Skip to contents

Revoked Providers & Suppliers

Source: R/end-revocations.R
revocations.Rd

Information on providers and suppliers currently revoked from the Medicare program.

Usage

revocations(
  npi = NULL,
  enid = NULL,
  first = NULL,
  last = NULL,
  org_name = NULL,
  multi = NULL,
  state = NULL,
  prov_desc = NULL,
  reason = NULL,
  start_year = NULL,
  end_year = NULL,
  count = FALSE
)

Source

Arguments

npi

<int> National Provider Identifier

enid

<chr> Medicare Enrollment ID

first, last

<chr> Individual provider name

org_name

<chr> Organization name

multi

<lgl> Provider has multiple NPIs

state

<chr> Enrollment state abbreviation

prov_desc

<chr> Provider type enrollment description

reason

<chr> Reason for revocation

start_year, end_year

<int> year of revocation/expiration

count

<lgl> Return the total row count

Value

A tibble containing the search results.

Details

The Revoked Medicare Providers and Suppliers dataset contains information on providers and suppliers who are revoked and under a current re-enrollment bar. This dataset includes provider and supplier names, NPIs, revocation authorities pursuant to 42 CFR § 424.535, revocation effective dates, and re-enrollment bar expiration dates. This dataset is based on information gathered from the Provider Enrollment, Chain and Ownership System (PECOS).

Reasons

  • § 424.535 Revocation of enrollment in the Medicare program.

    1. Noncompliance

      • Business Location Not Properly Licensed

      • Enrollment Requirements

      • Not Professionally Licensed

      • Provider/Supplier Type Requirements Not Met

        • DME Standards Not Met

        • IDTF Standards Not Met

    2. Provider Or Supplier Conduct

      • Exclusion

      • Other

    3. Felonies

    4. False Or Misleading Information

    5. On-Site Review

    6. Grounds related to provider and supplier screening requirements

    7. Misuse of billing number

    8. Abuse Of Billing Privileges

      • Pattern Or Practice

    9. Failure To Report

    10. Failure To Document

    11. Initial reserve operating funds

    12. Other Program Termination - Medicaid - Other Federal Health Care Program

    13. Prescribing Authority

    14. Improper Prescribing Practices

    15. False Claims Act (FCA)

    16. Reserved

    17. Debt Referred To Treasury

    18. Revoked Under Different Name, Numerical Identifier Or Business Identity

    19. Affiliation That Poses An Undue Risk

    20. Billing from non-compliant location

    21. Abusive ordering, certifying, referring, or prescribing of Part A or B services, items or drugs

    22. Patient Harm

    23. Violation Of Provider And Supplier Standards

Source: Code of Federal Regulations

Examples

revocations(count = TRUE)
#> ◼ revocations | 7,059 rows | 2 pages

revocations(org_name = not_blank(), count = TRUE)
#> ✔ revocations returned 3,876 results

revocations(org_name = starts("B"), count = TRUE)
#> ✔ revocations returned 204 results

revocations(prov_desc = contains("CARDIO"), state = excludes(c("GA", "OH")))
#> ✔ revocations returned 45 results
#> ✔ Retrieving 1 page
#> # A tibble: 45 × 11
#>    org_name first   last    enid     npi multi state prov_desc reason start_date
#>    <chr>    <chr>   <chr>   <chr>  <int> <int> <chr> <chr>     <chr>  <date>    
#>  1 NA       JUAN    KURDI   I200… 1.57e9     0 TX    PRACTITI… 424.5… 2023-09-28
#>  2 NA       RONALD  CARLISH I200… 1.64e9     0 CA    PRACTITI… 424.5… 2022-12-13
#>  3 NA       STEVE   NOZAD   I200… 1.96e9     0 NY    PRACTITI… 424.5… 2020-10-30
#>  4 NA       RAED    JITAN   I200… 1.03e9     0 WV    PRACTITI… 424.5… 2020-02-14
#>  5 NA       RAYMOND CATANIA I200… 1.02e9     0 NJ    PRACTITI… 424.5… 2021-03-08
#>  6 NA       ROBERT  VACCAR… I200… 1.92e9     0 NY    PRACTITI… 424.5… 2023-08-20
#>  7 NA       STEVEN  HEFTER  I200… 1.61e9     0 AL    PRACTITI… 424.5… 2017-12-01
#>  8 NA       BRYAN   PERRY   I200… 1.24e9     0 OK    PRACTITI… 424.5… 2020-05-21
#>  9 NA       KLAUS   RENTROP I200… 1.19e9     0 NY    PRACTITI… 424.5… 2023-09-15
#> 10 NA       JOHN    MCCLURE I200… 1.43e9     0 MI    PRACTITI… 424.5… 2022-11-02
#> # ℹ 35 more rows
#> # ℹ 1 more variable: end_date <date>