| Provider Name | License Number | NPI Number | Provider Type | Exclusion Effective Date | SSN/FEIN |
| ABASSI ANSIR | | | Manager | 03/20/2025 | Verify |
| AVILA EDGAR | | 1790345676 | Pharmacy Owner | 03/27/2025 | Verify |
| BARROSO MYRMA | | | Case Manager | 03/27/2025 | Verify |
| BERETSKY OLEG | 00443456 | | Registered Nurse | 04/10/2025 | Verify |
| BLANDING JESSICA MAURINE AKA/DBA JESSICA M. LEE | 00323289 | | Licensed Practical Nurse | 03/27/2025 | Verify |
| BONILLA CANDICE B | 00635520 | 1457828964 | Registered Nurse | 03/27/2025 | Verify |
| BRESLIN KEVIN | | | Chief Executive Officer | 03/23/2025 | Verify |
| BROADWAY RX ENTERPRISES INC | 00035269 | 1376074005 | Pharmacy | 03/13/2025 | Verify |
| BRONX MEDICAL HEALTH PROVIDER PC | 00123635 | 1093352874 | Multi Type Group Services | 04/10/2025 | Verify |
| CARRANZA YOLANY MEJIA | | | Dentist (unlicensed) | 04/10/2025 | Verify |
| CASTRO DIANA | 00005687 | 1518993476 | Podiatrist | 03/13/2025 | Verify |
| CENCHITZ JENNIFER | 00261086 | | Licensed Practical Nurse | 03/20/2025 | Verify |
| CHAUDHARI MANSINH AKA/DBA MONSI KOOVA | | | Company Operator | 04/10/2025 | Verify |
| CODINGTON RACHELLE | | | Day Hab Staff | 04/10/2025 | Verify |
| CRANIAL SCIENTIFIC INC. | | 1881959351 | Durable Medical Equipment Company | 04/03/2025 | Verify |
| CRAWFORD STEVEN | | | Credentialed Alcoholism and Substance Abuse Counselor | 04/10/2025 | Verify |
| DAVIS JEROME | | | Direct Support Professional | 04/10/2025 | Verify |
| DOYLE TIMOTHY C. | | | Operations Manager | 03/20/2025 | Verify |
| EASY CARE MEDICAL SERVICES PC | 00129142 | 1952074585 | Medical Services Group | 03/23/2025 | Verify |
| ELEYINAFE MEDICAL CARE PC | 00120013 | 1730780719 | Medical Practice | 03/23/2025 | Verify |
| EMPIRE CARE AGENCY LLC | | 1427710953 | Home Care Agency | 03/19/2025 | Verify |
| FADHEL ARKAN | | | Transportation Company Owner | 04/10/2025 | Verify |
| FADHEL MUNEF | | | Transportation Company Owner | 04/03/2025 | Verify |
| FAMILY SOCIAL ADULT DAY CARE INC. | | | Adult Day Care | 03/20/2025 | Verify |
| FISHBERGER KENNETH I | 00129974 | 1649291451 | Physician | 03/13/2025 | Verify |
| GABRIEL JESSIE R. | | | Employee | 03/23/2025 | Verify |
| GRENNAN KIMBERLY DIANE | 00462749 | 1619308012 | Registered Nurse | 03/13/2025 | Verify |
| HAMDI OMNEAH | | | Other | 03/20/2025 | Verify |
| HASHMI AMRAN | | | Manager | 03/20/2025 | Verify |
| HOLMAN VARENE SEMONE | 00288570 | | Licensed Practical Nurse | 03/20/2025 | Verify |
| HOOPOE TRANSPORTATION INC | | | Transportation Company | 04/03/2025 | Verify |
| IBRAHIM JAMIL MD | 00226342 | 1245222587 | Physician | 03/20/2025 | Verify |
| ISLAMOV DILSHOD | | | Owner | 03/20/2025 | Verify |
| JACKSON ASHLEY AKA/DBA ASHLEY FRANK | 00028397 | | Dentist Hygienist | 04/03/2025 | Verify |
| KASTRINOS MICHAEL JOSEPH | 00684800 | | Registered Nurse | 03/20/2025 | Verify |
| KATES JUSTIN | | | Care Technician | 04/10/2025 | Verify |
| KISSANE AMELIA AKA/DBA AMELIA DAVIS | 00701725 | 1538322342 | Registered Nurse | 03/20/2025 | Verify |
| KLIM DEIDRE | 00700842 | | Registered Nurse | 03/20/2025 | Verify |
| KODSI EHAB M | 00239223 | 1063594752 | Physician | 03/23/2025 | Verify |
| LAI YU JEN | 00211328 | 1083787071 | Physician | 03/20/2025 | Verify |
| LAKE ROBERT | | | Prosthetist & Orthotists | 04/03/2025 | Verify |
| MCKENNA JENNIFER CONSTANCE | 00401330 | 1770898694 | NP Pediatrics and Psychiatry | 03/27/2025 | Verify |
| METZLER RONALD | | | Transportation Driver | 04/10/2025 | Verify |
| MICHAEL GEORGE ALLEYNE MD PC | 00113515 | 1932615119 | Physician Group | 03/23/2025 | Verify |
| MITCHELL CHRISTOPHER | | | Direct Support Professional | 04/10/2025 | Verify |
| NEWCOMBE SCOTT | | | Medical Biller | 03/13/2025 | Verify |
| NOTTINGHAM LINDSAY | | | Counselor Assistant | 03/27/2025 | Verify |
| NOWIERSKI ANNA LEE | 00030223 | 1295989010 | Pharmacist | 03/27/2025 | Verify |
| ORTHO WORKS INC | | 1073524336 | Medical Appliance Dealer | 04/03/2025 | Verify |
| PETTWAY LASHEA | | | Employee | 03/20/2025 | Verify |
| QUEEN CITY TRANSPORTATION INC | | | Transportation Provider | 04/10/2025 | Verify |
| QUEVEDO JORGE | | | CONSUMER DIRECTED AIDE | 04/03/2025 | Verify |
| RAKHRA SHAVETA | 00334987 | | Licensed Practical Nurse | 03/20/2025 | Verify |
| REYNOLDS CHEREECE | 00285266 | | Licensed Practical Nurse | 03/20/2025 | Verify |
| RIZZO TANIA M | | | Pharmacy President | 03/13/2025 | Verify |
| ROC CITY TRANSPORT LLC | | | Transportation Company | 04/03/2025 | Verify |
| ROSE KENISHA HEIKA | 00800046 | | Registered Nurse | 03/20/2025 | Verify |
| SJ HEALTHCARE MANAGEMENT SERVICES, LLC | | | Medical Billing Company | 03/13/2025 | Verify |
| SJT DRUG CORP AKA/DBA CORONA CHEMISTS PHARMACY | 00038586 | 1417540840 | Pharmacy | 03/13/2025 | Verify |
| SMITH HEATHER MISTINA | | | Driver | 03/20/2025 | Verify |
| SPINNER JESSICA LYNN | 00315192 | | Licensed Practical Nurse | 03/13/2025 | Verify |
| THELUS SPECIALTY CARE AGENCY LLC | | 1437505914 | Home Health Agency | 03/23/2025 | Verify |
| THOMAS ZINIA | 00305816 | 1376687301 | Physician | 03/27/2025 | Verify |
| TOTAL CARE & REHABILITATION MEDICIN | 00009856 | 1730321605 | Medical Practice | 03/23/2025 | Verify |
| TRISETO ORTHOTIC SOLUTIONS INC. AKA/DBA BRACE911.COM | | 1285129205 | Prosthetist & Orthotists Supplier | 04/03/2025 | Verify |
| TUPER PARKER | | | Direct Support Professional | 03/13/2025 | Verify |
| VERTEX MOBILE DIAGNOSTICS INC | WAIVER68 | 1316416126 | Chiropractor Services | 03/20/2025 | Verify |