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 | 1710613500 | nppes_providers | deterministic_pk | 1.000 | 2026-06-10 | evidencerecorded: 2026-06-10 methodology: entity-graph/v1 evidence: {"rule":"D-NPI","source_pk":"1710613500","entity_type_code":"2"} |
| pac_id | 3274903653 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1710613500","rule":"D-PECOS","enrlmt_id":"O20221229000261","pecos_asct_cntl_id":"3274903653"} |
| pecos_enrlmt_id | O20221229000261 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1710613500","rule":"D-PECOS","enrlmt_id":"O20221229000261"} |
Graph edges
One-hop relationships — ownership, chain membership, operation — each backed by a federal source row.
| Relationship | Entity | Confidence | Source table | Provenance |
|---|---|---|---|---|
| ← owns | DANIEL W FUNK | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"40","association_date":"09/22/2022","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"0042210924","source_pk":229576,"type_owner":"I","enrollment_id":"O20221229000261","role_code_owner":"40","role_text_owner":"CORPORATE OFFICER","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | ALYSSA KOLP | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"09/12/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"0749773760","source_pk":229579,"type_owner":"I","enrollment_id":"O20221229000261","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | KENNETH M FUNK | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"09/22/2022","percentage_ownership":100} evidence: {"rule":"D-OWNER","owner_pac":"2860428380","source_pk":229581,"type_owner":"I","enrollment_id":"O20221229000261","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":100,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | BLUE LAKE POST CUTE HOLDCO LLC (FL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"34","association_date":"09/22/2022","percentage_ownership":100} evidence: {"rule":"D-OWNER","owner_pac":"3072983451","source_pk":229585,"type_owner":"O","enrollment_id":"O20221229000261","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":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | HOWARD LIPKOWITZ | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"03/31/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3476046491","source_pk":229586,"type_owner":"I","enrollment_id":"O20221229000261","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | OWNER PAC 3971096918 | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"04/01/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3971096918","source_pk":229588,"type_owner":"I","enrollment_id":"O20221229000261","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | KMOM LLC (FL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"09/22/2022","percentage_ownership":100} evidence: {"rule":"D-OWNER","owner_pac":"5193196756","source_pk":229589,"type_owner":"O","enrollment_id":"O20221229000261","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":100,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | BRITTANI DANIELS | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"09/08/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"5294228219","source_pk":229590,"type_owner":"I","enrollment_id":"O20221229000261","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | OWNER PAC 5496248445 | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"04/01/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"5496248445","source_pk":229592,"type_owner":"I","enrollment_id":"O20221229000261","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | SPENCER MCCONNON | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"11/14/2022","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6103319124","source_pk":229593,"type_owner":"I","enrollment_id":"O20221229000261","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | SHEREE EASON | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"05/12/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6204329220","source_pk":229595,"type_owner":"I","enrollment_id":"O20221229000261","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | ALANA C KEMP | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"05/12/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6406349448","source_pk":229597,"type_owner":"I","enrollment_id":"O20221229000261","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | PATRICA ROMERO | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"03/01/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6406882711","source_pk":229599,"type_owner":"I","enrollment_id":"O20221229000261","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | OWNER PAC 6709379746 (FL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"09/22/2022","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6709379746","source_pk":229601,"type_owner":"O","enrollment_id":"O20221229000261","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | OWNER PAC 6800389842 (OR) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"06/26/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6800389842","source_pk":229602,"type_owner":"O","enrollment_id":"O20221229000261","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | JEREMIAH NEUBIA | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"02/12/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7012400047","source_pk":229603,"type_owner":"I","enrollment_id":"O20221229000261","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | HUSAM EDDIN (FL) | 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":"7113945874","source_pk":229605,"type_owner":"I","enrollment_id":"O20221229000261","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | ALEXIS E CAMPBELL | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"08/11/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7214420256","source_pk":229607,"type_owner":"I","enrollment_id":"O20221229000261","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | STERLING D SMITH | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"40","association_date":"07/19/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7416323332","source_pk":229609,"type_owner":"I","enrollment_id":"O20221229000261","role_code_owner":"40","role_text_owner":"CORPORATE OFFICER","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | ELEVATION HEALTHCARE LLC (FL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"35","association_date":"09/22/2022","percentage_ownership":100} evidence: {"rule":"D-OWNER","owner_pac":"7517337991","source_pk":229612,"type_owner":"O","enrollment_id":"O20221229000261","role_code_owner":"35","role_text_owner":"5% OR GREATER INDIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":100,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | MICHELLE KARPOWICZ | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"07/16/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"8123511169","source_pk":229615,"type_owner":"I","enrollment_id":"O20221229000261","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | MATTHEW W FUNK | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"04/17/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"8224521240","source_pk":229617,"type_owner":"I","enrollment_id":"O20221229000261","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | OWNER PAC 8426541467 (FL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"11/22/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"8426541467","source_pk":229619,"type_owner":"O","enrollment_id":"O20221229000261","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | JACOB LINDSEY | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"40","association_date":"07/01/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"8820440126","source_pk":229620,"type_owner":"I","enrollment_id":"O20221229000261","role_code_owner":"40","role_text_owner":"CORPORATE OFFICER","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
| ← owns | PHARMERICA (FL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"11/22/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"9335632371","source_pk":229623,"type_owner":"O","enrollment_id":"O20221229000261","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BLUE LAKE POST ACUTE LLC"} |
Current record
Current claims returned for this entity, grouped by provenance subject. The table exposes the source identifier recorded for each claim.
org · 1710613500 JSON
| Metric | Value | Asserted | Source |
|---|---|---|---|
| enumeration_date | 2022-07-25 | 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 | BLUE LAKE POST ACUTE 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 | FL | 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 1710613500: 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=…