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 | 1396804712 | nppes_providers | deterministic_pk | 1.000 | 2026-06-11 | evidencerecorded: 2026-06-11 methodology: entity-graph/v1 evidence: {"rule":"D-NPI","source_pk":"1396804712","entity_type_code":"1"} |
| pac_id | 7416972690 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-12 | evidencerecorded: 2026-06-12 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20051006000580","pecos_asct_cntl_id":"7416972690"} |
| pecos_enrlmt_id | I20230516003053 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20230516003053"} |
| pecos_enrlmt_id | I20210406001779 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-15 | evidencerecorded: 2026-06-15 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20210406001779"} |
| pecos_enrlmt_id | I20210713000874 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-15 | evidencerecorded: 2026-06-15 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20210713000874"} |
| pecos_enrlmt_id | I20210802001855 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-15 | evidencerecorded: 2026-06-15 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20210802001855"} |
| pecos_enrlmt_id | I20210804002934 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-15 | evidencerecorded: 2026-06-15 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20210804002934"} |
| pecos_enrlmt_id | I20210809003413 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-15 | evidencerecorded: 2026-06-15 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20210809003413"} |
| pecos_enrlmt_id | I20210809003777 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-15 | evidencerecorded: 2026-06-15 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20210809003777"} |
| pecos_enrlmt_id | I20210809003790 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-15 | evidencerecorded: 2026-06-15 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20210809003790"} |
| pecos_enrlmt_id | I20210810000103 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-15 | evidencerecorded: 2026-06-15 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20210810000103"} |
| pecos_enrlmt_id | I20210812002944 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-15 | evidencerecorded: 2026-06-15 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20210812002944"} |
| pecos_enrlmt_id | I20210830000856 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-15 | evidencerecorded: 2026-06-15 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20210830000856"} |
| pecos_enrlmt_id | I20210825001298 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-15 | evidencerecorded: 2026-06-15 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20210825001298"} |
| pecos_enrlmt_id | I20210828000195 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-15 | evidencerecorded: 2026-06-15 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20210828000195"} |
| pecos_enrlmt_id | I20210830000483 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-15 | evidencerecorded: 2026-06-15 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20210830000483"} |
| pecos_enrlmt_id | I20210830000697 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-15 | evidencerecorded: 2026-06-15 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20210830000697"} |
| pecos_enrlmt_id | I20210831002898 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-15 | evidencerecorded: 2026-06-15 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20210831002898"} |
| pecos_enrlmt_id | I20211004000148 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-15 | evidencerecorded: 2026-06-15 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20211004000148"} |
| pecos_enrlmt_id | I20220221000196 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20220221000196"} |
| pecos_enrlmt_id | I20220425002374 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20220425002374"} |
| pecos_enrlmt_id | I20220524000046 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20220524000046"} |
| pecos_enrlmt_id | I20221122000593 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20221122000593"} |
| pecos_enrlmt_id | I20221213002669 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20221213002669"} |
| pecos_enrlmt_id | I20221220000585 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20221220000585"} |
| pecos_enrlmt_id | I20230105002251 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20230105002251"} |
| pecos_enrlmt_id | I20230220000942 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20230220000942"} |
| pecos_enrlmt_id | I20230222002622 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20230222002622"} |
| pecos_enrlmt_id | I20230925002193 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20230925002193"} |
| pecos_enrlmt_id | I20230821001458 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20230821001458"} |
| pecos_enrlmt_id | I20230830001022 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20230830001022"} |
| pecos_enrlmt_id | I20230830003792 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20230830003792"} |
| pecos_enrlmt_id | I20230830004135 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20230830004135"} |
| pecos_enrlmt_id | I20230831003330 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20230831003330"} |
| pecos_enrlmt_id | I20230911002975 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20230911002975"} |
| pecos_enrlmt_id | I20230914002226 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20230914002226"} |
| pecos_enrlmt_id | I20231011002240 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20231011002240"} |
| pecos_enrlmt_id | I20231101001313 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20231101001313"} |
| pecos_enrlmt_id | I20240110002966 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20240110002966"} |
| pecos_enrlmt_id | I20240417001022 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20240417001022"} |
| pecos_enrlmt_id | I20241108003463 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20241108003463"} |
| pecos_enrlmt_id | I20241120001639 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20241120001639"} |
| pecos_enrlmt_id | I20241202001619 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20241202001619"} |
| pecos_enrlmt_id | I20241202001772 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20241202001772"} |
| pecos_enrlmt_id | I20250225002808 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20250225002808"} |
| pecos_enrlmt_id | I20250606002287 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20250606002287"} |
| pecos_enrlmt_id | I20250616001517 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20250616001517"} |
| pecos_enrlmt_id | I20250619002041 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20250619002041"} |
| pecos_enrlmt_id | I20051006000580 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-12 | evidencerecorded: 2026-06-12 methodology: entity-graph/v1 evidence: {"npi":"1396804712","rule":"D-PECOS","enrlmt_id":"I20051006000580"} |
Graph edges
One-hop relationships — ownership, chain membership, operation — each backed by a federal source row.
| Relationship | Entity | Confidence | Source table | Provenance |
|---|---|---|---|---|
| owns → | SOUTH LIMESTONE HOSPITAL DISTRICT (TX) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-14 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"06/01/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7416972690","source_pk":278338,"type_owner":"I","enrollment_id":"O20251006001745","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pac_id","percentage_ownership_raw":null,"enrollment_organization_name":"SOUTH LIMESTONE HOSPITAL DISTRICT"} |
| owns → | PARKVIEW NURSING AND REHAB, LLC (WI) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"01/01/2020","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7416972690","source_pk":186389,"type_owner":"I","enrollment_id":"O20181213000122","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"PARKVIEW NURSING AND REHAB LLC"} |
| owns → | ESKRIDGE OPERATOR, LLC (KS) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"04/10/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7416972690","source_pk":195054,"type_owner":"I","enrollment_id":"O20191022000844","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"ESKRIDGE OPERATOR LLC"} |
| owns → | SOUTH LIMESTONE HOSPITAL DISTRICT (TX) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"06/01/2025","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7416972690","source_pk":278338,"type_owner":"I","enrollment_id":"O20251006001745","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"SOUTH LIMESTONE HOSPITAL DISTRICT"} |
Current record
Current claims returned for this entity, grouped by provenance subject. The table exposes the source identifier recorded for each claim.
provider · 1396804712 JSON
| Metric | Value | Asserted | Source |
|---|---|---|---|
| credential | MD | 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 | 2006-12-08 | 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 |
| first_name | BOBBY | 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 |
| last_name | MALIK | 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 | CT | 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 | 207R00000X | 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 |
| years_active | 19 years | 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 1396804712: 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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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: 2026-09-20T13:18:06.303Z
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
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
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: 2026-06-12
methodology: cms-order-referring/v1
last_checked: 2026-09-20T13:18:06.303Z
confidence: 1
data_availability: present
pipeline_version: b1fa680
doi: —
license: US-Government-Works
coverage_start: 2026-06-12
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: 2026-09-20T13:18:06.303Z
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 file47 Medicare enrollment records 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: 2026-09-20T13:18:06.303Z
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=…