Jerad Chance Divine, D.D.S.
NPI 1841587250ActiveIndividual· Dentist, Endodontics· Wichita, KS
Opted out of Medicare from September 2018 to September 2028. Dentist, Endodontics (D.D.S.) in Wichita, Kansas, licensed in KS and MO, with an NPI issued in July 2011. Part D covered 584 prescriptions written in 2024, 100% of them generic. Peter Brasseler Holdings, LLC reported $32.31 in payments in 2024, mostly food and beverage.
Overview
| NPI | 1841587250 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | D.D.S. |
| Sole proprietor | No |
| NPI issued | Jul 6, 2011 |
| Last updated in NPPES | Dec 12, 2022 |
| Certified by provider | Dec 12, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Endodontics Primary | 1223E0200X | 61283 | KS |
| Dentist, General Practice | 1223G0001X | 2011014424 | MO |
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 |
|---|---|
| Opt-out | Opted out Sep 11, 2018 – Sep 11, 2028 |
| Can order and refer | Yes |
During an opt-out period the provider sees Medicare patients only under private contracts, and Medicare does not pay claims for their services.
Part D prescriptions in 2024
| Prescriptions (claims) | 584 · 584 30-day fills |
|---|---|
| Patients | 338 |
| Total drug cost | $2,396 |
| Generic share | 100% of claims |
Industry payments (Open Payments)
- 2024$32.31 · 1 payment from 1 company
Top paying companies in 2024
| Company | Amount | Payments |
|---|---|---|
| Peter Brasseler Holdings, LLC | $32.31 | 1 |
What the 2024 payments were for
- Food and Beverage$32.31 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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