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 |
|---|---|---|---|---|---|---|
| cms_op_profile_id | 10891752 | cms_open_payments | exact_npi_in_open_payments | 1.000 | 2026-06-13 | evidencerecorded: 2026-06-13 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-OP-NPI","recipient_profile_id":"10891752"} |
| npi | 1396079562 | nppes_providers | deterministic_pk | 1.000 | 2026-06-11 | evidencerecorded: 2026-06-11 methodology: entity-graph/v1 evidence: {"rule":"D-NPI","source_pk":"1396079562","entity_type_code":"1"} |
| pac_id | 3375938673 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20220324000536","pecos_asct_cntl_id":"3375938673"} |
| pecos_enrlmt_id | I20220324000536 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20220324000536"} |
| pecos_enrlmt_id | I20220408000610 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20220408000610"} |
| pecos_enrlmt_id | I20220607001869 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20220607001869"} |
| pecos_enrlmt_id | I20221019001567 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20221019001567"} |
| pecos_enrlmt_id | I20221110000926 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20221110000926"} |
| pecos_enrlmt_id | I20221116000878 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20221116000878"} |
| pecos_enrlmt_id | I20221130002195 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20221130002195"} |
| pecos_enrlmt_id | I20221206000536 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20221206000536"} |
| pecos_enrlmt_id | I20221223000169 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20221223000169"} |
| pecos_enrlmt_id | I20230209000542 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20230209000542"} |
| pecos_enrlmt_id | I20230615003722 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20230615003722"} |
| pecos_enrlmt_id | I20231128001255 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20231128001255"} |
| pecos_enrlmt_id | I20231204001368 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20231204001368"} |
| pecos_enrlmt_id | I20240302000307 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20240302000307"} |
| pecos_enrlmt_id | I20240827002804 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20240827002804"} |
| pecos_enrlmt_id | I20240902000020 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20240902000020"} |
| pecos_enrlmt_id | I20241107003491 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20241107003491"} |
| pecos_enrlmt_id | I20241123000382 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20241123000382"} |
| pecos_enrlmt_id | I20250221000809 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20250221000809"} |
| pecos_enrlmt_id | I20250411002430 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20250411002430"} |
| pecos_enrlmt_id | I20250415003441 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20250415003441"} |
| pecos_enrlmt_id | I20251029000180 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20251029000180"} |
| pecos_enrlmt_id | I20230426001146 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20230426001146"} |
| pecos_enrlmt_id | I20230503000165 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396079562","rule":"D-PECOS","enrlmt_id":"I20230503000165"} |
Graph edges
One-hop relationships — ownership, chain membership, operation — each backed by a federal source row.
| Relationship | Entity | Confidence | Source table | Provenance |
|---|---|---|---|---|
| ← pays | Biogen, Inc. (MA) | 1.000 | cms_open_payments | evidencerecorded: 2026-06-13 methodology: entity-graph/v1 attributes: {"source":"cms_open_payments"} evidence: {"rule":"D-OP-PAYS","record_type":"general","recipient_npi":"1396079562","manufacturer_id":"100000000193","nature_of_payment":"Food and Beverage"} |
| ← pays | Collaborative Care Diagnostics, LLC (MN) | 1.000 | cms_open_payments | evidencerecorded: 2026-06-14 methodology: entity-graph/v1 attributes: {"source":"cms_open_payments"} evidence: {"rule":"D-OP-PAYS","record_type":"general","recipient_npi":"1396079562","manufacturer_id":"100000086367","nature_of_payment":"Food and Beverage"} |
Current record
Current claims returned for this entity, grouped by provenance subject. The table exposes the source identifier recorded for each claim.
provider · 1396079562 JSON
| Metric | Value | Asserted | Source |
|---|---|---|---|
| credential | NP | 2026-06-11 | 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 | 2009-09-22 | 2026-06-11 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| first_name | RICKY | 2026-06-11 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| last_name | MICHEL | 2026-06-11 | 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 | CA | 2026-06-11 | 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 | 363L00000X | 2026-06-11 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| years_active | 16 years | 2026-06-11 | 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 1396079562: 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
On file2 CMS Open Payments records on file. Ask Fonteum for the largest payments and a cited total.
14-tuple provenance (1)
Order & referring eligibility
On fileOn the CMS Order and Referring roster — eligible to order and refer in 4 of 5 Medicare benefit categories.
- Part B: Y
- DME: Y
- HHA: Y
- PMD: Y
- Hospice: N
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 file24 Medicare enrollment records 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=…