Panacea Brain and Spine, LLC
NPI 1457622763ActiveOrganization· Neurological Surgery· Lake Havasu City, AZ
Neurological Surgery in Lake Havasu City, Arizona, registered in NPPES in January 2012. The authorized official on file is Chad Hartley, MD, Owner. Enrolled in Medicare as dme supplier - physician - neurosurgery and part b supplier - clinic/group practice.
Overview
| NPI | 1457622763 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 18, 2012 |
| Last updated in NPPES | Jun 29, 2020 |
| Certified by provider | Jun 29, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Neurological Surgery Primary | 207T00000X | 46605 | AZ |
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) | Enrolled DME Supplier - Physician - Neurosurgery (AZ); Part B Supplier - Clinic/Group Practice (AZ) |
|---|
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