NPI 1164498812
NPI 1164498812DeactivatedUnknown
This NPI was deactivated on Feb 5, 2026. Claims billed under a deactivated NPI are rejected.
This NPI was deactivated in February 2026. Provider. 194 Medicare patients in 2024, $510,601 paid; nearly all of their 137 Part D prescriptions were generic (98%).
Overview
| NPI | 1164498812 |
|---|---|
| Status | Deactivated Feb 5, 2026 |
| Entity type | Unknown |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 194 |
|---|---|
| Services billed | 3,303 across 31 procedure codes |
| Paid by Medicare | $510,601 |
Part D prescriptions in 2024
| Prescriptions (claims) | 137 · 196 30-day fills |
|---|---|
| Patients | 47 |
| Total drug cost | $1,519 |
| Generic share | 98% of claims |