","enrollment_id":"O20060710000268","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":5.42,"enrollment_organization_name":"CC LAKE INC"} |
| ← owns | OWNER PAC 9537643630 (TX) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"09/18/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"9537643630","source_pk":39862,"type_owner":"O","enrollment_id":"O20060710000268","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"CC LAKE INC"} |
Current record
Current claims returned for this entity, grouped by provenance subject. The table exposes the source identifier recorded for each claim.
org · 1649220906 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 | 2006-05-10 | 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 | CC LAKE INC | 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 | IL | 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 1649220906: 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.
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: 2026-09-20T17:05:26.364Z
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: —
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: 2026-09-20T17:05:26.364Z
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: —
NY Medicaid (OMIG)
source: NY Office of the Medicaid Inspector General (OMIG)
dataset_id: ny-omig-exclusions
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T17:05:26.364Z
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: —
OH Medicaid (ODM)
source: Ohio Department of Medicaid (ODM)
dataset_id: oh-odm-exclusions
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T17:05:26.364Z
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: —
GA Medicaid (DCH OIG)
source: Georgia DCH Office of Inspector General
dataset_id: ga-dch-exclusions
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T17:05:26.364Z
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: —
PA Medicaid (Medicheck)
source: Pennsylvania Department of Human Services (DHS)
dataset_id: pa-dhs-medicheck
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T17:05:26.364Z
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: —
NC Medicaid (DHHS)
source: NC DHHS, Division of Health Benefits (NC Medicaid)
dataset_id: nc-dhhs-exclusions
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T17:05:26.364Z
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: —
MD Medicaid
source: Maryland Department of Health (MDH)
dataset_id: md-mdh-sanctioned
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T17:05:26.364Z
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: —
WA Medicaid
source: Washington State Health Care Authority (HCA)
dataset_id: wa-hca-termination-exclusion
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T17:05:26.364Z
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: —
IA Medicaid
source: Iowa Health and Human Services (Iowa Medicaid)
dataset_id: ia-medicaid-exclusions
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T17:05:26.364Z
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: —
MS Medicaid
source: Mississippi Division of Medicaid (DOM)
dataset_id: ms-dom-sanctioned
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T17:05:26.364Z
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: —
MT Medicaid
source: Montana Department of Public Health and Human Services (DPHHS)
dataset_id: mt-dphhs-exclusions
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T17:05:26.364Z
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: —
CO Medicaid
source: Colorado Department of Health Care Policy & Financing (HCPF)
dataset_id: co-hcpf-terminations
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T17:05:26.364Z
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: —
IN Medicaid
source: Indiana FSSA, Office of Medicaid Policy and Planning (OMPP)
dataset_id: in-ompp-terminations
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T17:05:26.364Z
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: —
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: 2026-09-20T17:05:26.364Z
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: —
KY Medicaid
source: Kentucky CHFS, Department for Medicaid Services (DMS)
dataset_id: ky-dms-terminations
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T17:05:26.364Z
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: —
NH Medicaid
source: New Hampshire Department of Health and Human Services (DHHS)
dataset_id: nh-dhhs-sanctions
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T17:05:26.364Z
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: —
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: 2026-09-20T17:05:26.364Z
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: —
TN Medicaid
source: Tennessee TennCare, Office of Program Integrity
dataset_id: tn-tenncare-terminated
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T17:05:26.364Z
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: —
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: 2026-09-20T17:05:26.364Z
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: —
LA Medicaid
source: Louisiana Department of Health (LDH), Program Integrity
dataset_id: la-ldh-adverse-actions
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T17:05:26.364Z
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: —
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: 2026-09-20T17:05:26.364Z
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: —
MA Medicaid
source: Massachusetts MassHealth (EOHHS), Office of Program Integrity
dataset_id: ma-masshealth-exclusions
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T17:05:26.364Z
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: —
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: 2026-09-20T17:05:26.364Z
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: —
OIG CIA
source: HHS Office of Inspector General — Corporate Integrity Agreements
dataset_id: oig-cia
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T17:05:26.364Z
confidence: 1
data_availability: not_flagged, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: US-Government-Works
coverage_start: —
coverage_end: —
slsa_provenance_url: —
CMS Penalties
source: Centers for Medicare & Medicaid Services (CMS) — Civil Money Penalties
dataset_id: cms-cmp
snapshot: —
methodology: v2026.05.0
last_checked: 2026-09-20T17:05:26.364Z
confidence: 1
data_availability: not_flagged, snapshot_date_unavailable
pipeline_version: b1fa680
doi: —
license: US-Government-Works
coverage_start: —
coverage_end: —
slsa_provenance_url: —
Industry payments
None on file0 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: 2026-09-20T17:05:26.364Z
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: —
Order & referring eligibility
None on fileNo 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: 2026-09-20T17:05:26.364Z
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: —
Medicare opt-out
None on fileNo 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: 2026-09-20T17:05:26.364Z
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: —
Revalidation
On file1 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: 2026-09-20T17:05:26.364Z
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: —
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=…