This provider appears on OIG LEIE federal exclusion list. Reason: License revocation or suspension. Exclusion date: 2020-10-20.
Listing this provider in a network directory may constitute a compliance violation and expose the carrier to civil monetary penalties.
NPI 1417966144 · Physician Assistant - Medical · Kaiser
Provider appears on federal exclusion list while listed in 1 active carrier network.
NPPES
GREENWOOD VILLAGE, 80111
Freshness: Unknown
Network Status
Listed with 1 carrier
DORA License
Voluntary Surrender
Medicare
Enrolled but no billing activity
Care Compare
No Care Compare data
Federal Exclusion
License revocation or suspension
Source: OIG LEIE
Excluded since: 2020-10-20
Automatic "confirmed" ghost indicator
PECOS Enrollment
Active NPI with specialty classification
DORA license expired or revoked
No Medicare billing · No electronic endpoint
Single address source (NPPES)
Weak network corroboration
1 network across 1 carrier
Listed in 1 carrier networks despite federal exclusion — carriers may not be aware of exclusion status.
Disclaimer: This analysis uses publicly available federal and state data sources. It does not constitute a determination of provider status or network participation. Contact the provider or health plan directly to verify current status.
Medicare enrolled