NPI 1164410650
NPI 1164410650DeactivatedUnknown
This NPI was deactivated on May 21, 2026. Claims billed under a deactivated NPI are rejected.
This NPI was deactivated in May 2026. Provider. 152 Medicare patients in 2024, $192,696 paid; nearly all of their 1,944 Part D prescriptions were generic (93%).
Overview
| NPI | 1164410650 |
|---|---|
| Status | Deactivated May 21, 2026 |
| Entity type | Unknown |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 152 |
|---|---|
| Services billed | 2,741 across 16 procedure codes |
| Paid by Medicare | $192,696 |
Part D prescriptions in 2024
| Prescriptions (claims) | 1,944 · 2,089 30-day fills |
|---|---|
| Patients | 241 |
| Total drug cost | $154,646 |
| Generic share | 93% of claims |