Office of the Medicaid Inspector General
Medicaid Exclusions
Medicaid Exclusions Short List



Exclusions Short List


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You searched for: Short List
List Execution Date: 3/21/2025 3:28:38 AM.
Records returned: .
Data was last updated: 3/21/2025 12:01:08 AM.

Provider NameLicense NumberNPI NumberProvider TypeExclusion Effective DateSSN/FEIN
ABASSI ANSIRManager03/20/2025Verify
BONSU VANESSA003094361407111529Licensed Practical Nurse02/25/2025Verify
BOW DENNISDriver02/26/2025Verify
BROADWAY RX ENTERPRISES INC000352691376074005Pharmacy03/13/2025Verify
CALDIT GLENN PATRICK00746716Registered Nurse02/25/2025Verify
CASTRO DIANA000056871518993476Podiatrist03/13/2025Verify
CENCHITZ JENNIFER00261086Licensed Practical Nurse03/20/2025Verify
CHACKO JISHA CHERIAN005391521073804944Registered Nurse02/20/2025Verify
CHO WOOJIN002702391275859563Physician03/09/2025Verify
COLLIER DEBORAH ANN00563594Registered Nurse03/09/2025Verify
CONTRERAS-MERCED YASNARY000286451598349862Massage Therapist02/25/2025Verify
CURRAN SARA JANE000557861679857403Pharmacist03/09/2025Verify
DOYLE TIMOTHY C.Operations Manager03/20/2025Verify
EGGLESTON SHAMIKACase Manager 02/26/2025Verify
EMPIRE CARE AGENCY LLC1427710953Home Care Agency 03/19/2025Verify
ENU CHRISTOPHER CHUKWUEMEKA001090921679570824Physician03/09/2025Verify
FAMILY SOCIAL ADULT DAY CARE INC.Adult Day Care03/20/2025Verify
FISHBERGER KENNETH I001299741649291451Physician03/13/2025Verify
FOFFOU GUIDE MBOU AKA/DBA FOFFOU GUIDE MBOU00791680Registered Nurse02/20/2025Verify
FOLLETTE JAMES W001445441780655704Physician02/26/2025Verify
GALLO TANYACounselor02/26/2025Verify
GJENASHAJ LORI005641671568883643Registered Nurse02/25/2025Verify
GRENNAN KIMBERLY DIANE004627491619308012Registered Nurse03/13/2025Verify
HAMDI OMNEAHNon Medical 03/20/2025Verify
HASHMI AMRANManager03/20/2025Verify
HASSAN MOHAMED ALAA000604741245613587Pharmacist03/09/2025Verify
HOLMAN VARENE SEMONE00288570Licensed Practical Nurse03/20/2025Verify
Harrison Missibi Ngeah00337451Licensed Practical Nurse02/20/2025Verify
IBRAHIM JAMIL MD002263421245222587Physician03/20/2025Verify
ISLAMOV DILSHODOwner03/20/2025Verify
JABBOUR ANNA000462251174910806Pharmacist02/25/2025Verify
KASTRINOS MICHAEL JOSEPH00684800Registered Nurse03/20/2025Verify
KESSLER JENNIFER L00501972Registered Nurse02/25/2025Verify
KHAN AIMAL002680301346456654Physician02/26/2025Verify
KLIM DEIDRE00700842Registered Professional Nurse03/20/2025Verify
KWAIZER STEPHANIECounselor02/26/2025Verify
LAI YU JEN002113281083787071Physician03/20/2025Verify
LAUDAN SEAN003252001033659248Licensed Practical Nurse02/25/2025Verify
LAVENTURE ROBERT KENDALL00523659Registered Nurse03/09/2025Verify
MASON PATRICKDirect Support Professional02/26/2025Verify
MATTICE CHRISTEL BLUE00323858Licensed Practical Nurse02/26/2025Verify
MCFARLANE KERI AKA/DBA KERI BENTLEY003052301588688998Physician02/26/2025Verify
MILLER NATOSHA N002929131649564238Licensed Practical Nurse02/25/2025Verify
NEWCOMBE SCOTTBilling Consultant03/13/2025Verify
PETTWAY LASHEAEmployee03/20/2025Verify
PFOHL JEAN00489883Registered Nurse02/25/2025Verify
PICARD PAULIESchool Safety Team Staff02/26/2025Verify
PORCH JOHNNYMaintenance Worker 02/26/2025Verify
RAKHRA SHAVETA00334987Licensed Practical Nurse03/20/2025Verify
REYNOLDS CHEREECE00285266Licensed Practical Nurse03/20/2025Verify
RIZZO TANIA MPharmacy President03/13/2025Verify
ROSE KENISHA HEIKA00800046Registered Professional Nurse03/20/2025Verify
SJ HEALTHCARE MANAGEMENT SERVICES, LLCBilling Company03/13/2025Verify
SJT DRUG CORP AKA/DBA CORONA CHEMISTS PHARMACY000385861417540840Pharmacy03/13/2025Verify
SMITH HEATHER MISTINASupervising Driver03/20/2025Verify
SPINNER JESSICA LYNN00315192Licensed Practical Nurse03/13/2025Verify
TUPER PARKERDirect Support Professional 03/13/2025Verify
VERTEX MOBILE DIAGNOSTICS INCWAIVER681316416126Chiropractor Services03/20/2025Verify
WHITE ELLA RAEDirect Support Professional 03/09/2025Verify
WILLIAMS STEFANIE L00646317Registered Nurse03/09/2025Verify
YOUNG ROBERT00026694Massage Therapist03/09/2025Verify

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