Ennoble Hc Mso Holdco Inc
NPI 1174445712ActiveOrganization· Family Medicine, Geriatric Medicine· Hackensack, NJ
Family Medicine, Geriatric Medicine in Hackensack, New Jersey, registered in NPPES in July 2026. The authorized official on file is Kushabhadra Hc Dmv Das, Ceo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1174445712 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 27, 2026 |
| Last updated in NPPES | Jul 27, 2026 |
| Certified by provider | Jul 27, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine, Geriatric Medicine Primary | 207QG0300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (OH) |
|---|
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