Orthopedic and Sports Enhancement Center, LLC
NPI 1003900820ActiveOrganization· Specialist· Bloomington, IL
Specialist in Bloomington, Illinois, registered in NPPES in October 2006. The authorized official on file is J. Anthony Dustman, President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1003900820 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 3, 2006 |
| Last updated in NPPES | Sep 12, 2017 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist Primary | 174400000X | — | — |
| Orthopaedic Surgery | 207X00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IL) |
|---|
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