Petersen Health Care Roseville LLC
NPI 1710201793ActiveOrganization· Skilled Nursing Facility· Roseville, IL
Skilled Nursing Facility in Roseville, Illinois, registered in NPPES in March 2010. The authorized official on file is Mark Petersen, Manager. Enrolled in Medicare as part b supplier - mass immunization (roster biller only).
Overview
| NPI | 1710201793 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 20, 2010 |
| Last updated in NPPES | Feb 14, 2024 |
| Certified by provider | Feb 14, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Skilled Nursing Facility Primary | 314000000X | — | — |
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 - Mass Immunization (Roster Biller Only) (IL) |
|---|
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