Medicaid Michigan Sanction Provider List September 7, 2022 ...

148
Entity Name Last Name First Name Middle Name Provider Category NPI# City License# Sanction Date1 Sanction Source Sanction Date2 Sanction Source Reason 1st Priority Physical Therapy LLC Group 1134422363 Detroit 8/2/2016 MDHHS-OIG Summary Suspension A.N.N. Inc Home Health Agency 1598814501 Livonia 7/22/2015 MDHHS-OIG Summary Suspension A Dental Center PC - Allen Park Dental Group Allen Park 5/20/2004 HHS 1128(a)(1) A Dental Center PC - Southgate Dental Group Southgate 7/20/2004 1128(a)(1) Acadian Diagnostic Laboratories LLC Laboratory 1316370950 Baton Rouge, LA 19D2062876 5/15/2021 MDHHS Terminated Advance Visiting Physicians Group 1740478270 Farmington Hills 1/2/2022 MDHHS Terminated Advance Visiting Physicians Oshiyoye Adekunle Owner 1740478270 Farmington Hills 1/2/2022 MDHHS Terminated Advanced Care Services Group 1811290794 Oak Park 12/22/2015 HHS 6/8/2018 MDHHS-OIG Summary Suspension Terminated Advanced Homecare Pharmacy Pharmacy 1710923107 Redford 5301008284 10/14/2015 MI-Licensing and Regulatory Affairs Voluntarily Surrendered Advanced Medical Services PLLC dba Advanced Sleep Diagnostic of Michigan Group 1922451632 Lansing 7/16/2018 MDHHS-OIG 8/15/2018 MDHHS-OIG Summary Suspension Terminated Advanced Sleep Neurodiagnostics PC Group 1134143654 Farmington Hills 10/15/2017 MDHHS-OIG 4/21/2022 MDHHS-OIG Summary Suspension Terminated Alam, Waseem MD PC Medical Group 1184724114 Bloomfield Hills 7/29/2015 MDHHS-OIG 11/8/2018 MDHHS-OIG Summary Suspension Terminated Alfred Associates Incorporated Group 1437721461 Farmington Hills 1/2/2022 MDHHS Terminated Alfred Associates Incorporated Oshiyoye Adekunle Owner 1437721461 Farmington Hills 1/2/2022 MDHHS Terminated Ali Elhorr M.D.P.C. Medical Group 1558651422 Dearborn 5/19/2015 DCH-OIG 11/1/2019 MDHHS-OIG Summary Suspension Terminated Medicaid Michigan Sanction Provider List September 13, 2022 [email protected]

Transcript of Medicaid Michigan Sanction Provider List September 7, 2022 ...

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

1st Priority Physical Therapy LLC Group 1134422363 Detroit 8/2/2016 MDHHS-OIGSummary Suspension

A.N.N. Inc Home Health Agency 1598814501 Livonia 7/22/2015 MDHHS-OIGSummary Suspension

A Dental Center PC - Allen Park Dental Group Allen Park 5/20/2004 HHS 1128(a)(1)

A Dental Center PC - Southgate Dental Group Southgate 7/20/2004 1128(a)(1)Acadian Diagnostic Laboratories LLC Laboratory 1316370950 Baton Rouge, LA 19D2062876 5/15/2021 MDHHS TerminatedAdvance Visiting Physicians Group 1740478270 Farmington Hills 1/2/2022 MDHHS TerminatedAdvance Visiting Physicians Oshiyoye Adekunle Owner 1740478270 Farmington Hills 1/2/2022 MDHHS Terminated

Advanced Care Services Group 1811290794 Oak Park 12/22/2015 HHS 6/8/2018 MDHHS-OIG

Summary Suspension Terminated

Advanced Homecare Pharmacy Pharmacy 1710923107 Redford 5301008284 10/14/2015

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Advanced Medical Services PLLC dba Advanced Sleep Diagnostic of Michigan Group 1922451632 Lansing 7/16/2018 MDHHS-OIG 8/15/2018 MDHHS-OIG

Summary Suspension Terminated

Advanced Sleep Neurodiagnostics PC Group 1134143654 Farmington Hills 10/15/2017 MDHHS-OIG 4/21/2022 MDHHS-OIG

Summary Suspension Terminated

Alam, Waseem MD PC Medical Group 1184724114 Bloomfield Hills 7/29/2015 MDHHS-OIG 11/8/2018 MDHHS-OIG

Summary Suspension Terminated

Alfred Associates Incorporated Group 1437721461 Farmington Hills 1/2/2022 MDHHS Terminated

Alfred Associates Incorporated Oshiyoye Adekunle Owner 1437721461 Farmington Hills 1/2/2022 MDHHS Terminated

Ali Elhorr M.D.P.C. Medical Group 1558651422 Dearborn 5/19/2015 DCH-OIG 11/1/2019 MDHHS-OIG

Summary Suspension Terminated

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

All American Pharmacy LLC Pharmacy 1609151109 Flint 2/14/2018

MI-Licensing and Regulatory Affairs

Volunatarily Surrendered - Controlled Substance Facilty License Only

Allied Geriatric Services PC Medical Group 1821196551 Birmingham 3/6/2013 DCH 10/29/2018 MDHHS-OIG

Summary Suspension Terminated

American Home Doctors PC Medical Group 1740623222 Warren 8/21/2021 HHS RevokjedAmerican Home Care Assistants LLC Home Help Agency Detroit 8/17/2020 MDHHS-OIG

Summary Suspension

American Medical Missionary Care Home Help Agency 1578600920 Saginaw 12/5/2016 MDHHS-OIG 1/9/2017 MDHHS-OIG

Summary Suspension Termination

Andy's Motown Pharmacy Pharmacy 1053355271 Detroit 5301008407 3/28/2011

MI-Licensing and Regulatory Affairs Suspended

Angels Touch Home Health Care LLC Home Health 1922252865 Taylor 3/6/2013 DCH

Summary Suspension

Ashton Drugs Pharmacy 1861426793 Detroit 5301005477 10/13/2021

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

ATCG Laboratory clinical Laboratory 1316311863 Irvine, CA 05D2104354 9/10/2022 Kentucky Terminated

At Home Doctors P.C. Group 1851627053 Lansing 5/23/2013 DCH-OIG DCH-OIG Suspended Terminated

Awerbuch, Gavin MD PC Group 1003130352 Saginaw 6/19/2014 DCH-OIG 11/6/2018 MDHHS-OIG

Summary Suspension Terminated

Ban Mecheal MD PC Gruup 1033301569 Livonia 9/17/2019 MDHHS-OIGSummary Suspension

Bay City Vascular P.C. Group 1346424009 Bay City 9/30/2015 MDHHS-OIGSummary Suspension

Beacon Pointe Pharmacy & Surgical INC Pharmacy 1356495709 Grosse Pointe 5301006388 11/29/2021 MDHHS-OIG

Summary Suspension

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Bennett Family Chiropractic PLLC Chiropractic Group 1386881191 Auburn Hills 5/27/2020 MDHHS-OIG

Summary Suspension and Termination

Benstar Pharmacy LLC Pharmacy 1255679924 Detroit 5301010006 11/2/2017

MI-Licensing and Regulatory Affairs

2/14/18 6/14/18 MDHHS-OIG

Summary Suspended Volunatrily Surrendered Terminated

Beval Medical Equipment & Supplies Supplier 1235163551 Royal Oak 562580933 06/11/2015 CMS RevokedBirmingham Rehab & Physical Therapy Center, Inc.

Rehab Therapy Services Detroit 36687 12/18/2003 HHS 1128(a)(1)

Breakthrough Believers Recovery and Healing Center Group 1376866160 Grand Rapids 3/31/2021 MDHHS-OIG

Summary Suspension

BrightSmiles Dental Group 1508229014 West Bloomfield 20153421 1/26/2017 MDHHS TerminatedBrightSmiles PA 161 Dental Group 1083848311 Waterfrd 20152161 1/26/2017 MDHHS Terminated

Broadstreet Nursing Center Nursing Facility 83418 9/27/2000

C. Bazo Group PLLC Group 1376846162 Port Huron 4/5/2022 MDHHS-OIGSummary Suspension

Canton Urgent Care P.C. Group 1992830863 Canton 5/18/2016 MDHHS-OIG 1/18/2021 MDHHS-OIG

Summary Suspension Termination

Carpenter Pharmacy Pharmacy 1578655627 Hamtramck 5315015095 6/14/2018

MI-Licensing and Regulatory Affairs 10/10/2018

MI-Licensing and Regulatory Affairs

Controlled Substance C3-Facility license only summary suspended Suspended

Cedar Knoll Care Center Nursing Facility Grass Lake 3/7/2007 DCHLicense Revocation

Center Light Home Help Care Home Help Agency Detroit 5/12/2020 MDHHS-OIGSummary Suspension

Centrad Healthcare LLC Group 1346243979 Naperville, IL 11/14/2017 MDHHS-OIGSummary Suspension

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Christina L Kimbrough PLLC Group 1770933194 Southfield 5/1/2018 MDHHS-OIG 12/21/2018 MDHHS-OIG

Summary Suspension Terminated

Claro Scientific Labs Laboratory 1609388842 Lafayette, CO 06D2137868 12/31/2021 MDHHS TerminatedClaro Scientific Labs Roiter Victor Owner 1609388842 Lafayette, CO 12/31/2021 MDHHS Terminated

Clinical Psychiatric Medicine PC Group 1386677185 Grandville 7/18/2013 DCH-OIG Suspended

Commerce Township Pharmacy Pharmacy 1851616452 Commerce Township 8/31/2011 DCH 5/30/2016 MDHHS-OIG

Summary Suspension Terminated

Community Rehabiltation Services Group 1669424776 Rose City 7/13/2016 MDHHS-OIG

Summary Suspension

Compassionate Doctors PC Group 1326153578 Southfield 7/30/2013 DCH-OIG 1128(a)(2)Complete Health, LLC Group Group 1083801500 Livonia 6/21/2011 HHS

Creams N Caps Pharmacy 1386972859 Southfield 5301010570 10/14/2015

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Cutting Edge Orthopaedics LLC Group 1295070746 Sylvania, OH 9/15/2015 MDHHS-OIG Suspended

Davenport Pharmacy Pharmacy 1548585136 Saginaw 8/31/2011 DCH-OIG 5/23/2016 MDHHS-OIG

Summary Suspension Termination

Dearborn Pharmacy, Inc. Pharmacy Dearborn 2/20/2006 HHS 1128(a)(3)

Dearborn Family Medicine Center Medical Group 1467407080 Dearborn 7/8/2013 DCH-OIG 5/5/2016 MDHHS-OIG

Summary Suspension Terminated

Dearborn Nuro Clinic PC Group 1568638088 Dearborn 12/1/2016 MDHHS-OIG 4/12/2018 MDHHS-OIG

Summary Suspension Terminated

Dearborn Podiatric Surgeons PC Group 1447467485 Dearborn 12/3/2017 MDHHS-OIG 12/26/2018 MDHHS-OIG

Summary Suspension Terminated

Dearborn Rx Pharmacy Group 1982054383 Dearborn 5301010958 7/26/2017

MI-Licensing and Regulatory Affairs 12/13/2017

MI-Licensing and Regulatory Affairs

Summary Suspension Voluntary Termination

Detroit Diverse Care, Inc. Physician Group Detroit 3/16/1997 HHS 1128(a)(1)

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Detroit Medical Clinic Medical Group 1245244110 Detroit 7/30/2013 DCH-OIG 10/31/2019 MDHHS-OIGSummary Suspension

Diamond Pharmacy Pharmacy 1720380140 Kalamazoo NCPDP 2374724 8/19/2011 DCH 6/2/2016 MDHHS

Summary Suspension Termination

Divine Pharmacy LLC Pharmacy 1003273202 Detroit 5301010794 4/13/2020 MDHHS-OIG 6/9/2021

MI-Licensing and Regulatory Affairs

Summary SuspensionVoluntarily Surrendered

Downriver Medical Associates PLC Physician Group 1114055811 Monroe 3/21/2013 DCH 11/13/18 DCH

Summary Suspension Termination

Dr Henderson Judy MD Family Medicine PLLC Group 1841737277 Niles 6/1/2021 MDHHS-OIG

Summary Suspension

Drug Max Inc Pharmacy 1538210414 Dearborn 5301005961 11/30/2021 MDHHS-OIGSummary Suspension

Durand Clinic PC Physician Group Durand 9/20/2001 HHS 1128(a)(3)

Dwight E. Smith MD PC Physician Group 1003849753 Detroit 5/29/2012 DCHSummary Suspension

Dynasty Health Solutions Inc Medical Group 1326586942 FErndale 8/4/2020 MDHHS-OIGSummary Suspension

East Village Pharmacy Pharmacy 1982928818 Dearborn 8/29/2016 MDHHS-OIGSummary Suspension

EB James Nursing Center Nursing Facility Detroit 83422 2/12/2002

MI-Licensing and Regulatory Affairs

License Revocation and Summary Suspension

El Medical Inc Group 1295049815 Manassas Park , VA 6587530001 7/8/2022 HHS Termination

Elrington Medical Center PLLCMedical Supply Company 1205875697 Redford 10/22/2013 DCH-OIG

Summary Suspension

Elrose Health Services, Inc. SA Treatment Detroit 21431 4/17/1995

MI-Licensing and Regulatory Affairs 10/20/1998 HHS

10/20/98: 1128(a)(1)

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Elrose Health Services, Inc. SA Treatment Detroit 21391 4/17/1995

MI-Licensing and Regulatory Affairs 10/20/1998 HHS

10/20/98: 1128(a)(1)

Elrose Health Services, Inc. SA Treatment Detroit 20731 4/17/1995

MI-Licensing and Regulatory Affairs 10/20/1998 HHS

10/20/98: 1128(a)(1)

Enjoy Dental Care PC Dental Group Detroit 5/20/2004 HHS 1128(a)(1)Essentials Adult Day Care Group 1912459256 Detroit 7/8/2022 HHS Termination

Express Discount Pharmacy Pharmacy 1225537962 Detroit 5301011289 1/8/2021

MI-Licensing and Regulatory Affairs Suspended

EZ Sleep Supplies LLC Medical Supplier 1871640383 Okemos 7/16/2018 MDHHS-OIG 8/15/2018 MDHHS-OIG

Summary Suspension Terminated

Fleth Discount Pharmacy LLC Pharmacy 1245670447 Warren 5301010191 3/5/2018

MI-Licensing and Regulatory Affairs Revoked

Four Leaf Clover Inc Medical Group 1750451357 Westland 7/29/2015 MDHHS-OIGSummary Suspension

Francis Street Medical Associaes P.C. Medical Group 1730245499 Jackson 6/29/2016 MDHHS-OIG

Summary Suspension

Friendz Pharmacy Fabode Abiodun Pharmacy 1396051629 Detroit 5301009394 6/27/2018 MDHHS-OIG 4/29/2022 MDHHS-OIG

Summary Suspension Terminated

Friendship Manor Nursing Home Nursing Facility Detroit 3/21/2006 DCH

License Revocation and Summary Suspension

General Medicine PC Group 1811945199 Novi 6/28/2019 MDHHS Terminated

Georgetown Poidatric Surgeons PC Group 1508905985 Sterling Heights 12/3/2017 MDHHS-OIG 12/26/2018 MDHHS-OIG

Summary Suspension Terminated

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Glen Saperstein LLC Medical Group 1184045296 Saginaw 3/15/2017 MDHHS-OIGSummary Suspension

Global Health Pharmacy Pharmacy 1326342486 Pontiac 5301009521 6/27/2018 MDHHS-OIG 4/29/2022 MDHHS-OIG

Summary Suspension Terminated

Gracee Pharmacy Okoh Isiah Pharmacy 129512124 Highland Park 5301011430 5/31/2021 MDHHS-OIGSummary Suspension

Great Health Pharmacy Inc Pharmacy 1235609249 Madison Heights 5301011510 12/22/2021

MI-Licensing and Regulatory Affairs 4/26/2022

MI-Licensing and Regulatory Affairs

Summary Suspension Revoked

Greater Detroit Physical Therapy & Rehabilitation PC Group 1205865318 Westland 7/29/2015 MDHHS-OIG 3/29/2019 MDHHS-OIG

Summary Suspension Terminated

Green Cross Medical Center P.C. Group 1427126655 Detroit 6/14/2016 MDHHS-OIG 8/31/2018 MDHHS-OIG

Summary Suspension Terminated

Happy Hearts Home Care Agency Home Help Agency Jackson 5/26/2020 MDHHS-OIGSummary Suspension

Harmony Interational Group 1487717666 Detroit 1/16/2013 DCH-OIG 1/16/2013 DCH

Suspended Suspended Terminated

Harmony Turning Point PLLC Group 1588979686 Southfield 10/20/2013 HHS Excluded

Harper Dermatology PC Group 1598032070 Roseville 3/5/2018 MDHHS-OIG 11/1/2019 MDHHS-OIG

Summary Suspension Terminated

Hartford Chiropractic Clinic Group 1699882951 Hartford 6/6/2017 MDHHS-OIG 9/23/2017 MDHHS-OIG

Summary Suspension Terminated

Hatem Ataya M.D. PC Group 1528295375 Davison 6/18/2015 DCH-OIGSummary Suspension

Healing Hands Chiropractic Clinic LLC Group 1871779025 Coldwater 4/29/2015 DCH-OIG 9/26/2018 MDHHS-OIG

Summary Suspension Terminated

Health Dimnsions Pharmacy Pharmacy 1740346600 Farmington Hills 5301006453 3/30/2022 MDHHS-OIGSummary Suspension

Heritage Medical Pharmacy LLC Pharmacy 1225526601 Redford 5301011367 12/1/2021 MDHHS-OIGSummary Suspension

Highland Park Pharmacy Pharmacy 1104097781 Warren 8/31/2011 DCH-OIG 5/25/2016 MDHHS-OIG

Summary Suspension Terminated

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Hi-Tech Home Health Care INC. Home Health Agency 1669702593 Farmington Hills 7/28/2016 HHS TerminatedHome Clinic P.C. Group 1962645689 Southfield 12/29/2015 MDHHS-OIG Temination

Home Physician Services PC Group 1346347523 Troy 3/6/2013 DCH-OIG3/6/2013 08/09/2016

DCH MDHHS-OIG

Summary Suspension Termination Termination

Homecare Doctors LLC Group 1487723771 Detroit 7/30/2013 DCH-OIG 10/29/2018 MDHHS-OIG

Summary Suspension Terminated

Hope N Guidance Home Care Home Help Agency Detroit 3/16/2022 MDHHS-OIGSummary Suspension

House Calls Physicians PLLC Group 1033273008 Allen Park 5/21/2013 DCH-OIG 5/5/2016 MDHHS-OIG

Summary Suspension Terminated

Hugs of Love Home Health Care LLC Home Health Agency Eastpointe 5/27/2020 MDHHS-OIG

Summary Suspension

Independent Care Pharmacy LLC Pharmacy 1619131141 Dearborn 8/11/2011 DCH-OIG 5/23/2016 MDHHS-OIG

Summary Suspension Terminated

Jefferson Medical Industrial Clinic P.C. Group 1407178627 Detroit 7/4/2016 MDHHS-OIG 1/9/2017 MDHHS-OIG

Summary Suspension Ternminated

Joe's Discount Pharmacy Pharmacy 1770953234 Detroit 5301010738 6/13/2018

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

John R. Verbovsky D.O. P.C. Dental Group 1508153909 Sterling Heights 3/10/2015 MDHHS-OIG 12/14/2015 MDHHS-OIG Suspended Terminated

Jones Psychological Services PLLC Medical Group 1295092310 Port Huron 5/9/2018 MDHHS-OIG 6/8/2018 MDHHS-OIG

Summary Suspension Terminated

Josephson Nursing Home Nursing Facility 1700891504 Ironwood 1070000191 4/18/2012 DCHSummary Suspension

Kalamazoo Footcare Specialists PC Podiatry Group Kalamazoo 4/10/2007 HHS 1128(b)(1)

Kentwood Pharmacy Pharmacy 1346419892 Grand Rapids 11/24/2010 MDHHS-OIG 5/23/2016 MDHHS-OIGSuspended Terminated

Kentwood Pharmacy Pharmacy 1558478610 Grand Rapids 11/24/2010 MDHHS-OIG 5/23/2016 MDHHS-OIGSuspended Terminated

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Kentwood Pharmacy Pharmacy 1841446192 Shepherd 11/24/2010 MDHHS-OIG 5/23/2016 MDHHS-OIGSuspended Terminated

Kentwood Pharmacy Pharmacy 1548426992 Alma 11/24/2010 MDHHS-OIG 5/23/2016 MDHHS-OIGSuspended Terminated

Kentwood Pharmacy Pharmacy 1760638019 Saint Louis 11/24/2010 MDHHS-OIG 5/23/2016 MDHHS-OIGSuspended Terminated

Kirk Anthony DPM PC Group 1578872438 Grand Rapids 7/18/2013 DCH-OIG Suspended

Krish Pharmacy Inc Pharmacy 1871698266 Chesterfield 7/30/2013 DCH-OIG 5/18/2016 MDHHS- OIG

Summarily Suspended Terminated

LFC Pharmacy LLC Kazan Chadi Pharmacy 1548890684 Dearborn 5301012212 11/24/2021 MDHHS-OIGSummary Suspension

L & L Nursing Center, Inc. Nursing Facility Detroit 83430 10/8/1998

MI-Licensing and Regulatory Affairs

License Revocation

Lake MI Doctors Housecalls (D/B/A Lake MI Mobile Doctors, P.C) Group 1700950607 Southfield 12/3/2013 DCH-OIG

Summary Suspended

Lakeshore Diagnostic Ultrasound Group 1598746919 Essexville 11/8/2019 HHS-OIG Excluded

Lansing Podiatry PLLC Group 1730550138 East Lansing 7/12/2022 MDHHS-OIG

Suspended and terminated

LaSalle Nursing Home Nursing Facility Detroit 83453 11/14/2003

MI-Licensing and Regulatory Affairs

License Revocation and decertification

Liberty Express Care Group 1508066036 Saginaw 12/5/2016 MDHHS-OIG 2/9/2017 Summary Suspension

Life Care Sleep & Health Center LLC Group 1477584688 Lansing 7/16/2018 MDHHS-OIG 8/15/2018 MDHHS-OIG

Summary Suspension Terminated

Life Transition Services LLC Group 1760876825 Clinton Township 6/29/2022 MDHHS-OIGSummary Suspension

Litchfield Nursing Centre Nursing Facility Litchfield 5/4/2007 HHSDecertification

LiteMed Rx Inc Pharmacy 1457774366 Garden City 5301010314 2/4/2017 HHS RevokedLittle Traverse Bay Family Medicine Group 1417136425 Petosky 3/16/2015 DCH-OIG Terminated

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Livernois Family Medical Service Group 1417985441 Livernois 4/6/2015 DCH-OIG 6/2/2016 MDHHS-OIG

Summary Suspension Termination

Livernois Family Pharmacy Pharmacy 1790866416 Detroit 5301007422 8/26/2014 DCH-OIG Suspended

Livestrong Pharmacy Pharmacy 1275925950 Detroit 12/25/2017 MDHHS-OIG 4/21/2022 MDHHS-OIG

Summary Suspension Terminated

Livonia Care Pharmacy Pharmacy 1942560529 Port Huron 5301009802 1/25/2018 MDHHS-OIGSummary Suspension

Madison Pharmacy Inc Pharmacy 1790961118 Madison Heights 5301009979 8/9/2017

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Mancewicz & White DDS, PC Dental Group Grand Rapids 6/20/2002 HHS 1128(a)(1)

Medaplex Dental Center Dental Group 1326343542 Oak Park 1/18/2017 MDHHS-OIG 6/15/2018 MDHHS-OIG

Summary Suspension Terminated

Metric Lab Services LLC Laboratory 1699287300 Ridgeland, MS 5/15/2021 MDHHS Terminated

Metro Mobile Physicians Group 1962704239 Ferndale 7/13/2016 MDHHS-OIG 9/30/2019 MDHHS-OIG

Summary Suspension Termination

Michigan Brain and Spine Ohysicians Group, PLLC Group 1760771117 Southfield 3/10/2015 DCH-OIG 4/26/2017 MDHHS-OIG

Summary Suspension Terminated

Michigan Diagnostic Services Inc. Group 1497923858 Bloomfield Hills 10/8/2018 MDHHS-OIG 11/7/2018 MDHHS-OIG

Summary Suspension Terminated

Midwest Family Diagnostics PLC Group 1184952053 Warren 7/3/2013 DCH-OIG 5/5/2016 MDHHS-OIGSuspended Terminated

Midwest Family Practice PLC Group 1770819864 Warren 7/3/2013 DCH-OIG 5/5/2016 MDHHS-OIG

Summary Suspension Terminated

Midwest Prostate & Urological Institute Group 1508834755 Saginaw 2/13/2017 MDHHS-OIG 8/31/2018 MDHHS-OIG

Summary Suspension Terminated

Millner, Joel A MD PC Medical Group 1265715700 Ferndale 6/20/2014 DCH-OIGSummary Suspension

Monroe Geriatric Evaluation and Management Services PLLC Group 1215117023 Monroe 3/21/2013 DCH-OIG 11/13/2018 MDHHS-OIG

Summary Suspension Terminated

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Monroe Medical Clinic PLLC Group 1972699312 Durand 9/18/2013 DCH-OIG

Summary Suspension/Termination

Moss, David M., DPM, PC Group Garden City 8/20/2003 HHS 1128(a)(1)

Mykal Discount Pharmacy Pharmacy 1043549223 Detroit 5301009264 3/18/2011 DCH 7/11/2016 MDHHS-OIG

Summary Suspension Termination

MyKal Discount Pharmacy #2 Pharmacy 1780992750 Pontiac 5301009423 3/18/2011 DCH 7/11/2016 MDHHS-OIG

Summary Suspension Termination

My Visiting Physicians PC Group 1740512201 Southfield 1/16/2013 DCH-OIG

Summary Suspension/ Termination

Nat Lab Laboratory 1861934168 Detroit 12/25/2017 MDHHS-OIG 4/21/2022 MDHHS-OIG

Summary Suspension Terminated

National Laboratories Inc Laboratory 1144645235 Detroit 12/25/2017 MDHHS-OIG 4/21/2022 MDHHS-OIG

Summary Suspension Terminated

Neurology Michigan PC Group 1336406552 Wyandotte 7/21/2022 MDHHS-OIG TerminatedNever Give Up Hope Counseling Service PLLC Group 1598220204 Roseville 5/4/2022 MDHHS-OIG

Summary Suspension

New Center Medical PC Group 1316482870 Detroit 12/18/2017 MDHHS-OIGSummary Suspension

New Era Alternative Treatment Center, Inc. (NEAT) SA Treatment Flint 50219 9/20/2001 HHS

New Era Alternative Treatment Center, Inc. (NEAT) SA Treatment Highland Park 21310 9/20/2001 HHS

New Millenium Drugs LTC Pharmacy 1609881259 Inkster 5301008540 5/3/2022 MDHHS-OIGSummary Suspension

Northside Medical Clinic PC Group 1841357464 Cheboygan 4/4/2016 MDHHS-OIG 1/10/2019 MDHHS-OIG

Summary Suspension Terminated

Northwest Industrial & Medical Services PC Group 1346364619 Detroit 7/3/2013 DCH-OIG SuspendedNottingham Pharmacy Pharmacy 1730209743 Detroit 5301005956 8/5/2020 MDHHS-OIG Suspended

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Omega Pharmacy Pharmacy 1508299710 Pontiac 5301010143 2/21/2016

MI-Licensing and Regulatory Affairs Suspended

One on One Care LLC Group 1871997775 Warren 10/15/2017 MDHHS-OIG 10/31/2019 MDHHS -OIG

Summary Suspension Terminated

One Step At A time Counseling Services Inc Grou[ 1447686910 Roseville 5/4/2022 MDHHS-OIG

Summary Suspension

Open Heart Community Care Services Inc Group 1972971216 Roseville 3/12/2022 MDHHS Terminated

OURLAB Laboratory 1760461909 Nashville, TN 11/25/2013 State of TN

Suspended/debarred from state of TN

Oval Dental Dental Group 1215476387 Westland 12/19/2018 MDHHS-OIG 8/7/2020 MDHHS

Summary Suspension Terminated

Park Dental of Okemos P.C. Dental Group 1477890689 Okemos 7/6/2016 MDHHS-OIGSummary Suspension

Park Medical Clinic PC Medical Group Troy 7/29/1997 HHS 1128(a)(1)

Patient Choice Internal Medicine Group 1396094926 Detroit 7/13/2016 MDHHS-OIG 9/30/2019 MDHHS-OIG

Summary Suspension Termination

Peaceful Surroundings Group 1346806940 Detroit 7/20/2022 MDHHS-OIGSummary Suspension

Peaceful Surroundings Group 1225601032 Detroit 7/20/2022 MDHHS-OIGSummary Suspension

People Pharmacy LLC Pharmacy 1720121668 Detroit 5301008586 11/20/2018

MI-Licensing and Regulatory Affairs 6/11/2019 MDHHS-OIG

Summary SuspensionSummary Suspension

Peoples Pharmacy Corp Pharmacy 1255655130 Detroit 5315044450 10/14/2015

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Personal Angels Advocates LLC Home Help Agency Eastpointe 5/27/2020 MDHHS-OIGSummary Suspension

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Phoenix Visiting Physicians PLLC Group 1235458217 Livonia 5/29/2012 DCH-OIGSummary Suspension

Pickens, Alex M.D.P.C. Group 1952529091 Detroit 8/23/2017 MDHHS-OIGSummary Suspension

Pondview Personal Physician PC Group 1245430230 Madison Heights 11/14/2017 MDHHS-OIG 4/15/2022 MDHHS-OIG

Summary Suspension Terminated

Precare Pharmacy Pharmacy 1346686854 Redford 5301010095 6/27/2018 MDHHS-OIG 4/29/2022 MDHHS-OIG

Summary Suspension Terminated

Preferred Home Health Care Inc Home Health Agency 1801871496 Mount Clemens 237457 7/30/2013 DCH-OIG Suspended

Preferred Pharmacy Pharmacy 1669616785 Troy 8/30/2011 DCH-OIG 5/25/2016 MDHHS-OIG

Summary Suspension Terminated

Preferred Pharmacy Pharmacy 1922322007 Troy 8/30/2011 DCH 5/25/2016 MDHHS-OIG

Summary Suspension Termination

Premier Medical Center PLLC Group 1659631265 Warren 7/3/2013 DCH-OIG 5/5/2016 MDHHS-OIGSuspended Terminated

Preserve Independence Group 1831658541 Warren 7/8/2022 HHS Terminated

Princes Pharmacy Pharmacy 1063872034 Lincoln Park 5301010886 11/18/2021

Mi- Licensing and Regulartory Affairs Suspended

Professional Consultants, Inc Group 1063578045 Bloomfield Hills 3/11/2015 DCH-OIG 4/4/2022 MDHHS-OIG

Summary Suspension Terminated

Provider Service Organization Group 1447610704 Canton 5/8/2021 MDHHS TerminatedQandil Family Medical and Urgent Care PLLC Medical Group 1013149616 Hamtramck 1/15/2013 DCH-OIG

Summary Suspension

Riverside Professional Drugs Inc. Pharmacy 1720196181 Trenton 5/15/2013

MI-Licensing and

Regulatory Affairs

Summary Suspension

Rizwan Qadir MD PC Medical Group 1003095043 Detroit 7/29/2015 MDHHS-OIGSummary Suspension

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Rockafellow Psychological Services Group 1538444930 Oxford 7/6/2016 MDHHS-OIG 1/10/2019 MDHHS-OIG

Summary Suspension Terminated

Roth, Michael A MD PC Group 1831190917 Farmington Hills 8/9/2016 MDHHS-OIG 8/31/2018 MDHHS-OIG

Summary Suspension Terminated

Rosewood Living Center Nursing Facility Detroit 83447 8/14/2003

MI-Licensing and Regulatory Affairs

License revocation and summary suspension

Saab Drugs, Inc. Pharmacy 1538260633 Livonia 5301007790 6/18/2009 HHS 1128(a)(4)

Saab Drugs, Inc.Pharmacy/Medical Supplier 1538260633 Farmington Hills 5301007790 6/18/2009 HHS 1128(a)(4)

Saginaw Valley Medical Center Group 1184146581 Saginaw 6/30/2022 MDHHS-OIGSummary Suspension

Sav-Max Pharmacy Pharmacy 1750346557 Detroit 7/30/2013 DCH-OIG Suspended

Serv-U-Well Pharmacy Pharmacy 1275544785 Detroit 8/11/2015

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Shelby Dental Center PC Dental Group 1154626687 Shelby Township 1/18/2017 MDHHS-OIG 6/15/2018 MDHHS-OIG

Summary Suspension Terminated

SKA at Home Visting Doctor PC Group 1043507379 Albion 7/3/2013 DCH-OIG 0/12/2016 MDHHS-OIGSuspended Terminated

Sleep Diagnostics of Michigan PC Group 1407827900 West Branch 7/16/2018 MDHHS-OIG 8/15/2018 MDHHS-OIG

Summary Suspension Terminated

Soliman Medical Center PLLC Group 1952503559 Wayne 7/3/2013 DCH-OIG SuspendedSoliman Medical Center PLLC Group 1619946043 Wayne 7/3/2013 DCH-OIG SuspendedSomewere to Go Something to Do Adult Day Care LLC Group 1467853754 Lathrup Village 6/28/2019 MDHHS Terminated

Southwest Discounty Pharmacy Pharmacy 1578690186 Detroit 5301008142 6/13/2018

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Southwest Visiting Physicians Group 1881868685 Warren 12/29/2015 MDHHS-OIG Terminated

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Spectrum Diagnostice Lab LLC Laboratory 1497173348 Arlinton, TX 45D2081429 5/8/2021 MDHHS TerminatedSumpter Integrated Healthcare Clinic PLLC Group 1639734957 RiverRouge 5/4/2022 MDHHS-OIG

Summary Suspension

Sunrise Pharmacy Pharmacy 1457996662 Detroit 5301012190 8/5/2020 MDHHS-OIG Suspended

Super Mart Pharmacy Pharmacy 1124322128 Detroit 5301009405 3/14/2018

MI-Licensing and Regulatory Affairs

Summary Suspension

Symed IncMedical Supply Company 1548341217 Chicago, IL 2/4/2022 SAM Suspended

Synergy Pharmacy Pharmacy 1932601317 Detroit 5301011166 8/5/2020 MDHHS-OIG Suspended

Synergy Home Services Corporation

Saunders-Davenport Khadisha Home Help Agency Southfield 3/30/2021 MDHHS-OIG 4/1/2022 MDHHS-OIG

Summary Suspension Termination

Taylor Medical and Substance Abuse Clinic Group 1386974335 Taylor 7/3/2013 DCH-OIG 4/15/2014 DCH-OIG

Suspended/Terminated

Tower Dental Care Group 1306019609 Detroit 2/18/2010 HHS 1128(b)(8)

Tri County Physician Group Group 1386942035 Detroit 2/7/2017 MDHHS-OIG 12/18/2017 MDHHS-OIG

Summary Suspension Summary Suspension

Tri State Physicians Group PC Group 1033654595 Detroit 11/12/2017 MDHHS-OIGSummary Suspension

Trust Care Clinic PLLC Group 1053461848 Davison 6/18/2015 DCH-OIG Suspended

Tein Cities Nursing & Rehab LLC Nursiong Facility 1316541048 Benton Harbor 235544 9/10/2022 Medicare Terminatd

United Family Care Group 1164756417 Hamtramck 2/14/2022 MDHHS-OIGSummary Suspension

Universal Grace Pharmacy Pharmacy 1417328436 Warren 5301010751 11/9/2020 MDHHS-OIGSummary Suspension

Universal Home Medical Equipment & Supplies LLC Supplier 1730334939 Livonia 4/26/2016 CMS Revoked

Universal Pharmacy Pharmacy 1700057726 Warren 5301008817 11/9/2020 MDHHS-OIGSummary Suspension

Universal Pharmacy of Saginaw Pharmacy 1568868305 Saginaw 5315068278 4/11/2018

MI-Licensing and Regulatory Affairs

Controlled Substance license suspended

University Pediatricians Group 1124265335 Detroit 8/15/2022 MDHHS-OIG Terminated

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Urban Health Care Group PLLC Group 1629449152 Southfield 8/15/2018 MDHHS-OIG 9/14/2018 MDHHS-OIG

Summary Suspension Terminated

Venoy Nursing Center Nursing Facility Wayne 5/6/1998

MI-Licensing and Regulatory Affairs

Licensing Revocation and Summary Suspension

Venus Pharmacy Inc Pharmacy 1629469036 Battle Creelk 5301011019 1/15/2022

Mi- Licensing and Regulartory Affairs Revoked

Vernor MC Inc Medical Group 1871720342 Detroit 4/15/2020 MIDHHS-OIG TerminationVinay Malviya MD PC Medical Goup 1831611870 Southfield 4/6/2022 HHS-OIG Suspended

Vinsons Home Help LLC Home Help Agency Southfield 11/24/2021 MDHHS-OIGSummary Suspension

Visiting Doctors of America PC Group 1659519981 Southfield 7/30/2013 DCH-OIG 11/13/2018 MDHHS-OIGSuspended Terminated

Vital Pharmacy Pharmacy 1801947791 Dearborn Heights 5301005762 3/15/2019

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Waren Family Pharmacy LLC Pharmacy 1891337804 Warren 5310012441 11/23/2021 MDHHS-OIGSummary Suspension

Washington Blvd. Dental PC Dental Group Detroit 8/31/2007 HHS 1128(a)(1)

Wayne Campus Pharmacy Pharmacy 1760767974 Detroit 11/4/2020 MDHHS-OIGSummary Suspension

Wayne Pharmacy Pharmacy 1235437807 Detroit 8/30/2011 DCH 7/11/2016 MDHHS-OIG

Summary Suspension Termination

Wellspect HealthcareMedical Supply Company 1740581461

Waltham, Massachusetts 6532080001 9/10/2022 Medicare Terminated

Western Wayne Pharmacy Pharmacy 1962850248 Inkster 531010913 4/12/2022 MDHHS-OIGSummary Suspension

Women's Health Care Specialist PC Medical Group 1447479977 Kalamazoo 7/9/2020 MDHHs-OIG Terminated

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Woodward Nursing Center Nursing Facility Detroit 9/20/2004

MI-Licensing and Regulatory Affairs

Involuntary Termination

Woodward Urgent Care PLLC Medical Group 1861746893 Detroit 7/28/2015 MDHHS-OIGSummary Suspension

World Health Care MC LLC Group 1952565160 Detroit 3/21/2013 DCHSummary Suspension

Wyoming Discount Pharmacy Inc Berri Youseff Pharmacy & Owner 1013322353 Detroit 5301010556 10/4/2021 MDHHS-OIGSummary Suspension

Young RehabCo PC DBA Okemos Therapy Services Group 1033225842 Okemos 10/1/2019 MDHHS-OIG

Summary Suspension

Zagerman Enterprises, Inc. Group Grandville 10/19/2005 DCH-OIG Suspended

Aagesen Larry K Dentist 1063572667 Bad Axe 2901009390 7/13/2013

MI-Licensing and Regulatory Affairs Suspended

Abcumby Keshuna Home Help Auburn Hills 8/21/2017 MDHHS

Abdaal John Home Help Commerce Township 10/30/2018 MDHHS

Wayne Campus Pharmacy Abdallah Hassan Pharmacy 1760767974 Detroit 11/4/2020 MDHHS-OIGSummary Suspension

Abdallah Hassan Pharmacist 1669594099 Detroi 11/4/2020 MDHHS-OIGSummary Suspension

Ark Pharmacy Abdelrazzaq Ali Pharmacy 1932502283 Detroit 11/3/2020 MDHHS-OIGSummary Suspension

Sav-Max PharmacyAbuhaniehRifai

IsmailMahmoud Pharmacy 1982930954 Detroit 5301009202 7/15/2019 MDHHS-OIG

Summary Suspension

Ackerman Jr Robert A Physician 1487630075 North Muskegon 4301077358 5/18/2016

MI-Licensing and Regulatory Affairs

Summary Suspension

Acree Freeman Home Help Jackson 3/8/2022 MDHHSAdams Amy Home Help Mount Morris 6/24/2015 DCHAdams Angela Home Help Detroit 7/24/2017 MDHHSAdams Donald Lee Home Help Benton Harbor 11/30/2015 MDHHSAdams Jamal Home Help Detroit 7/6/2017 MDHHSAdams Kenneth Home Help Detroit 3/4/2019 MDHHSAdams Kim Home Help Detroit 2/27/2019 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Adams Nanette D Home Help Grand Rapids 7/1/2022 MDHHS

Addison ReginalsNon-Emergency Transportation Detroit 12/12/2017 MDHHS

Crownz Medical Pharmacy Adepoju Adeniyi Pharmacy 1588121875 Warren 5301011544 8/11/2020 MDHHS-OIG

Summary Suspension and Termination

Adray Allie A. Chiropractor Dearborn 2301006500 7/4/1996 DCH-OIG 1128(b)(14)

Adu-Beniako Solomon Physician 1114090511 Livonia 4301084828 5/5/2019

MI-Licensing and Regulatory Affairs Suspended

Agbebiyi Jonathon A Physician 1588734081 Southfield 4301041053 1/16/2013 DCH-OIGSummary Suspension

Ahmad Anas Physician 1740595735 East Grand Rapids 4301097387 5/9/2019

MI-Licensing and Regulatory Affairs

Summary Suspension

Ahmed Asm Akter Physician 1053475814 Hamtramck 4301073086 5/23/2018 MDHHS-OIGSummary Suspension

Ahmed Syed Arif Physician Marlette 7/22/1991 HHS 1128(b)(4)

Akinwumi Abbey A Physician 1144244708 Detroit 4301071164 7/30/2013 DCH-OIG

11/16/2016 11/29/2016 03/31/2017 10/31/2019

MI- Licensing and Regulatory Affairs MI- Licensing and Regulatory Affairs HHS MDHHS-OIG

Suspended Suspended Summary Suspended Excluded Terminated

Akra Darren Home Help Detroit 10/25/2018 MDHHSAkram Aleem Home Help Detroit 6/6/2019 MDHHS

Akram Imran Physician 1740808690 Flint 4351046451 7/5/2022

MI-Licensign and regulatiry Affairs

Summary Suspension

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Alagbe Rosy U. Registered Nurse 1952428179 Grove City, OH 4704281554 6/2/2012

MI-Licensing and Regulatory Affairs Suspended

Alajrad Muhannad Physician Trenton 4301061516 5/6/1997 HHS 1128(b)(4)

Alam Waseem Physician 1477571818 Bloomfield Hills 4301072403 7/29/2015 MDHHS-OIG

08/02/2017 9/20/2017 2/12/1811/8/18

MI- Licensing and Regulatory Affairs HHS-OIG MI-Liceneing and Regulatory AffairsMDHHS-OIG

Summary Suspension Summary Suspension Excluded Revoked Terminated

Alexander Robert L Physician 1265475099 Plainwell 4301044385 11/22/2014

MI-Licensing and Regulatory Affairs

Summary Suspension

Alexander Sharon Denise Home Help Detroit 3/31/2015 DCHAlexander Ulysses D Home Help Detroit 5/17/2022 MDHHS

Al-Falahat Nihad Home Help Shelby Township 10/8/2018 MDHHS-OIGSummary Suspension

Ali Sekne Home Help Dearborn 4/25/2019 HHS-OIGAlizada Sean Home Help East Lansing 8/6/2018 MDHHS

Allard Raymond P Physician 1093702607 Sherdian 5101011651 6/24/2020

MI-Licensing and Regulatory Affairs

Summary Suspension

Allen Alicia Home Help Detroit 12/22/2015 MDHHS

All About Chores LLC Allen Gary L Home Help Agency Southfield 3/20/2019 MDHHS-OIGSummary Suspension

Allen Janice Home Help Nashville 5/8/2018 MDHHSAllen Lester Home Help Detroit 3/22/2022 MDHHSAllen Robert Home Help Detroit 2/22/2016 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Allende-Jimenez Norberto Physician 1285723809 Detroit 4301061931 10/23/2019

MI-Licensing and Regulatory Affairs

Summary Suspension

Allie Christopher Home Help Detroit 5/25/2021 MDHHSAllos Najim Home Help Sterling Heights 11/8/2018 MDHHSAlmon Douglas Home Help Novi 1/7/2021 MDHHS

Al-Murisi Verna Home Help Hamtramck 7/13/2016 MDHHS-OIG3/10/20176/29/2017

MDHHS-OIG HHS-OIG

Summary Suspension Terminated Excluded

Alshaikh Nida Dentist 1144407552 Hamtramck 2901018547 12/19/2018 MDHHS-OIG

7/31/2019 01/20/2020 08/07/2020

MI-Licensing and Regulatory Affairs MDHHS-OIG HHS-OIG MDHHS-OIG

Summary SuspensionSuspended Excluded Terminated

Alston Nathan Home Help Mount Pleasant 10/5/2021 MDHHSAlston Jerome Home Help Lansing 3/15/2022 MDHHS

Alt Nan B. Psychiatrist 1417139692 White Cloud 4301045669 7/18/2013 DCH-OIG 9/16/2012 01/20/2016

MI-Licensing and Regulatory Affairs HHS-OIG

Suspended Suspended Excluded

Alt William J Physician 1912998337 Holland 4301020997 7/18/2013 DCH-OIG1/20/2016 12/29/2016

MI-Licensing and Regulatory AffairsHHS-OIG

Suspended Suspended Terminated

Altantawi Bassel Physician 1497797526 Canton 4301074111 6/20/2016 MDHHS-OIG

2/9/2017 08/20/2017 01/18/2021

MI-Licensing and Regulatory Affairs HHS MDHHS-OIG

Summary Suspension Summmary Suspension Excluded Termination

Alwajed Zahra Home Help Detroit 9/25/2018 MDHHS-OIG

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Alyas Arkan Home Help Sterling Heights 4/11/2016 MDHHSAmerson Kevin Home Help Detroit 5/27/2015 DCH

U.S. Medical Supply, Inc. Amr Hussein M. Medical Supplier Livonia 11/5/2002 DCH 9/20/2004 HHS

11/5/02: Violation of Medicaid False Claim Act9/20/04: 1128(a)(1)

Andersen Judith C Physician 1073551198 Rochester 4301044420 6/22/2014

MI-Licensing and Regulatory Affairs Suspended

Anderson Connie Home Help Prescott 5/12/2016 MDHHSAnderson Coy Home Help Redford 5/24/2018 MDHHSAnderson Dantonetee Home Help Detroit 9/6/2016 MDHHSAnderson Gerald Home Help Detroit 9/21/2017 MDHHS

Anderson JuliusNon-Emergency Transportation Detroit 4/18/2018 MDHHS

Anderson Kelvin Lamont Home Help Detroit 3/24/2015 DCHAnderson Maurcie Home Help Detroit 12/28/2016 MDHHSAnderson Paula Home Help Iron Mountain 1/8/2015 DCHAnderson Rose Home Help Muskegon 8/29/2019 MDHHSAndrews Christian Home Help Detroit 12/6/2017 MDHHSAndrews Glenn Walter Physician Detroit 4301407042 5/26/1997 HHS 1128(b)(4)Andrews Monda Home Help Ypsilanti 10/22/2018 MDHHSAndrews Quenta Home Help Grand Rapids 1/19/2016 MDHHSAndrews Wunika Kenyetta Home Help Detroit 11/30/2015 MDHHS

Ansari Inamul Hag Physician Detroit 4301044238 8/29/1993 HHS 10/11/1993 DCH

8/29/93: 1128(a)(1)10/11/93: Violation of Medicaid False Claim Act

Anthony Kirk J Podiatrist 1144330556 Grand Rapids 5901400050 5/25/2013

MI-Licensing and Regulatory Affairs 7/18/2013 DCH-OIG

Suspended Suspended

Anthony Tora Home Help Detroit 11/30/2015 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Antoin Firas Home Help Sterling Heights 4/8/2020 MDHHSAnuskziewicz Michael Home Help Port Huron 10/4/2016 MDHHSAranda Raul E. Physician Detroit 4301038425 3/15/1990 HHS 1128(b)(3)

Araujo MarioNon-Emergency Transportation Holland 7/20/2017 MDHHS

Archbold Donna Home Help Harrison 10/11/2018 MDHHS

Elite Wellness LLC AriasRaymond & Emelitza Physician Group 1174765515 Westland 5/29/2012 DCH 10/17/2013 DCH-OIG

Summary Suspension Termination

Armola Adam Home Help Alma 7/31/2018 MDHHSArmstead Candis Home Help Detroit 8/19/2019 MDHHSArmstead Cory Home Help Ypsilanti 11/20/2018 MDHHSArmstrong Clifford Home Help Warren 8/24/2020 MDHHSArnold Clifton Home Help Grand Rapids 3/18/2019 MDHHSArnold Pearl R Home Help Jackson 12/7/2020 MDHHS

Arnold William J. Physician Detroit 4301015572 9/19/200205/24/2012 04/07/2015

DCH-OIG DCH-OIG

11/28(a)(3) Summary Suspension Termination

Aronoff Joanne Medical Supplier Detroit 8/29/1994 4/10/1996

8/29/94: Violation of Medicaid False Claim Act4/10/96: 1128(b)(5)

Action Sales & Rental Company Aronoff Larry Medical Supplier Detroit 10/24/1989 HHS 1128Aa

Asbahi Mowafak S Physician 1295787687 Northville 4301033455 12/6/2021

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Asbury Arnita Home Help Eastpointe 2/9/2015 DCH

Access Care Home Care, Inc Ashford Falusic Patient Recruiter 1134174006 Ypsilanti 5/22/2012 DCHSummary Suspension

Acton Rental & Sales Company Ashford Falusic Employee Ypsilanti 5/22/2012 DCHSummary Suspension

Aslivio Rumel Home Help Sterling Heights 9/1/2022 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Ataya Hatem M Physician 1881664829 Davison 4301079461 6/18/2015 DCH-OIG

8/5/2015 10/30/2015 07/19/2017

MI-Licensing and Regulatory Affairs MI-Licensing and Regulatory AffairsHHS-OIG

Suspended Summary Suspension Summay Suspension Excluded

Atkins Irvin Home Help Grand Rapids 11/22/2016 MDHHS

Atluri Sunitha Physician Auburn Hills 4301062120 3/21/2007

MI-Licensing and Regulatory Affairs

License Suspended

Atri Manohar Physician 1346242591 Saginaw 4301406605 12/23/2019 MDHHS-OIG

Summary Suspension and Termination

Attanasio Franco A Physician 1760453930 Saint Clair Shores 4301057789 12/19/2019

MI-Licensing and Regulatory Affairs

Summary Suspension

Atwood Jessica L Home Help Ossineke 10/22/2021 MDHHS 5/5/2022 MDHHSAugust Jeffrey A. Podiatrist Clawson 5901001206 10/22/1991 HHS 1128(b)(4)Austin Madron Home Help Ypsilanti 8/1/2019 MDHHSAutman Nicole Home Help Jackson 10/26/2017 MDHHSAvant Edward Home Help Detroit 11/12/2019 MDHHS Terminated

Awada Sam- Hussein Physician 1811984594 Warren 4301079394 7/3/2013 DCH-OIG

1/21/2016 05/05/2016 06/20/2016

MI-Licensing and Regulatory Affairs MDHHS-OIG HHS

Suspended Summary Suspension Terminated Excluded

Awerbuch Gavin Physician 1811984487 Saginaw 4301405226 6/19/2014 DCH-OIG11/6/20184/18/2019

MDHHS-OIGHHS-OIG

Summary Suspension Terminated Excluded

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Maecenas Health Systems Awusah Solomon Group 1003155607 Southfield 8/14/2018 MDHHS-OIGSummary Suspension

Awusah Solomon Physician 1922245083 Southfield 4301093171 8/14/2018 MDHHS-OIGSummary Suspension

Ayers Antwone Home Help Roseville 2/3/2015 DCHBaber DeMarcus Home Help Saginaw 6/23/2016 MDHHS

Backos Eric Physician 1780625251 Warren 4301048249 1/2/2019 MDHHS-OIGSummary Suspension

Bacon Michael Physician 1912965799 Petoskey 5101006585 5/31/2019

MI-Licensing and Regulatory Affairs

Summary Suspension

Bailey Craig Physician 1619106119 Southfield 4301093034 8/23/2019

MI-Licensing and Regulatory Affairs Suspended

Bailey Melvina Home Help New Haven 1/20/2016 MDHHSBaker Carmen Vietta Home Help Detroit 11/30/2015 MDHHSBaker Marques Home Help Kalamazoo 12/19/2016 MDHHSBalakrishna Banga M. Physician Southfield 4301031899 5/18/2000 HHS 1128(a)(1)Baldwin Demarco Home Help Detroit 10/29/2018 MDHHSBaldwin Jr. Milton Home Help Essexville 9/21/2015 MDHHSBallard Carlton Home Help Kalamazoo 4/21/2016 MDHHSBallard Ebony Home Help Detroit 10/11/2018 MDHHSBanks Angela A Home Help Jackson 11/30/2015 MDHHSBanks Laron Home Help Southfield 7/3/2019 MDHHSBanks Nolan Home Help Detroit 12/16/2019 MDHHSBanks Willie Home Help Detroit 8/21/2019 MDHHSBankston Audrea Home Help Port Huron 1/14/2016 MDHHS

Bansal Sudha Physician 1922053008 Adrain 4301404631 3/17/2021

MI-Licensing and Regulatory Affairs

Disciplinary Limited

Bansil Chyawan K Physical Therapist 1306933908 Lansing 5501002045 3/18/2013 DCH Suspended Barbee Nicholas Home Help New Baltimore 1/23/2020 MDHHSBarclay Roy Home Help Detroit 11/7/2014 DCH

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Barden John H Physician 1669495446 Taylor 5101006701 6/3/2011

MI-Licensing and Regulatory Affairs Suspended

Bargouthy Sameer Home Help Bay City 5/13/2016 MDHHSBarlow Thomas Home Help Flint 11/8/2018 MDHHS

Mary E.Barna DPM & Assoc Barna Mary Medical Group 1598730962 Allen Park 1/19/2021 MDHHS-OIGSummary Suspension

Barna Mary Podiatrist 114295510 Allen Park 5901001379 560101/19/2021 MDHHS-OIGSummary Suspension

Barna Michael Physician 1508800194 4301051173 1/18/2021 MDHHS-OIG 3/25/2021

MI-Licensing and Regulatory Affairs

Summary Suspension Summary Suspension

Barnes Sterling Home Help Saginaw Arcadia 10/2/2018 MDHHSBarnes Terrell Home Help Detroit 4/20/2020 MDHHSBarnett Marshon Home Help Romulus 8/23/2018 MDHHSBarnett Wontoria Home Help Detroit 8/14/2018 MDHHS

Barney Gregory Therapist Niles 6401010818 11/3/2020 MDHHS-OIGSummary Suspension

Barrera Jesse M Home Help Muskegon 1/5/2016 MDHHSBarrett Althea Home Help Saginaw 7/6/2017 MDHHSBarteran Yvonne Home Help Oak Park 6/30/2021 MDHHS

Barth Timothy Paul Physician 1356512909 Southfield 4301049340 4/4/2017 MDHHS-OIG

9/28/2017 2/12/18 11/29/18

MI- Licensing and Regulatory Affairs MDHHS-OIG

Summary Suspension Revoked Terminated

bartholomai Tara D Home Help Swartz Creek 6/17/2022 MDHHSBartholomew Monica B Home Help Cedar Springs 5/27/2022 MDHHS

Bartz Nicholas William Physician Jackson 5101008283 4/27/2000 DCH 9/20/2000

4/27/00: Violation of Medicaid False Claim Act9/20/00: 1128(a)(a)

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Barudin Barry Physician 1528095585 Greenville 4301032178 11/16/2016

MI-Licensing and Regulatory Affairs Suspended

Bashir Javaid M Physician 1427071059 Jackson 4301047107 7/3/2013 DCH-OIG

12/8/2014 0219/2015 06/04/2015 04/10/2015

MI-Licensing and Regulatory Affairs HHS DCH-OIG MI-Licensing and Regulatory Affairs

Suspended Suspended Excluded- HHS Terminated Revoked

Bass Bernard A Home Help Detroit 11/30/2015 MDHHSBassett ANgela Home Help Detroit 12/23/2019 MDHHS

Bastow Bradley D Physician 1346221082 South Haven 5101008849 5/12/2017

MI-Licensing and Regulatory Affairs 10/4/2018

MI-Licensing and Regulatory Affairs

Summary Suspension Suspended

Bates sabrena Home Help Detroit 2/5/2018 MDHHSBattle Gail Home Help Detroit 8/6/2019 MDHHSBattle Lashannua S Home Help Detroit 4/27/2015 DCHBattle Robert Home Help Twin Lake 3/13/2019 MDHHS

Baul Terry Scott Physician 1942375837 Detroit 4301042171 12/2/2020 MDHHS-OIGSummary Suspension

Baxter Jermaine Home Help Detroit 1/17/2019 MDHHSBayless Jeffrey Home Help Detroit 11/8/2017 MDHHSBaysinger Christopher Home Help Ludington 2/16/2017 MDHHS

Bazo Charbal B Physician 1689643496 Port Huron 4301058428 4/5/2022 MDHHS-OIGSummary Suspension

Bazzi Chadi Pharmacist 1578096947 Hamtramck 5302031084 8/7/2018 MDHHS-OIGSummary Suspended

Better Care Neighborhood Pharmacy Bazzi Chadi Pharmacy 1891801890 Hamtramck 5301008106 8/7/2018 MDHHS-OIG

Summary Suspended

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Beale, Jr James Physician 1316934409 Southfiled 4301035963 5/22/2016

MI-Licensing and Regulatory Affairs Suspended

Beale, Jr Raymond Home Help Detroit 11/14/2016 MDHHSBean Dominique Home Help Detroit 10/13/2014 DCHBeard Rodney Home Help Detroit 3/23/2015 DCHBeard Tanya Home Help Detroit 12/20/2017 MDHHSBearden Michael Home Help Detroit 8/17/2017 MDHHSBearden Tiffany Home Help Roseville 8/28/2017 MDHHSBeasley Jermaine Home Help Belleville 10/5/2017 MDHHSBeasley Rogers Home Help Detroit 10/13/2017 MDHHS

Beck Lori A Nurse Practitioner 1164400917 Clyde Township 4707190306 7/14/2022

MI-Licensing and Regulatory Affairs

Summary Suspended

Bedell Michael Home Help Detroit 8/30/2018 MDHHSBeebe Michael Home Help Marion 4/25/2018 MDHHSBeech Melvin Home Help Grand Rapids 7/27/2016 MDHHSBeecham Paula Home Help Detroit 11/12/2014 DCH

Afzal Beemath MD PC Beemath Afzal Group 1972946580 Lathrup Village 11/27/2018 MDHHS-OIGSummary Suspension

Beemath Afzal Physician 1427226737 Lathrup Village 4301085743 11/27/2018 MDHHS-OIG 2/27/2020

MI-Licensing and Regulatory Affairs

Summary Suspension Suspended

Beemon Vickie Home Help Saginaw 8/19/2022 MDHHS

Behnan Richard A Podiatrist 1306924337 Clarkston 5901001092 3/25/2013 DCHSummary Suspension

Belcher Brandy Home Help Port Huron 9/17/2020 MDHHSBelin Jason C Home Help Greenville 3/28/2022 MDHHSBell Deangelo Home Help Flint 11/19/2015 MDHHSBell James E Home Help Benton Harbor 3/23/2015 DCHBell Omar Home Help Detroit 5/7/2018 MDHHS

Bell Sarah Counselor 1548607187 Linden 6401012946 07/24/20221

MI-Licensing and Reguilatory Affairs

Discilplinary Limited License

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Bellamy Emmanuel Home Help Southfield 1/19/2016 MDHHSBellamy Herbert Home Help Sterling Heights 11/30/2015 MDHHSBelling Angela M Home Help Menominee 1/19/2022 MDHHS

Bellinger Thomas M Physician 1457316655 Freeland 4301406493 5/10/2015

MI-Licensing and Regulatory Affairs

Summary Suspension

Bellman Galen Home Help Vassar 9/10/2018 MDHHSEaton Manor, Inc Benisatto Salvatore D. Nursing Facility Charlotte 7/20/2004 HHS 1128(a)(1)

Benjamin Corncella Home Help Kalamazoo 1/26/2021 MDHHS

Bennett Chas Chiropractor 1063423671 Kawkawlin 2301009215 4/27/2020 MDHHS-OIG

Summary Suspension and Termination

Bennett Derek K. Private Duty Nurse 1770022873 Highland Park 4704180735 2/21/2020

MI-Licensing and Regulatory Affairs Suspended

Inkster Pharmacy Bennett Donald J. Pharmacy Inkster 5301004725 1/24/1994 DCH 8/10/1994

1/24/94: Violation of Medicaid False Claim Act8/10/94: 1128(a)(1)

Bennett TaraNon-Emergency Transportation Kincheloe 6/8/2017 MDHHS

Benson AnthonyNon-Emergency Transportation Adrian 8/15/2019 MDHHS

Benson Arthur Home Help Lansing 4/27/2021 MDHHSBentley Melvin Home Help Detroit 12/5/2017 MDHHSBeothers Melinda Home Help Melvindale 9/16/2019 MDHHS-OIGBerbaum Gerald L. Chiropractor Brighton 2301002246 5/20/2001 HHS 1128(a)(3)

Bergman Gary D Physician 1740272061 Farmington Hills 4301024824 5/18/2016

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Bergman Steven Paul Physician 1699739177 Caledonia 5101008850 10/3/2008

MI-Licensing and Regulatory Affairs

Summary Suspension

Bergran Harvey A. Physician Muskegon 5101005122 6/28/1992 HHS 1128(b)(3)Berk Richard I. Podiatrist Ann Arbor 5901001060 11/7/2000 HHS 1128(b)(4)

Conant Plaza Pharmacy LLC Berri Samir R Pharmacy 1437202587 Detroit 5301007843 5/22/2018 MDHHS-OIGSummary Suspension

Buckley's Pharmacy 103BerriCole

SamirAnthony Pharmacy 1902148356 Warren 5301010625 5/22/2018 MDHHS-OIG

Summary Suspension

Buckley's Pharmacy 104

BerriColeHamka

Samir Anthony Ghassan Pharmacy 1922421528 Detroit 5301010311 5/22/2018 MDHHS-OIG

Summary Suspension

Buckley's Pharmacy 102

BerriColeRahman

SamirAnthonyShamimur Pharmacy 1962764506 Hazel Park 5301009840 5/22/2018 MDHHS-OIG

Summary Suspension

Buckley's Pharmacy 105

BerriColeRahman

SamirAnthonyShamimur Pharmacy 1861882599 Warren 5301010625 5/22/2018 MDHHS-OIG

Summary Suspension

Berro Moneach R Physical Therapist 1184026049 Jerome 5501010919 11/22/2021

MI-Licensing and Regulatory Affairs

Summary Suspension

Berry Alphonso Physician 1770553521 Farmington Hills 4301053422 7/30/2013 DCH-OIG5/18/201710/29/2018

HHSMDHHS-OIG

Suspended ExcludedTerminated

Berry Corinthian Home Help Detroit 11/5/2015 MDHHS

Beseau Catherine Rebecca Physician 1194820068 Union Lake 4704226477 5/14/2009

MI-Licensing and Regulatory Affairs Suspended

Besemer Mikelle Home Help Cedar Springs 2/3/2015 DCHBessey Vicki Jo Home Help Grand Rapids 11/5/2014 DCH

Betro Jospeh Physician 1326026006 Novi 5101009687 10/15/2017 MDHHS-OIG4/5/2022 04/07/2022

MDHHS-OIG MI_Bureau of Licensing and regulatory Affairs

Suspended Terminated Summary Suspension

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Beyer Rogers Physician 1295718138 PawPaw 4301046890 2/6/2020

MI-Licensing and Regulatory Affairs 7/9/2020 MDHHS-OIG

Limited License Terminated

Bhargava Ajay Physical Therapist 1669588018 Okemos 5501005343 10/1/2019 MDHHS-OIGSummary Suspension

Biddles Marquis R Home Help Detroit 2/25/2021 MDHHSBigham Brian Home Help Muskegon 8/16/2021 MDHHS

Bilani Sami Suheil Dentist 1821140187 Hamtramck 290116822 4/12/2001 DCH 9/20/2001

4/12/01: Violation of Medicaid False Claim Act9/20/01: 1128(a)(1)

Bilani, Sami S., DDS, PC (aka Family Dentist PC) Bilani Sami Suheil Dental Group Hamtramck 4/12/2001 DCH 9/20/2001

4/12/01: Violation of Medicaid False Claim Act9/20/01: 1128(a)(1)

First Care Hamtramck Dental PC Bilani Sami Suheil Dental Group Hamtramck 4/12/2001 DCH 9/20/2001

4/12/01: Violation of Medicaid False Claim Act9/20/01: 1128(a)(1)

Billups Sherman Home Help Oak Park 5/22/2017 MDHHS

Bischoff William H. Chiropractor Fenton 2301002126 12/22/1991 HHSLicense Revocation

Bivens Dontae Home Help Detroit 11/14/2016 MDHHSBlack Andrea Home Help Detroit 2/3/2016 MDHHSBlack Arvin D Home Help Dowagiac 3/6/2015 DCHBlack Christopher Home Help Inkster 5/30/2019 MDHHSBlack Ebony Home Help Grandville 1/20/2021 MDHHSBlack Kakeshia Home Help Detroit 11/7/2019 MDHHSBlack Lawrence Home Help Detroit 5/19/2015 DCH

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Rehabilitative Counseling and Behavioral Black Regina Group 1366785032 Clinton Township 5/22/2020 MDHHS-OIG 4/8/2022 MDHHS-OIG

Summary Suspension Terminated

Black Tasha Home Help Kalamazoo 11/30/2015 MDHHSBlackbey Anthony Home Help Detroit 12/4/2018 MDHHSBlackburn Patricia Ann Home Help Port Huron 6/2/2015 DCHBlackmon Kariaba Home Help Muskegon 8/11/2015 MDHHSBlackshear Jameel Home Help Detroit 3/7/2019 MDHHSBlair Patrick E Home Help Niagara 2/5/2015 DCHBlakeley Courtney Home Help Grand rapids 8/2/2017 MDHHSBlakney Donald William-Ch Home Help Vermontville 4/10/2015 DCHBlanding Richard L. Dentist 1760665806 Detroit 2901010938 7/3/1988 HHS 1128(a)(1)Bledsoe Dayon Home Help Pontiac 3/22/2017 MDHHSBlevins Michael Home Help Grand Rapids 11/29/2018 MDHHSBlunt Darron Home Help Detroit 3/27/2019 MDHHS

Bobb-Semple HubertPodiatrist/Medical Supplier Highland Park 5901000976 11/12/1990 DCH

Violation of Medicaid False Claim Act

Body Tony Home Help Detroit 7/23/2019 MDHHS-OIG 8/22/2019 MDHHS-OIG

Summary SuspensionTerminated

Boggon Taryn Home Help Detroit 6/21/2016 MDHHSBohn Lindsey Home Help Port Huron 2/18/2016 MDHHS

Ashok Boinpally MD PC Boinpally Ashok Group 1871668392 Detroit 4/1/2019 MDHHS-OIG 8/7/2020 MDHHS-OIG

Summary Suspension Teminated

Boinpally Ashook Physician 1255421384 Detroit 4301055363 4/1/2019 MDHHS-OIG 8/7/2020 MDHHS-OIG

Summary Suspension Terminated

Bolton Dennis Home Help Dearborn Heights 3/27/2015 DCHBonds Rashimme Omar Home Help Pontiac 11/20/2014 DCHBonner Sirece Home Help Detroit 11/5/2014 DCHBonney Connell Home Help Detroit 8/8/2018 MDHHSBooker Earl Home Help Wyoming 2/27/2019 MDHHSBoone Jovan Home Help Detroit 10/3/2018 MDHHSBoone Terrance Home Help Kalamazoo 8/29/2019 MDHHS

Bosley Crystal Home Help Saginaw 7/18/2016 MDHHS-OIG6/15/178/31/17

MDHHS-OIGHHS-OIG

Summary Suspension Terminated Excluded

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Bosquez Gina Home Help Pontiac 4/27/2020 MDHHS-OIG 11/18/2021 hhs-oig

Summary Suspension Excluded

Bossenbery Stephen Physician 1487680302 Grand Rapids 4301087079 7/15/2013

MI-Licensing and Regulatory Affairs Suspended

Bowden Valerie Home Help Detroit 3/30/2015 DCH

Bowers Philip CRNA 1376672527 Huntington woods 4704156709 1/12/2017

MI-Licensing and Regulatory Affairs Suspended

Bowman Daniel Home Help Prescott 3/5/2018 MDHHSBoyd Jermaine Anthony Home Help Kalamazoo 11/30/2015 MDHHSBoykins Rashana Home Help Kalamazoo 5/20/2019 MDHHS 5/5/2021 MDHHSBradford Brandon C Home Help Detroit 2/4/2022 MDHHSBradford Christopher Home Help Hamtramck 11/14/2017 MDHHSBradley Angela Home Help Ferndate 3/9/2021 MDHHSBradley Korey Home Help Detroit 2/1/2021 MDHHSBradley John Wesley Home Help Detroit 12/15/2015 MDHHS Bradley Stewart Home Help Detroit 1/25/2016 MDHHS

Brandel Susan Mary Registered Nurse 1629006929 Grosse Pointe Farms 4704120861 6/7/2018

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Brander JayJay Home Help Wayland 8/6/2022 MDHHSBrandon Darrall Home Help Kalamazoo 12/15/2015 MDHHSBranham Bradley Willis Chiropractor Coldwater 2301007189 9/20/2001 HHS 1128(a)(3)Branson Reshon Home Help Kalamazoo 3/22/2021 MDHHSBrantley Ruth Home Help River Rouge 2/11/2014 DCH-OIG 7/7/2015 MDHHS-OIG TerminatedBraziel Sterling Home Help Detroit 6/6/2022 MDHHSBrazil Michael J. Physician Riverview 5101012432 10/19/1996 HHS 1128(a)(1)Breckenridge Raymond Home Help Detroit 2/25/2020 MDHHSBrewer Akeem Olajuwon Home Help Saginaw 1/30/2015 DCHBrewer David Home Help Inkster 4/19/2018 MDHHSBrewer Rosetta Home Help Battle Creek 1/7/2016 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Brewster Mark Physician 1275773046 Birmingham

43010904535315044736 (CS only) 11/27/2017

MI-Licensing and Regulatory Affairs

5/16/2018 9/20/201810/10/2018

MI-Licensing and Regulatory Affairs HHS-OIGMI- Licensing and Regulatory Affairs

Summary Suspension Suspended Terminated Controlled Substance license only revoked

Briggs Erran Home Help South Haven 9/12/2019 MDHHSBrimmer Nicole Home Help Grand Rapids 6/26/2019 MDHHSBritt Claudius Home Help Inkster 3/23/2017 MDHHS

Britz Joseph Physician 1811004617 Ludington 4301060161 3/12/2011

MI-Licensing and Regulatory Affairs

Suspended, Drug Diversion, Mental/Physical Inability

Broadnax Olivia Home Help Detroit 11/5/2016 MDHHS TerminatedBrock Dameon Home Help Lansing 11/12/2019 MDHHSBrock Holly Home Help Midland 8/19/2021 MDHHSBrockitt Michelle Home Help Fort Gratiot 5/30/2018 MDHHSBrocks Alicia Home Help Muskegon 1/13/2016 MDHHSBrod Jason Stewart Home Help Oak Park 4/28/2015 DCHBrook Reginald Home Help Detroit 4/2/2015 DCHBrooks Donta Home Help Detroit 11/1/2017 MDHHSBrooks Ginger Home Help Detroit 5/14/2021 MDHHSBrooks John C Home Help Detroit 11/30/2015 MDHHSBrooks Pamela Home Help Reed City 12/28/2016 MDHHSBrooks Rebecca Home Help Grand Rapids 4/15/2021 MDHHSBrooks Robert Home Help Detroit 3/19/2019 MDHHSBrooks Sharon Home Help Detroit 3/6/2018 MDHHSBroome Shanequa Home Help Pontiac 3/27/2019 MDHHSBrower Carol T Home Help PawPaw 4/14/2015 DCHBrown Akeem Home Help Flint 5/1/2018 MDHHSBrown Annie Home Help Three Rivers 1/19/2021 MDHHSBrown Anthony Home Help Detroit 1/7/2016 MDHHSBrown Bertha Home Help Detroit 4/14/2016 MDHHSBrown Carema Home Help Detroit 3/20/2018 MDHHSBrown Charles T Home Help Jackson 11/30/2015 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Brown Dennis Home Help Croswell 5/10/2021 MDHHSBrown Derrick Home Help Detroit 1/9/2019 MDHHSBrown Ebony Home Help Detroit 11/16/2015 MDHHSBrown Izell Home Help Detroit 1/19/2017 MDHHSBrown Jaremy Anton Home Help Port Huron 2/5/2015 DCHBrown Koreen Home Help Lincoln Park 10/10/2016 MDHHSBrown Kwan Home Help Monroe 12/8/2015 MDHHSBrown Larry Home Help Eastpointe 12/14/2016 MDHHSBrown Lonnell Home Help Detroit 7/22/2021 MDHHS

Brown Mark A Dentist 1740208172 Madison Heights 2901013422 11/5/2015

MI-Licensing and Regulatory Affairs

Summary Suspension

Advanced Professional Patient Care PLLC Brown Meiuttenun Group 1083074850 Southfield 8/14/2018 MDHHS-OIG

Summary Suspension

Medical Home Visits PLLC Brown Meiuttenun Group 1972898369 Southfield 8/14/2018 MDHHS-OIGSummary Suspension

Professional Patient Care PC Brown Meiuttenun Group 1740683176 Detroit 8/14/2018 MDHHS-OIGSummary Suspension

Brown Meiuttenun Physician 1790793941 Southfield 4301088766 8/14/2018 MDHHS-OIGSummary Suspension

Brown Randy Home Help Saginaw 7/27/2016 MDHHSLansing Meidcal PLLC Brown Remona Group 1316307085 Lansing 2/20/2020 MDHHS-OIG Terminated

Brown Remona Nurse Practitioner 1265988653 East Lansing 4704284531 5/17/2019

MI-Licensing and Regulatory Affairs 2/20/2020 MDHHS-OIG

Summary Suspension Terminated

Brown Scott Physician 1760581383 Lansing 5601002665 5/23/2011

MI-Licensing and Regulatory Affairs 5/3/2018

MI-Licensing and Regulatory Affairs

Summary Suspension Disciplinary Limited

Brown Steven Deshawn Home Help Romulus 4/21/2015 DCHBrown Warren A Home Help Detroit 3/29/2022 MDHHS

Brown Zack B. Physician 1447331160 Detroit 4301036091 10/15/1988 DCH

Violation of Medicaid False Claim Act

Lansing Medical PLLC Brown Remona Urgent Care 1306238241 Lansing 2/20/2020 MDHHS-OIG Terminated

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Brown-Fagan Lisa Counselor 1700011020 Flint 6401011313 1/21/2020 MDHHS-OIGSummary Suspension

Browning Quentin Home Help Southfield 8/2/2018 MDHHSBrubaker Leo D. Physician Muskegon Heights 5101003994 3/21/1990 HHS 1128(b)(4)Bruns Frank Home Help Ypsilanti 5/3/2018 MDHHS

Brunt Jason Physician 1619979713 Warren 5101013443 8/17/2020 MDHHS-OIGSummary Suspension

Bryant Jermaine Home Help Highland Park 7/27/2016 MDHHS

Buchner KasyNon-Emergency Transportation Alpena 3/23/2017 MDHHS

Buckner Billy Joe Home Help Grand Rapids 12/26/2014 DCHBuckner Eric Home Help Ypsilanti 6/11/2019 MDHHS

Budayr Reema Dentist 1972683506 Canton 8/6/2018 MDHHS-OIG9/5/20184/18/19

MDHHS-OIGHHS-OIG

Summary Suspension TerminatedExcluded

Budhram Kameron Psychiatrist 1598253080 West Bloomfield 5101025414 6/14/2022 MDHHS-OIGSummary Suspensioin

Buford Keith Home Help Detroit 11/5/2016 MDHHSBuie Leeshaun Home Help Detroit 11/30/2015 MDHHSBunn Scott Home Help Wyoming 9/20/2016 MDHHSBurch Michelle Home Help Akron 7/31/2018 MDHHS

Burdette III James B. Physician Assistant 1235366162 Southfield 560100221 6/26/2018 MDHHS

Disciplinary Limited License

Burgin Chandra S Home Help Baldwin 11/30/2015 MDHHSBurke Damarcus Home Help Flint 7/26/2016 MDHHS

Burke Jeffrey P Physical Therapist 1336141704 Gaylord 5501008037 12/7/2014

MI-Licensing and Regulatory Affairs

4/14/2015 10/20/2015

MI-Licensing and Regulatory AffairsMI-Licensing and Regulatory Affiars

Summary Suspension Summary Supension Summary Suspension

Burkes Derrick Ramone Home Help Detroit 11/24/2014 DCH

Burkes Derricka Home Help Inkster 11/10/2020 MDHHS-OIGSummary Suspension

Burleigh Leo Anthony Home Help Port Huron 4/12/2022 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Burman Matthew L. Physician 1427054899 Bloomfield Hills 4301030145 5/2/2009

MI-Licensing and Regulatory Affairs Suspended

Burrell Johnathan Home Help Mount Clemens 1/20/2018 MDHHSBurton Daniel Home Help Delton 1/7/2016 MDHHSBurton Ericka Home Help Detroit 2/19/2019 MDHHSBurton Jomo Home Help Detroit 9/10/2019 MDHHSBurton Reginald Home Help Detroit 7/15/2022 MDHHSBusher Jason Home Help Detroit 6/25/2015 DCHBuszek Robert F. Physician Highland Park 5101006226 10/6/1994 HHS 1128(b)(4)

Butler Dennis A Dentist 1053499475 Southfield 2901011373 1/24/2013

MI-Licensing and Regulatory Affairs Suspended

Butler Donzel Home Help Detroit 10/12/2016 MDHHSButler Earnest Leon Home Help Detroit 1/21/2015 DCHButler Michael Home Help Detroit 2/20/2019 MDHHSButler Tony Eugene Home Help Detroit 4/1/2015 DCH

Butler-Jackson Lois Michelle Physician 1508846320 Southfield 4301051182 8/3/2013

MI-Licensing and Regulatory Affairs 3/14/2012

MI-Licensing and Regulatory Affairs

Terminated Suspended

Byl Danny H. Dentist Potterville 2901013592 8/18/1997 HHS 1128(b)(4)Byrd Antwone Home Help Detroit 11/22/2016 MDHHSCain Wilhelmina Home Help Benton Harbor 6/21/2018 MDHHSCajer Chochon Home Help Detroit 3/23/2017 MDHHS

iCare Home Help Agency Caldwell Kevin Home Help Agency Battle Creek 10/1/2019 MDHHS-OIG TerminatedCalhoun Lawrence Home Help Detroit 10/9/2018 MDHHS

Call Richard A Physician Assistant 17604249772 Bay City 5601004029 12/4/2019

MI-Licensing and Regulatory Affairs 8/20/2020

MI-Licensing and Regulatory Affairs

Suspended Suspended

Callahan Keith H. Dentist Flint 2901014674 5/25/1997 HHS 1128(b)(3)Calloway Lowantha HomeHelp Detroit 1/19/2021 MDHHSCaluya Kristina Home Help Grand Rapids 8/6/2019 MDHHS TerminatedCamak Toikinte Home Help Detroit 5/17/2018 MDHHSCamp Clarence L. Dentist 1649347212 Detroit 2901015197 10/20/1999 HHS 1128(b)(14)

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Campbell Cavin Home Help Wyandotte 1/21/2017 MDHHSCampbell Jimmy Home Help Pontiac 7/25/2019 MDHHSCampbell Nichoe D Home Help Kalamazoo 12/28/2021 MDHHSCampbell Steven K. Physician Flint 4301048115 4/10/1991 HHS 1128(b)(4)Campbell Sylvester Home Help Highland Park 3/25/2015 DCHCannady Tyronne Home Help Saginaw 9/24/2019 MDHHS

Cantrell DonaldNon-Emergency Transportation Williamsburg 2/16/2017 MDHHS

Capanna Diane CRNA 1457345480 Saint Claire Shores 4704082314 11/11/2018

Mi-Licensing and Regulatory Affairs Suspended

Capriccioso Richard P. Physician Detroit 4301047689 11/11/1992 HHS 1128(a)(2)Carlton George W Home Help Detroit 10/1/2021 MDHHSCarmona Luis M. Home Help Battle Creek 3/3/2021 MDHHS

Carothers George G. Physician 1679531669 Grand Rapids 5101005885 6/25/2018 MDHHS

Disciplinary Limited License

Carpenter Samantha Home Help Hale 12/8/2015 MDHHS

Carpenter Thomas Physician 1952301699 Redington Beach, FL 5101010046 8/8/2018 MDHHS-OIGSummary Suspension

Carr Nakisia Home Help Detroit 8/17/2016 MDHHSCarr Tyran Home Help Detroit 6/25/2019 MDHHSCarrier Shannon Lyn Home Help Harrison Township 3/23/2015 DCHCarroll Julian D. Home Help Detroit 12/14/2020 MDHHSCarter Aloysous Home Help Detroit 12/19/2019 MDHHS

Carter Beth A Physician 1962529990 New HAven 4301065530 6/17/2020

MI-Licensing and Regulatory Affairs

Summary Suspension

Carter Corey Home Help Hazel Park 10/27/2017 MDHHSCarter Cornell Home Help Detroit 1/25/2021 MDHHSCarter Donald L Home Help Saginaw 9/29/2021 MDHHSCarter Gerald Home Help Detroit 3/29/2016 MDHHSCason Marlon Home Help Detroit 10/26/2020 MDHHSCastelow Tracy Home Help Highland Park 9/16/2019 MDHHSCastleberry Barbara Home Help Augusta 8/29/2017 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Castro-Urrutia Fernando Jose Physician 1578580411 Coldwater 4301067134 6/16/2017

MI-Licensing and Regulatory Affairs

Disciplinary Limted License

Caudill Agnes Home Help Stockbridge 4/1/2020 MDHHSCaver Latoya Home Help Detroit 1/6/2016 MDHHSCelestino Karen Home Help Beaverton 5/1/2017 MDHHS

Chalfant Lance E. Chiropractor 1265491047 Jackson 2301006854 9/20/2013

MI-Licensing and Regulatory Affairs Suspended

Nu Care Medical PC Cham Harish Physician Group Detroit 5/4/1992 HHS 1128(a)(1)Cham Kirishna Physician Detroit 8/10/1994 HHS 1128(a)(1)Chambers Charlanne Home Help Grand Rapids 11/6/2015 MDHHS

Metro Home Visiting Physicians PLLC Chang Zongli Group 1730373440 Livonia 3/27/2018 MDHHS-OIG 11/1/2019 MDHHS-OIG

Summary Suspension Terminated

Chang Zongli Physician 1598807547 Livonia 4301087633 5/5/2017

MI-Licensing and Regulatory Affairs

3/27/20186/14/2019 11/01/2019

MDHHS-OIGMI-Licensing and Regulatory Affairs MDHHS-OIG

Summary Suspension Revoked Terminated

Chapman Oneal Home Help Saginaw 11/30/2015 MDHHSCharleston Adam Home Help Kalamazoo 11/30/2015 MDHHSChastang Debra Home Help Detroit 10/10/2016 MDHHSChatman Kimyatta Home Help Detroit 3/12/2019 MDHHSChears Ronald Home Help Detroit 3/20/2015 DCHChears Terrance Benard Home Help Detroit 3/6/2015 DCHCheathem JaWaun Home Help Detroit 7/17/2018 MDHHS

Cheeseman JacquelineNon-Emergency Transportation DeTour Village 6/19/2017 MDHHS

Cherry Joseph B Home Help Muskegon 11/30/2015 MDHHSChism David Home Help Pontiac 1/22/2019 MDHHS

Cholag Nofal Pharmacist 1407389570 Warren 5302033146 11/9/2020 MDHHS-OIGSummry Suspension

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Anson Pharmacy Chu Lap Pan Pharmacy 1962818625 Lambertville 5301010542 11/19/2018 MDHHS-OIG 3/15/2019

MI-Licensing and Regulatory Affairs

Summary Suspension Voluntary Surrendered

Chuanromanee Orapin Counselor 152845254 Ann Arbor 6401015108 2/7/2021

Mi-Licensing and Regulatory Affairs

Voluntarily Surrendered

Chun Kenneth K. Physician 1467511808 Bloomfield Hills 4301038189 9/13/2017

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Chupka Thomas E Dentist 1790011450 Sault Sainte Marie 2901011891 2/21/2013

MI-Licensing and Regulatory Affairs Suspended

Church Aimee Home Help Caro 1/27/2018 MDHHSChurch Kortez Home Help Saint Claire Shores 5/10/2017 MDHHSCiesielski Leonard Home Help Bay City 8/11/2015 MDHHSClark Carla Home Help Grand Rapids 7/14/2016 MDHHSClark Frank L. Physician Petosky 4301042015 7/8/1993 HHS 1128(b)(3)Clark Gregory Home Help Grand Rapids 12/1/2015 MDHHSClark Michael Home Help Genessee 4/9/2021 MDHHSClark Lawrence Home Help Detroit 12/29/2016 MDHHS

Clark Randall Physician 1063573319 Grand Rapids 4301050413 9/13/2021

MI-Licensing and Regulatory Affairs

Summary Suspension

A Loving Touch Clark Shawnell Home Help Agency Oak Park 7/3/2019 MDHHS-OIGSummary Suspension

Clark Shawnell Home Help Oak Park 7/3/2019 MDHHS-OIGSummary Suspension

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Clark StevenSocial Worker and Home Help 1801079686 Saginaw 6801013007 6/10/2019

Mi-Licensing and Regulatory Affairs

10/4/2019 08/07/2020

MI-Licensing and Regulatory Affairs MDHHS-OIG

Suspended Summary Suspension Terminated

EDM Treatment Center Clark Steven Medical Group 1942484647 Saginaw 2/4/2020 MDHHS-OIG 8/7/2020 MDHHS-OIG

Summary Suspension Terminated

Clausen Ronald Home Help Muskegon 5/4/2022 MDHHSClay Gladys Home Help Detroit 2/9/2016 MDHHSClay Jermaine Home Help Detroit 11/29/2016 MDHHSClaybren Tashawn Home Help Roseville 10/17/2018 MDHHSCleveland Genea N Home Help Romulus 11/30/2015 MDHHSClowney Antwan Home Help Detroit 7/15/2022 MDHHSCoates Brenda Lee Home Help Benton Harbor 3/30/2015 DCHCoates Richard Home Help Redford 7/13/2017 MDHHSCochran Lawrence Home Help Ferndale 4/17/2017 MDHHS

Cody Stephanie Nurse Practitioner 1477022721 Mt. Clemens 4704287935 12/23/2020

MI-Licensing and Regulatory Affairs

Summary Suspension

Coffee MarcoNon-Emergency Transportation Harper Woods 1/3/2018 MDHHS

Cogborn Kamaal Home Help Detroit 1/20/2022 MDHHSPersonalized Family Healthcare PC Cogswell Steven Group 1669646618 Troy 11/21/2018 MDHHS-OIG

Summary Suspension

Cogswell Steven Physician 1528001922 Troy 4301059909 11/21/2018 MDHHS-OIG 3/7/2019

MI-Licensing and Regulatory Affairs

Summary SuspensionSummary Suspension

Cohen Abbott B. Podiatrist Alpena 5901001980 8/19/2004 HHS 1128(a)(4)Cohen Stanley B Podiatrist 1326014358 Detroit 5901001139 2/9/2017 HHS RevokedColbert Marion Home Help Detroit 2/13/2017 MDHHSCole Dianna M Home Help Coleman 2/28/2022 MDHHS

Cole EarlNon-Emergency Transportation Bay City 1/8/2018 MDHHS

Cole Katrina Home Help Grand Rapids 4/18/2016 MDHHSCole Tamika Home Help Highland Park 10/1/2019 MDHHS-OIG TerminatedCole Diana Home Help Coleman 5/8/2017 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Coleman Aaron Home Help Detroit 7/26/2021 MDHHSColeman Darius Home Help Detroit 7/26/2021 MDHHSColeman Derrick Home Help Detroit 7/8/2020 MDHHSColeman Donald Home Help Center Lake 9/26/2017 MDHHSColeman Issac Home Help Pontiac 3/28/2019 MDHHS

Coleman Kendella Counselor 1891190070 Redford 6401014587 5/8/2020

MI-Licensing and Regulatory Affairs 1/15/2021

MI-Licensing and Regulatory Affairs

Suspended Disciplinary Limited

Coleman Kenneth Home Help Warren 12/2/2016 MDHHSColeman Ray Home Help Lansing 1/13/2016 MDHHSColeman Richo Home Help Detroit 1/21/2017 MDHHSColeman Shantel HoemHelp Pontiac 9/24/2021 MDHHS

Colen Chaim Physician 1255548269 Petoskey 4301080334 2/27/2020

MI-Licensing and Regulatory Affairs Suspended

Coles Arturo Home Help Detroit 12/19/2016 MDHHS 12/21/2021 MDHHS

Collazo Luis M Physician 1699849885 Fraser 4301062191 7/30/2013 DCH-OIG8/20/2015 10/29/2015

HHS MDHHS-OIG

Suspended Excluded Terminated

Collier Jeffrey Home Help Sault Sainte Marie 7/8/2015 DCH 11/24/2021 MDHHSCollingwood Carol Home Help Port Huron 7/10/2018 MDHHSCollins Brooke Hime Help Kalamazoo 11/16/2021 MDHHSCollins Travell Home Help Ypsilanti 10/31/2016 MDHHSColvin Diane Home Help Detroit 10/30/2018 MDHHSConley Cheryl Home Help Detroit 2/3/2015 DCH

Connors Andrea J Nurse Practitioner 1124212113 Willis 4704239544 10/26/2014 LARA 3/11/2015

MI-Licensing and Regulatory Affairs

Suspeneded Revoked

Conway Terrance Home Help Detroit 4/15/2019 MDHHSCoogan Cary Home Help Inkster 10/8/2015 MDHHS

Cook Brian W Physician 1790727642 Howell 4301051801 5/17/2013

MI-Licensing and Regulatory Affairs Suspended

Cook Daniel Home Help Central Lake 10/15/2020 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Cook Dwayne Physician 1447229125 Belding 4301074284 12/26/2017

MI-Licensing and Regulatory Affairs Suspended

Cook Stephanie Home Help Detroit 5/9/2019 MDHHS

Cooke Jeffrey S. Podiatrist Centerville 5901001109 7/20/2005 HHS 8/20/2007 HHS

7/20/05: 1128(a)(1)8/20/07: 1128(a)(1)

Cool Patte Home Help Burton 10/29/2014 DCHCooper Elizabeth Home Help Lansing 4/1/2015 DCHCooper Grace Home Help Benton Harbor 11/23/2015 DCHCooper Judith Home Help Mantisique 1/30/2017 MDHHSCooper Lorena M Home Help Southfield 11/30/2015 MDHHS

Cooper Scott Physician 1215917760 West Bloomfield 4301053306 6/22/2020 MDHHS-OIGSummary Suspension

Cordial Amber Home Help Owosso 2/4/2020 MDHHSCorhn Brian Home Help Benton Harbor 11/30/2015 MDHHSCornelius Denice M. Physician Lansing 5101009416 5/20/2001 HHS 1128(a)(4)

Cornfield Robert H DPM Cornfield Robert Group 1790990471 Rochester Hills 12/18/2019 MDHHS-OIGSummary Suspension

Cornfield Robert Physician 1295737096 Rochester Hills 5901001495 12/18/2019 MDHHS-OIGSummary Suspension

Corradi Martin Home Help Troy 10/29/2016 MDHHSCortez Samson Home Help Marysville 3/17/2015 DCHCoulter Deniesha Home Help Flint 5/24/2018 MDHHSCounts Anna Marie Home Help Ecorse 2/13/2015 DCHCowan Arthur Home Help Detroit 1/8/2019 MDHHSCowans Mosiah Home Help Ypsilanti 12/8/2021 MDHHSCox Teanne Home Help Detroit 5/16/2019 MDHHS

Crawford Barry Physician 1366881112 Grand Blanc 5101024437 4/13/2022

MI-Licensing and Regulatory Affairs

Summary Suspension

Crawford Keema Home Help Pontiac 3/20/2015 DCHCritchett Thomas Anthony Home Help Port Huron 2/10/2015 DCHCroft Timothy Home Help Detroit 12/12/2016 MDHHSCroskey Kisean Lamar Home Help Pontiac 10/7/2014 DCHCross Linda K. Physician Lansing 4301041641 10/22/1991 HHS 1128(b)(4)Crothers Monica Home Help Hart 5/12/2016 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Crouch Tracy L Home Help Frederic 4/30/2020 MDHHS-OIG TerminatedCruz Evangelina Home Help Jackson 8/29/2018 MDHHSCruz Myrza Home Help Lansing 1/22/2015 DCHCumberland Mark Home Help Flat Rock 3/28/2019 MDHHSCummings Almondo Home Help Detroit 12/5/2019 MDHHS

Cunningham Darrell R Physician 1902998933 Stanton 5101012407 2/6/2013

MI-Licensing and Regulatory Affairs Suspended

Cunningham Frank Home Help Detroit 8/27/2018 MDHHSCunningham Bryan Home Help Detroit 4/8/2015 DCHCurry Robert Home Help Detroit 4/12/2017 MDHHSCurry Teisha Laann Home Help Highland Park 11/30/2015 MDHHSCurtis Joseph Home Help Romulus 9/21/2017 MDHHSCurtis Ronald Home Help Detroit 12/13/2018 MDHHS

Cushman Rachel M Social Work 1841682168 Redford 6801096892 1/8/2022

MI-Licensing and Regulatory Affairs Suspended

Cusumano Paul Social Worker 1215359948 Clarkston 6801094558 6/21/2018

MI-Licensing and Regulatory Affairs 7/21/2018

MI-Licensing and Regulatory Affairs

Suspended Disciplinary Limited Licnese

Cutright Monterea Home Help Detroit 4/11/2017 MDHHS

Cywiak Seymour N. Physician 1780956524 Farmington Hills 5101005504 8/1/2013

MI-Licensing and Regulatory Affairs Suspended

Czertko George Physician Detroit 4301033892 2/20/2001 HHS 1128(b)(4)

Dababneh Malik H Physician 1306853221 Dearborn 5101009532 4/10/2013

MI-Licensing and Regulatory Affairs

7/30/2013 12/29/2015 01/20/2015

DCH-OIG MDHHS-OIG HHS-OIG

Suspended Suspended Terminated Excluded

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Dabbagh Mamoun Physician 1962552158 Warren 4301045473 3/3/2016

MI-Licensing and Regulatory Affairs

3/3/2016 02/10/2017

MI-Bureau of Licensing and Regulatory Affairs

Summary Suspension Revoked

Franklin Center Pharmacy Dakhlallah Abed A Pharmacy 1073958831 Southfield 8/5/2019 MDHHS-OIG Terminated

Springwells Clinical Pharmacy Inc Dakhlallah Abed A Pharmacy 1427167196 Detroit 8/5/2019 MDHHS-OIG TerminatedDallman James H. Physician Muskegon 4301055294 6/17/1999 HHS 1128(a)(1)Dallo Joseph Home Help Petoskey 10/16/2018 MDHHS

Dai Care Services LLC Damisch Dildora Home Help Agency Farmington Hills 1/18/2017 MDHHS-OIGSummary Suspension

Milena Care Home Company LLC Damisch Dildora Home Help Farmington Hills 11/15/2017 MDHHS-OIG

Gerald F Daneshvar MD PLLC Daneshvar Gerald Group 1316347917 Warren 7/29/2015 DCH-OIG 9/28/2018 MDHHS-OIG

Summary SuspensionTerminated

Daneshvar Gerald Physician 1548427164 Warren 4301081745 7/29/2015 MDHHS-OIG

4/20/2018 5/21/18 9/20/18 9/28/182/4/19

MI-Bureau of Licensing and Regulatory AffairsHHS-OIG MDHHS-OIGMI-Bureau of Licensing and Regulatory Affairs

Summary Suspension Summary Suspension Summary Suspension Disolved Terminated TerminatedRevoked

Daniel Fady Home Help Shelby Townhip 6/22/2022 MDHHSDanger Pedro Home Help Grand Rapids 4/18/2019 MDHHS

Daniel Rajat Physician 1336203603 Bloomfield 4301060871 7/11/2013 DCH-OIG

5/26/2014 02/24/2015 09/20/2015

DCH-OIG MI-Licensing and regulatory Affairs HHS-OIG

Suspended Terminated Summary Suspension Excluded

Daniels Anthony Home Help Lincoln Park 5/3/2018 MDHHSDaniels Clarence Home Help Detroit 2/10/2016 MDHHSDaniels Reginald Home Help Pontiac 4/28/2015 DCHDaniels Tiffany Home Help Gaylord 2/13/2017 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Danis Christine Home Help Hastings 8/9/2016 MDHHSDavidson Zyra Home Help Lansing 3/30/2017 MDHHSDavis Antoine L Home Help Detroit 8/1/2022 MDHHS

Davis Brenda M. Home Help Kalamazoo 10/8/2018 MDHHS-OIGSummary Suspension

Davis Cassandra Home Help Kalamazoo 12/7/2017 MDHHSRange Transportation Services LLC Davis Darrell

Non Emergency Transportation Livonia 8/12/2020 MDHHS

Carriage Park Community Services Davis Gene Home Help Agency Romulus 11/21/2018 MDHHS-OIG

Summary Suspension

Davis Horace J Physician 1033126651 Jackson 5101007157 6/29/2016 MDHHS-OIG

8/7/20179/20/201810/4/2018 12/21/2018

MI- Licensing and Regulatory Affairs HHS-OIGMI- Licensing and Regulatory Affairs MDHHS-OIG

Summary Suspension Summary Suspension Terminated Suspended Terminated

Davis Joey Jay Home Help Utica 12/18/2014 DCHDavis Jurmel Home Help Detroit 10/22/2015 MDHHSDavis Keshia Home Help Southfield 11/6/2017 MDHHSDavis Lakeesa Home Help Detroit 5/19/2015 DCH-OIG Termination

Davis LindaNon-Emergency Transportation Farwell 5/9/2017 MDHHS

Davis Marcella Home Help Detroit 8/11/2015 MDHHS-OIG9/30/201901/20/2020

MDHHS-OIG HHS-OIG

Summary Suspension Terminated Excluded

Davis Marcus Home Help Muskegon 10/10/2017 MDHHS

Davis Marilyn Home Help Harper Woods 11/11/2014 DCH-OIGSummary Suspension

Davis Mishondia Home Help Mount Clemens 3/14/2016 MDHHSDavis Natesha Home Help Saginaw 4/29/2021 MDHHSDavis Norman Home Help Detroit 10/17/2017 MDHHSDavis Omar Home Help LansingDavis Sabourium Home Help Lansing 1/25/2015 MDHHSDavis Todd Home Help Detroit 6/29/2021 MDHHSDwkins Hozay Home Help Saginaw 5/5/2022 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Dawkins Telena Home Help Muskegon 11/26/2018 MDHHSDawood Ghaith Home Help South Field 9/8/2020 MDHHSDawood Rashawn Home Help Sterling Heights 3/15/2018 MDHHSDawson Dewayne Home Help Detroit 10/13/2021 MDHHS 6/7/2022 MDHHSDay Michael Home Help Roseville 12/9/2014 DCHDay Michelle Home Help Dearborn Heights 1/7/2021 MDHHSDay Norman Home Help Kalkaska 7/2/2019 MDHHSDay Randy Home Help Eastpointe 10/10/2017 MDHHSDay Frank Home Help Detroit 12/28/2016 MDHHS

Thumb Physical Medicine & Rehab De Gunzman Joel Group 1104129303 Bad Axe 9/18/2013 DCH 10/18/2013 DCH

Summary SuspensionTerminated Excluded

Dean AntonioNon-Emergency Transportation Detroit 3/22/2018 MDHHS

Dear Trent Home Help Lansing 5/11/2021 MDHHSDeboer Karol Home Help Lawton 6/11/2019 MDHHS

DeGuzman Joel I Physician 1952433963 Dearborn 4301091071 7/18/2013

MI-Licensing and Regulatory Affairs 8/15/2013 DCH

TerminatedSuspended

Dehaan Charles Physician 1144392499 Rockford, IL 4301056984 4/15/2014 DCH-OIG 1/10/2019 MDHHS-OIG

Summary Suspension Terminated

Dejesus Robet Home Help VanBuren Twp 12/17/2020 MDHHS

Dela Cruz Fanny A Physician 1689742397 Livonia 4301036977 3/4/2016

MI-Licensing and Regulatory Affairs

7/20/2016 04/20/2017

MI-Licemsing and Regulatory Affairs HHS

Summary Suspension Voluntary Termination Excluded

Delvecchio Ryan Lee Counselor 1124329222 Livonia 6451016320 6/18/2021

MI-Licensing and Regulatory Affairs Suspended

Dendy Ronald Home Help Columbiaville 12/19/2016 MDHHSDenno Denise Home Help Grayling 12/7/2015 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Derani Mohammad Physician 1902985310 Dearborn 4301045768 8/16/2017

MI-Licensing and Regulatory Affairs 12/27/2017

MI-Licensing and Regulatory Affairs

Suspended Revoked

Derickson Ronald E. Home Help Westland 6/13/2022 MDHHS-OIGSummary Suspension

Derosia StevenNon-Emergency Transportation Millersburg 3/9/2017 MDHHS

Desai Jasubhai K. Physician Highland Park 4301031425 2/27/1997 HHS 1128(b)(4)Desjardins Stephen Home Help Algonac 3/9/2020 MDHHS Temrinated

Deswal Maninder Podiatrist 1811235872 East Lansing 5901002470 6/10/2022

MI-Licensing and Regulatory Affairs 7/12/2022 MDHHS-OIG

Suspended Suspended and Terminated

DeVries Elisha Social Worker 1740624923 Grand Rapids 6801094687 10/11/2018

MI-Licensing and Regulatory Affairs 3/26/2019

MI-Licensing and Regulatory Affairs

Summary SuspensionDiscplinary Limited

Dewalt Alfred Home Help Pontiac 11/30/2015 MDHHSDewilde Steven B. Physician 1629507975 Plymouth 5101009688 9/20/2005 HHS 1128(a)(4)

Dial, JR. Lino Sevandal Physician 1245228568 Ludington 5101014103 2/22/2012 DCH 8/7/2013 DCHTerminatedSuspended

Diaz Cynthia A Home Help Saginaw 12/2/2016 MDHHSDick Guy Home Help Detroit 8/17/2016 MDHHSDickerson Patrick Home Help Lansing 5/1/2015 DCHDietz Brandon Home Help Alpena 11/17/2016 MDHHSDillard Alvin Home Help Toledo OH 6/19/2019 MDHHSDillard Michael Home Help Inkster 12/2/2015 MDHHSDillon Mary Home Help Detroit 6/13/2019 MDHHS

Distefano Kellie Physician Assistant 1386609543 Saugatuck 5601002464 4/3/2019

MI-Licensing and Regulatory Affairs

Summary Suspension

Dixon Jamine J Home Help Flint 4/30/2020 MDHHS-OIG TerminatedDixon Moses Home Help Kalamazoo 10/24/2017 MDHHSDixon Terrance Home Help Ypsilanti 10/15/2018 MDHHS

Dobbs JosephNon-Emergency Transportation Ishpeming 3/9/2017 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Dody Calvin Home Help Wayne 4/9/2021 MDHHSDonaldson Joaquin Home Help Grand Rapids 4/18/2017 MDHHSDorris Lisa Home Help Baldwin 10/10/2017 MDHHSDorris Machelle Home Help Baldwin 4/22/2015 DCHDorsette Pierre R. Home Help Jackson 12/9/2020 MDHHSDorsey Ervin Home Help Detroit 7/16/2015 DCHDorsey John K. Home Help Detroit 2/24/2021 MDHHSDorsey Orondey Home Help Detroit 11/30/2015 MDHHSDotson William Home Help Detroit 7/3/2019 MDHHSDougovito Michael F. Nurse Newberry 4704107350 4/20/2000 HHS 1128(b)(4)

Doutherd Lisa Social Worker 1831333509 Lansing 6802074536 11/10/2018

MI-Licensing and Regulatory Affairs Suspended

Doyle Christopher Lee Home Help Pinckney 6/1/2015 DCH

Dragoo Bruce Physician 1578568317 Grand Rapids 4301028716 9/1/2021

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Drawdy Evelyn Home Help Cadillac 1/26/2015 DCHDrewery Lakeycha Home Help Ypsilanti 7/17/2019 MDHHSDreyfuss Donald S. Physician Bloomfield Hills 5101005825 9/20/2000 HHS 1128(a)(1)Druitt Elizabeth Home Help Monroe 2/20/2019 MDHHSDrumm Randy E. Physician Edmore 5101009214 1/20/2003 HHS 1128(b)(4)

Susan Drust NP PLLC Drust Susan Medical Group 1558804674 Noron Shores 2/21/2020 MDHHS-OIGSummary Suspension

Drust Susan Nurse Practitioner 1619907722 Muskegon 4704168366 4/25/2019

MI-Licensing and Regulatory Affairs 2/21/2020 MDHHS-OIG

Summary Suspension Summary Suspension

Duck Deborah Home Help Eastpointe 3/18/2010 HHS-OIG

Duckett Bruce Devlon Dentist Flint 2901015928 3/30/2001 DCH 11/20/2002 HHS

3/30/01: Violation of Medicaid False Claim Act11/20/02: 1128(a)(1)

Dudley Hameen Home Help Grand Blanc 4/25/2019 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Dudley Janitta Home Help Clarkston 6/20/2018 MDHHSDudley Kevin Home Help Detroit 2/8/2018 MDHHSDuke Amanda Home Help Litchfield 8/2/2021 MDHHSDumont Julie Home Help Port Huron 10/14/2019 MDHHSDuncan Melody Home Help Harper Woods 4/6/2020 MDHHSDuskin Charles Home Help Detroit 2/10/2015 DCHDwight Heath H Home Help Detroit 11/30/2015 MDHHS

Abington Family Medical Center Inc. Dyke Edwin Physician Group Detroit 10/12/1993 HHS 1128(a)(1)Plymouth Medical Center Dyke Edwin Physician Group Detroit 10/12/1993 HHS 1128(a)(1)

Eaton Juanita Home Help Detroit 5/28/2019 MDHHSEarvin Latasha E. Home Help Grand Rapids 5/31/2022 MDHHSEbero Milagras Physician 1376552117 Dearborn Heights 7/3/2013 DCH-OIG Suspended

Eckert Ronald C. Dentist 1851504138 Okemos 2901007642 2/26/2001 DCH 8/20/2001 HHS

2/26/01: Violation of Medicaid False Claim Act8/20/01: 1128(a)(1)

Eckles Lisa Home Help Eastpointe 12/15/2016 MDHHSEdgarton Michele I Home Help Benton Harbor 11/4/2021 MDHHSEdwards Eric Home Help Detroit 5/23/2019 MDHHSEdwards Merrell Home Help Detroit 6/14/2018 MDHHS

Ekeledo Iroham Brown Pharmacy Detroit 5301009352 2/22/2011

MI-Licensing and Regulatory Affairs Suspended

Ekeledo Discount Pharmacy Ekeledo Iroham Brown Office Manager 1710207626 Kalamazoo 1/19/2012 HHS 1128(b)fEl Nichelle Home Help Warren 9/12/2018 MDHHS

Elder Stephen G Dentist 1427131499 Detroit 2901013050 7/6/2022

MI-Licensing and Regulatory Affairs Suspended

Elhorr Ali A Physician 1730379983 Independence, OH 4301080821 5/6/2014 DCH-OIG2/20/2017 11/01/2019

HHS MDHHS-OIG

Summary Suspension Excluded Terminated

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

House Calls Physicians PLLC ElHorr Hicham A. Medical Group 1033273008 Allen Park 5/21/2013 DCH-OIG 6/20/2016 HHS

Summarily Suspended Excluded

El-Horr Hicham A Physician 1255314779 Melvindale 4301080756 5/21/2013 DCH-OIG 5/5/2016 MDHHS-OIG

Summary Suspension Terminated

Elia (Cholak) Aziza Home Help Hazel Park 6/20/2019 HHS-OIG ExcludedElliott Marcus Home Help Grand Rapids 1/3/2022 MDHHSElliott Robert L. Chiropractor Redford 2301005227 12/20/1998 HHS 1128(b)(14)Elliott Scott Home Help Detroit 11/19/2019 MDHHSEllis Bernadette Home Help Jackson 3/23/2016 MDHHS

Ellis Christine Home Help Warren 7/17/2019 MDHHS-OIG 8/17/2019 MDHHS-OIG

Summary SuspendedTerminated

Ellis Kenya Home Help Warren 5/24/2017 MDHHS

Elrington Errol Glenn Physician 1568469294 Inkster 4301060303 10/22/2013 DCH 4/10/2015

MI-Licensing and Regulatory Affairs

Summary Suspension Summary Suspension

Elrington Errol G Physician 1568469294 Inkster 4301060303 12/11/2014

MI-Licensing and Regulatory Affairs 4/10/2015

MI-Licensing and Regulatiory Affairs

Summary Suspension Summary Suspension

Pharmacy 4 Less II Emadamerho Belief Pharmacy 1477821775 Detroit 531052950 (CS) 8/22/2018

MI-Licensing and Regulatory Affairs 11/19/2018 MDHHS-OIG

Controlled Substance License Only Summary SuspendedEnrollment - not just CS license Summary Suspended

Emanuel Esmerelda Home Help Orion 10/22/2015 MDHHSEmerson Marcellus Home Help Saginaw 11/21/2014 DCH

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Emerson Paul Howard Physician 1053458638 Taylor 5101010627 4/2/2009

MI-Licensing and Regulatory Affairs

Voluntary Termination

Ensley Nancy J Physician 1699715060 Duluth, MN 48610 -MN 12/8/2012 HHS & DCH SuspendedErvin Elyah Home Help Detroit 9/12/2017 MDHHSEskew Jermaine Home Help Warren 6/19/2017 MDHHSEstep Jaimie Home Help Bay City 4/7/2016 MDHHSEstes Johnny Home Help East Lansing 1/21/2017 MDHHS

Estes Michael Physician 1851341499 East Lansing 4301093275 6/8/2021

MI-Licensing and Regulatory Affairs Suspended

Ethridge II Jon Home Help Oak Park 5/31/2022 MDHHS-OIGSummary Suspension

Modern Pharmacy, Inc. Eustice Maurice B.Pharmacy/Medical Supplier Onaway 5301002064 5/4/1992 HHS 1128(a)(1)

Evans Frances Home Help Garden City 8/30/2019 MDHHS-OIG9/9/2019 09/19/2019

MDHHS HHS-OIG

Traverse City Residential Care, LLC Evans Helena Home Help Agency Kalkaska 3/26/2019 MDHHS-OIG

Summary Suspension

Evans James Physician 1669560389 Scottsdale, AZ 4301084145 6/1/2022 MDHHS

Limited Restricted License

Ewing Calvin Home Help Grand Rapids 11/28/2016 MDHHSEyestone Amanda Home Help Ludington 2/26/2018 MDHHSFair Charles Home Help Detroit 12/2/2021 MDHHSFaison Ashlie Home Help Warren 12/14/2017 MDHHS

Trudell Pharmacy Fakih Haytham Pharmacy 1699875088 Dearborn 5301006444 1/16/2019 MDHHS-OIG 4/25/2022 MDHHS-OIG

Summary Suspension Terminated

Dearborn Heights Pharmacy Fakih Nabil Pharmacy 1649389313 Dearborn Heights 5301007481 6/4/2019 MDHHS-OIGSummary Suspension

Falls Tiffany Home Help Saginaw 3/13/2018 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Fares Adbdelkader H Physician 1083751085 Dearborn 4301043357 11/3/2014 DCH-OIG10/21/2015 10/16/2015

MDHHS-OIG MI-Licesning and Regulatory Affairs

Suspended Terminated Summary Suspension Excluded Revoked

Farmer Patricia Home Help Lansing 1/19/2021 MDHHS-OIG

Farmer Patricia Home Help Lansing 8/6/2019 MDHHS-OIG 1/19/2021 MDHHS-OIG

Summary Suspension Termination

Farmer (Gaylord) Dena Kathryn Physician 1477655207 Linden 5101012166 12/20/2009 HHS 1128(b)(4)Farrington Michael Home Help Hazel Park 4/26/2018 MDHHSFason Leroy Home Help Detroit 10/10/2016 MDHHS

Michigan Hematology Oncology PC Fata Farid Tanios Group 1801942453 Rochester Hills 8/13/2013 DCH

12/02/2015 01/05/2016

DCH-OIG DCH-OIG

Summary Suspension Summary Suspension Termination

United Diagnostics PLLC Fata Farid Tanios Group 1003160755 Rochester Hills 8/6/2013

MI-Licensing and Regulatory Affairs

Fata Farid Tanios Physician 1417065186 Rochester Hills 4301072629 8/13/2013 DCH12/02/2015 01/05/2016

DCH-OIG DCH-OIG

Summary Suspension Summary Suspension Termination

Fattic Grover R. Physician Niles 4301017283 7/15/1988 DCH 4/18/1989 HHS

7/15/88: Violation of Medicaid False Claim Act4/18/89: 1128(b)(5)

Fee Susan C. Physician 1740254879 Antioch, IL 4301047442 7/17/2019

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Feher Amndrew A Dentist 1477610004 Warren 2901014314 7/27/2020

MI-Licensing and Regulatory Affairs

Summary Suspension

Feketia Brandy Home Help Monroe 12/12/2018 MDHHSFeliciano Nelson Home Help Detroit 8/30/2021 MDHHS

Feldman James D. Dentist 1457456634 Southfield 2901010597 9/27/2013

MI-Licensing and Regulatory Affairs Suspended

Felger Voctoria Home Help Reed City 10/24/2016 MDHHS

Felters Marguerite Nurse 1851934095 Saginaw 4703120840 1/19/2021 MDHHS-OIGSummary Suspension

Felton Darious Home Help Detroit 8/16/2022 MDHHS

Ferguson Richard D Physician 1497812010 Petosky 5101012069 3/16/2015 DCH-OIG6/18/2015 07/24/2015

HHS-OIG MI-Licensing and Regulatory Affairs

Terminated Excluded Revoked

Fernandez Jose A Home Help Detroit 11/30/2015 MDHHSFernandez Todd Home Help Lansing 12/12/2016 MDHHSFesler Jonthan Home Help Dowagiac 8/17/2017 MDHHSFetterer Jacob Home Help Kalamazoo 9/6/2022 MDHHS

Fields JamesNon Emergency Transportation Madison Heights 9/4/2019 MDHHS

Fikes Derrick Home Help Saginaw 7/26/2021 MDHHSFilcek Denise Home Help Wayland 11/20/2019 HHS-OIG ExcludedFinan Tyianne Home Help Detroit 9/8/2021 MDHHSFinch David L Home Help Jackson 11/30/2015 MDHHSFineis James L Home Help Lansing 4/27/2020 MDHHSFinney Arthur Home Help Flint 10/15/2020 MDHHS

Weidman Pharmacy Fiorillo Louis J. Pharmacy Weidman 5301002898 6/22/1994 DCH 8/10/1994 HHS

6/22/94: Violation of Medicaid False Claim Act8/10/94: 1128(a)(1)

Firestone Morey H. Optometrist Dearborn 4901001455 11/19/1997 HHS 1128(a)(2)

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Fish Deborah Home Help Allegan 9/16/2019 MDHHSFish Jason Home Help Pontiac 8/17/2017 MDHHSFisher Alvin Home Help Detroit 8/3/2017 MDHHSFisher Crystal Home Help Lansing 4/21/2021 MDHHS 2/17/2022 MDHHSFitch Scott Home Help Detroit 3/9/2020 MDHHS

Flamer Mariah Home Help Detroit 6/16/2022 MDHHS-OIGSummary Suspension

Flanery Holly Home Help Ludington 3/3/2020 MDHHSFlemons Eugene Home Help Detroit 12/4/2018 MDHHSFletcher Joseph Home Help Detroit 5/2/2019 MDHHSFletcher Robert Home Help Crystal 8/11/2015 MDHHSFlores Priscilla Home Help Detroit 1/14/2022 MDHHSFloyd Daytrell Home Help Detroit 12/20/2020 MDHHSFloyd-Martin Gerald Home Help Grand Rapids 7/24/2017 MDHHSFolsom Jennifer Home Help Sturgis 9/10/2019 MDHHSFord Allen Home Help Benton Harbor 12/22/2014 DCH

Ford Diane Registered Nurse 1720570906 Comstock Park 4704302081 7/2/2019

MI-Licensing and Regulatory Affairs Suspended

Ford Lakisha Home Help Detroit 11/25/2015 HHS-OIG ExcludedForman Michael Home Help Gaylord 9/16/2019 MDHHSForster Wenona Home Help Adrian 8/16/2018 MDHHSForsythe Tina Home Help Monroe 5/16/2018 MDHHS

Fort Newland C. Podiatrist Detroit 5901000496 3/18/1987 DCH 4/21/1988 HHS

3/18/87: Violation of Medicaid False Claim Act4/21/88: 1128(a)(1)

Forte Sandra L. Chiropractor Detroit 2301005177 1/6/1997 HHS 1128(b)(14)

Fortner BrianNon-Emergency Transportation Alpena 2/27/2017 MDHHS

Fortner Sean D Home Help Flint 5/19/2015 DCHFortune Aaron Home Help Detroit 12/16/2015 MDHHSFossett Tyrone Home Help Detroit 4/11/2016 MDHHSFoster Charles Home Help Benton Hrabor 8/22/2016 MDHHSFoster Larry Earl Home Help Detroit 5/15/2015 DCH

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Fowler Carl D Physician 1417989476 Detroit 4301045243 7/3/2013 DCH-OIG

4/15/2014 01/23/2015 03/19/2015 04/10/2015

DCH-OIG MI-Licensing and Regulatory Affairs HHS MI-Licensing and Regualtory Affairs

Suspended Terminated Summary Suspension Excluded Revoked

Fox Linda Home Help Kalamazoo 8/11/2015Fox Theresa Nurse Practitioner 1750855169 Jackson 4704281677 10/12/2019 MDHHS SuspendedFrank Brian Home Help Pontiac 8/1/2017 MDHHSFranklin Dshaun Home Help Detroit 5/4/2017 MDHHS

Franklin Jennifer Physician 1013115914 Harrison Township 4301095983 3/31/2016 MDHHS-OIG

3/29/2018 8/31/18 1/16/197/18/2019

MI-Bureau of Licensing and Regulatory Affairs MDHHS-OIG MI-Licensing and Regulatory AffairsHHS-OIG

Summary Suspension Summary Suspension Terminated RevokedExcluded

Franklin Jon Home Help Lansing 6/13/2019 MDHHS 9/6/2022 MDHHSFranklin Shaun Home Help Detroit 4/30/2020 MDHHS-OIG TerminatedFranks Kimberly Home Help Mesick 9/17/2019 MDHHSFrantz Danielle Home Help Muskegon 1/23/2019 MDHHSFrazier Marion Home Help Detroit 12/28/2016 MDHHS

Fredal Pharmacy Fredal Thomas Pharmacy Gross Pointe Farms 5301004236 5/23/1994 HHS 1128(b)(3)Freedland Joel E. Physician Lincoln Park 5101007189 8/7/1987 HHS 1128(a)(1)

Freeman Christopher Home Help Loretto 12/18/2018 MDHHS-OIG 1/17/2018 MDHHS-OIG

Summary Suspension Terminated

Freeman Richard F. Physician Detroit 4301026316 5/20/1998 HHS 1128(b)(4)Freeman Sean Home Help Detroit 2/22/2018 MDHHSFreeney Antoine Home Help Southgate 3/28/2016 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Frei Julia Physician 1396738597 Marquette 5101010701 12/27/2019

MI-Licensing and Regulatory Affairs Suspended

Freidl Harold D Physician 1962470435 Kalamazooo 4301036711 1/15/2013

MI-Licensing and Regulatory Affairs Suspended

Friedman Kenneth M. Dentist Roseville 2901014795 10/20/2003 HHS 1128(a)(2)Frierson Andre Home Help Muskegon 6/8/2017 MDHHS

Froehlich Darryl W. Nurse Practitioner 1932604774 Canton 4704226836 7/8/2022

MI-Licensing and Regulatory Affairs Suspended

Fronda Gerardo Physician 1457315160 Milwaukee, WI 48810-20 4/20/2022 Wi Licensing SurrenderedFrye Kenneth W. Physician Byron Center 5101003654 9/2/1997 HHS 1128(b)(4)Fuentes Leo Maupo Physician 1487873303 Detroit 4301034718 10/28/1981 HHS 1128(a)(1)Fulbright Leon Home Help Pontiac 1/23/2015 DCHFulghum Tyrone Home Help Detroit 6/27/2019 MDHHSFuller Damon Home Help Detroit 9/21/2016 MDHHSFullilove Delano Home Help Detroit 4/26/2022 MDHHS

Funderburg Clinical & Community Services Inc. Funderburg, Jr. Gerald R. Physician Group 1225254279 Detroit 5/29/2012 DCH

Summary Suspension

Furney Anthony A Home Help Detroit 11/16/2021 MDHHS

Fyn Mark Stephen Physician 1669624201 Roseville 4704201153 9/15/2009

MI-Licensing and Regulatory Affairs Suspended

Gaft Richard S Nurse Practitioner 1578626735 Gladwin 4704201154 8/13/2016

MI-Licensing and Regulatory Affairs Suspended

Gaidhane Virendra Pharmacy Owner 1265503288 Detroit 8/5/2020 MDHHS-OIG SuspendedGaines Tameso Home Help Detroit 12/5/2019 MDHHSGalbriath Donnie Home Help Alpena 11/30/2015 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Galecki Pawel A Physician 1295178739 Ypsilanti 4301103595 8/16/2021

MI-Licensing and Regulatory Affairs

Summary Suspension

Galmore Terry Home Help Lansing 12/31/2016 MDHHSGamble Keyon Home Help Detroit 11/28/2018 MDHHS

Gandy Kyle D Physician Assistant 1154502623 Midland 5601005166 4/15/2016

MI-Licensing and Regulatory Affairs 7/20/2016 HHS-OIG

Summary Suspension Excluded

Ganinous Anthony Home Help Detroit 11/14/2017 MDHHSGarcia Curtis Home Help Chesterfield 7/7/2016 MDHHSGarcia Laureen Home Help Lansing 6/13/2019 MDHHSGarcia Marcella Home Help Flint 4/28/2022 MDHHSGardner Brandon Home Help Detroit 3/2/2022 MDHHSGardner Sara Home Help Warren 11/30/2015 MDHHSGarlick Kaitlyn Home Help Portlage 8/10/2020 MDHHSGarner James Home Help Warren 4/7/2016 MDHHSGarner Rayshell Home Help Detroit 4/18/2019 MDHHSGarrison Earl Home Help Detroit 12/6/2017 MDHHSGarvie Joline Home Help Charlotte 11/30/2017 MDHHSGarza Veronica Home Help Kalamazoo 12/12/2019 MDHHSGaskin Antonio Home Help Clinton township 4/22/2019 MDHHSGatewood James Home Help Warren 11/26/2018 MDHHSGebhardt Mark James Home Help Houghtan Lake 3/31/2015 DCH 5/10/2018 MDHHS

Geha, James G. DPM, PC Geha James G. Podiatry Group Madison Heights 5901001042 3/18/1999 HHS 1128(a)(1)George Charles Home Help Three Rivers 10/26/2020 MDHHSGeorge Laheeb Home Help Sterling Heights 8/31/2016 MDHHSGeorge Lisa Home Help Pontiac 3/3/2016 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Geralt John A Physician 1972839447 Roseville 4301021869 7/30/2013 DCH-OIG

8/18/2016 01/31/2017 08/07/2017 11/8/2018

HHS-OIGMI-Licensing and Regulatory AffairsMI- Licensing and Regulatory AffairsMDHHS-OIG

Suspended Excluded Summary Suspension Revoked Terminated

Gerding Amanda Socail Worker 1881145878 Dewitt 6851099075 3/22/2022

MI-Licensing and Regulatory Affairs

Limited Restricted License

Geter Nancy Home Help Detroit 11/30/2015 MDHHS

Wayne Campus Pharmacy Ghussin Kindy Pharmacy 1760767974 Detroit 11/4/2020 MDHHS-OIGSummary Suspension

Gibbs Ebony Home Help Grand Rapids 10/31/2016 MDHHS

Gibbs Katrina Home Help Detroit 11/14/2018 MDHHSGibson Allen Home Help Detroit 10/30/2018 MDHHS

Gibson Denzel LPN 1689044786 Detroit 4703114723 1/4/2019

MI-Licensing and Regulatory Affairs

Summary Suspension

Gilbert Willie Home Help Detroit 2/5/2019 MDHHSGiles Jeff Home Help Detroit 11/30/2015 MDHHSGill Kathy Home Help Flint 8/30/2019 MDHHS-OIGGill William T Home Help Highland Park 11/30/2015 MDHHS

Gilleylen Lonia Home Help Grand Rapids 8/1/2018 MDHHS-OIG 8/3/2020 MDHHS-OIGSuspended Terminated

Gillihan Todd M Physician 1255474045 Chelsea 4901004251 10/20/2014

MI-Licensing and Regulatory Affairs 2/24/2016

MI-Licensing and Regulatory Affairs

Summary Suspension Summary Suspension

Gipson Dion Home Help Detroit 2/8/2018 MDHHSGipson James E Home Help Saginaw 12/3/2014 DCH

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Gissantaner Sharon Home Help Detroit 5/31/2019 MDHHSGist Trevon Home Help Detroit 5/21/2021 MDHHS

Giuliani James Physician 1821057829 West Bloomfield 5101009193 3/24/2015

MI-Licensing and Regulatory Affairs Suspended

Glass Michael Home Help Wyoming 9/24/2020 MDHHSGlenn Kevin Home Help Canton 5/2/2022 MDHHS

Gliha Gregory Physician Assistant 1447389044 Wayne 5601001483 6/26/2018 MDHHS

Disciplinary Limited License

Glover Jamal Home Help Flint 10/18/2016 MDHHSGlover Michelle Home Help Grand Rapids 7/7/2016 MDHHS

Godiali VassoGodziashvili Physician 1861572000 Bay City 4301065556 9/30/2015 MDHHS-OIG

Summary Suspension

Godoy, Charles MD PC Godoy Carlos Group 1912298902 Livonia 3/31/2016 MDHHS-OIG 10/30/2018 MDHHS-OIG

Summary Suspension Terminated

Godoy Carlos Physician 1881654705 Livonia 4301033015 3/31/2016 MDHHS-OIG

7/12/201710/30/20185/20/2019

MI-Licensing and Regulatory AffairsMDHHS-OIGHHS-OIG

Summary Suspension Voluntary Termination TerminatedExcluded

Goins Dearlando Home Help Detroit 8/23/2021 MDHHS

Goins Rondy D Podiatrist 1508904798 Detroit 5901001535 6/7/2012 DCH 12/30/2018 HHS-OIGSuspended Terminated

Goit Anissa Home Help wolverine 2/13/2020 MDHHSGolden Takah Home Help Muskegon 8/23/2016 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Goldfein Aaron S Physician 1053354787 Dearborn 4301082782 5/6/2014 DCH-OIG

2/14/2016 05/17/2017 6/20/2018 10/31/2019

MI-Licensing and Regulartory AffairsMI- Licensing amd Regulatory Affairs HHS-OIG MDHHS-OIG

Summary Suspension and Termination Suspension Suspended Excluded Terminated

Goldston EricNon- Emergency Transportation Inkster 2/25/2020 MDHHS

Medlife Rx Gomaa Mohamed Group 1205282266 Pontiac 10/30/2019 MDHHS-OIGSummary Suspension

Gomaa Mohamed Pharmacist 1043758246 Pontiac 5302045121 10/30/2019 MDHHS-OIG 10/13/2021

MI- Licensing and Regulatory Affairs

Summary Suspension Revoked

Gomez Alexander R Home Help Pinconning 4/9/2015 DCHGomez Angelena Home Help Pontiac 10/30/2018 MDHHSGonzales Edward Home Help Detroit 4/19/2018 MDHHSGonzalez-Tapia SanJuanita Home Help Lansing 4/24/2015 DCHGoode Girard Home Help Detroit 10/7/2019 MDHHSGooden laurence Home Help Detroit 12/12/2017 MDHHSGoodman Jaimar Home Help Detroit 9/6/2016 MDHHSGoodwin Krysal Home Help Kenockee 2/17/2021 MDHHS

Goole Rebecca Nurse Practitioner 1700330974 Vicksburg 4704201123 1/2/2021

MI-Licensing and Regulatory Affairs

Disciplinary Limited

Goosby Jerry Home Help Muskegon 4/16/2021 MDHHS

Gordon Carolyn Home Help Flint 6/4/2015 DCH-OIGSummary Supension

Gordon Craig Home Help Detroit 3/24/2021 MDHHSGordon Ken Home Help Lansing 1/7/2016 MDHHSGorial Susan Home Help Sterling Heights 3/20/2019 MDHHS

Goriee Eva Dentist 1821171638 Sterling Heights 2901017438 1/15/2020 MDHHS-OIGSummary Suspension

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Gorosh Richard P. Podiatrist Lansing 5901001179 2/20/2001 HHS 1128(a)(1)

Gosalakkal Jayaprakash Psychiatrist 1669764627 Grosse Pointe 4301104329 3/31/2021 MDHHS-OIGSummary Suspension

Gotcher Latrise Home Help Detroit 7/13/2016 MDHHS-OIG4/20/20174/27/2017

HHS-OIG MDHHS-OIG

Summary Suspension Excluded Terminated

Gotham James E. Physician Detroit 4301022173 10/11/1990 HHS 1128(a)(1)Grady Samuel Home Help Saginaw 9/2/2022 MDHHSGraham Theodore N. Physician Detroit 4301024579 7/30/1990 HHS 1128(a)(1)Gramm Donna Home Help Battle Creek 6/20/2018 MDHHSGramse Lawrence Home Help Flint 2/26/2015 DCHGrant Kelvin Renald Home Help Detroit 1/14/2015 DCHGrant Tammy Home Help White Cloud 8/23/2017 MDHHSGrappin Brian L. Chiropractor 1003931999 Flushing 2301002891 9/19/2002 HHS 1128(a)(3)Gray Monique R Home Help Inkster 10/4/2021 MDHHSGray Scott Home Help Twining 9/3/2019 MDHHSGray Vanita Home Help Detroit 1/14/2020 MDHHSGray William Home Help Detroit 1/14/2015 DCH

Gray Yev Podiatrist 1821006396 Chicago 5901002069 9/21/2017

MI-Licensing and Regulatory Affairs Suspended

Gray Steven Home Help Detroit 8/31/2020 MDHHSGreen Anthony Home Help Ludington 5/17/2016 MDHHSGreen Carlos Home Help Lansing 2/13/2020 MDHHSGreen Kejuan Home Help Detroit 7/26/2016 MDHHSGreen Kevin Home Help Southfield 3/6/2018 MDHHSGreen Lanell Home Help Muskegon Heights 8/6/2019 MDHHSGreen Rosezetta Home Help Detroit 9/18/2015 MDHHS

Green Toni Nurse Practitioner 1821457615 Harper Woods 4704241199 8/4/2020 MDHHS-OIGSummary Suspension

Greenbain Mark Psychiatrist 1326093709 Clinton 4301030022 9/26/2011 DCHSummary Suspension

Greenberg William A. Optometrist Harper Woods 4901002254 10/19/2006 HHS 1128(a)(2)Greene Antonio Home Help Kalamazoo 7/10/2015 DCHGreer Arthur C Home Help Muskegon 7/21/2020 MDHHS 9/16/2021 MDHHSGress Raymond C. Chiropractor Lake City 2301004963 4/10/1997 HHS 1128(b)(14)

Grewal Virinder S Physician 1427202050 Okemos 4301030430 3/21/2013 DCH 12/29/2015 MDHHS-OIG

Summary Suspension Terminated

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Griffin Andrae Home Help Eastpointe 8/17/2017 MDHHSGriffin Darryl K Home Help Saginaw 3/17/2022 MDHHSGriffin Erma Home Help Battle Creek 10/9/2014 DCHGriffin Kendricks Home Help Pontiac 2/14/2017 MDHHSGriffin Lonnie Leandry Home Help Pontiac 10/20/2014 DCHGriffin Willedtra Home Help Detroit 5/3/2016 MDHHSGriffins Steven D Home Help Saginaw 2/17/2022 MDHHSGriffith Curtis Evan Home Help Detroit 11/30/2015 MDHHSGrimmitt Joseph C Home Help Westland 11/21/2014 DCH

Grimshaw Kimberly Home Help Hawks 4/20/2020 MDHHS-OIG 11/6/2020 MDHHS-OIG

Summary Suspension Termination

Grissom Stanley Willis Home Help Muskegon 11/19/2014 DCHGross Charles Home Help Edwardsburg 3/7/2016 MDHHSGross Michael Home Help Eastpointe 4/23/2020 MDHHSGross Paul Home Help Port Huron 10/2/2019 MDHHSGross Robert Home Help Midland 11/3/2015 MDHHSGross Tina Home Help Eastpointe 12/5/2019 MDHHS

Grove Frederick Walter Physician 1538532833 Springport 4301033991 4/25/2018

MI-Licensing and Regulatory Affairs 11/14/2018

MI-Licensing and Regulatory Affairs

Summary Suspension Voluntarily Surrendered

Grubaugh Lisa Marie Home Help Harrison 6/12/2015 DCHGuerra Robert Home Help Flint 10/20/2014 DCHGuest Noelle Home Help Merritt 7/21/2016 MDHHS

Airport Apothecary Gujarathi Chetan Pharmacy 1831422294 Waterford NCPDP 2373253 8/23/2011 DCH 6/2/2016 MDHHS-OIG

Summary Suspension Terminated

Be Well Pharmacy Gujarathi Chetan Pharmacy 1891028759 Berkley NCPDP 2373227 8/19/2011 DCH 5/30/2016 MDHHS- OIG

Summary Suspension Termination

Responsible Care Pharmacy Gujarathi Chetan Pharmacy 1861668089 Detroit NCPDP 2371160 8/19/2011 DCH 5/23/2016 MDHHS-OIG

Summary Suspension Termination

Bio-Magnetic Resonance Inc. GunabalanRamasami (Ram) Medical Group 1508860206 Madison Heights 8/20/2017 HHS-OIG

10/9/2018 11/8/2018 MDHHS-OIG

Excluded Summary Suspension Terminated

Michigan Biotech Partners LLC GunabalanRamasami (Ram) Medical Group 1821095472 Allen Park 8/20/2017 HHS-OIG Excluded

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Sterling Medical Clinic PLLC GunabalanRamasami (Ram) Medical Group 1275767592 Sterling Heights 8/20/2017 HHS-OIG Excluded

Gunner Concetta Home Help Detroit 11/30/2015 MDHHSGutz Donald Home Help Wyandotte 5/12/2016 MDHHS

Guyaux Angelique M Home Help Sebewang 6/14/2022 MDHHS-OIGSummary Suspension

Guyton Jimmie Home Help Detroit 1/7/2016 MDHHS

Ha Hien D Pharmacist 1306070982 Sterling Heights 5302032761 6/14/2018

MI-Licensing and Regulatory Affairs 10/10/2018

MI-Licensing and Regulatory Affairs

Summary Suspension Suspended

Haacke Tracy Home Help Alpena 5/10/2016 MDHHSHairston Kenneth Home Help Roseville 2/10/2022 MDHHSHakim Marvin Home Help Oak Park 6/13/2017 MDHHS

Hakim Sakina S Physician 1659555621 Lexington, KY 5601005216 3/27/2017

MI-Licensing and Regulatory Affairs

5/18/2017 4/24/18

HHSMI-Licensing and Regulatory Affairs

Summary Suspension Excluded Revoked

Halaberda Daniel Chiropractor 1437273364 Wayne 2301004191 12/17/1989 HHS 12/21/1989 DCH

12/21/89: Violation of Medicaid False Claim Act12/17/89: 1128(b)(1)

Hale Angela M Private Duty Nurse 1295194249 Detroit 4703093931 7/4/2020

MI-Licensing and Regulatory Affairs

Limited Restricted License

Hall Booker Home Help Lansing 6/17/2015 DCHHall Bruce Home Help Leonard 12/31/2016 MDHHS

Hall Claude W Physician 1669404513 Farmington Hills 4301041684 8/30/2017

MI-Licensing and Regulatory Affairs 1/17/2018

MI-Licensing and Regulatory Affairs

Summary Suspension Summary Suspension

Hall Darline Home Help Detroit 9/10/2021 MDHHSHall DeAngelo D Home Help Detroit 5/27/2022 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Hall Joey Lee Home Help Redford 2/20/2015 DCH

Hallak Kassem M Physician 1629140447 Charlotte 4301062401 12/16/2011

MI-Licensing and Regulatory Affairs

10/10/2013 11/09/2013

DCH DCH

SuspendedSummary SuspensionTerminated

Halm Steven Home Help Gwinn 6/28/2017 MDHHSHalthon Tony Home Help Detroit 3/30/2017 MDHHS

Wayne Campus Pharmacy Hamaed Raef Pharmacy 1760767974 Detroit 11/4/2020 MDHHS-OIG Summary SuspHamama Nary Home Help Saint Clair Shores 11/3/2016 MDHHS

Hammond-Koskey David Physician Assistant 1871676254 Ludington 5601004543 9/18/2013 DCH 12/20/2014 HHS

Summary Suspension Excluded

United Home Care Providers of Michigan Inc Hammoud Alicia Facility 1386962645 Dearborn 5/7/2020 MDHHS-OIG Terminated

Hampton Akilah Home Help Kalamazoo 6/6/2022 MDHHS

Hampton HarryNon-Emergency Transportation Belleville 1/4/2018 MDHHS

Hankerson Garland Home Help Detroit 11/26/2019 MDHHSHanna Maher Home Help Sterling Ehights 9/1/2022 MDHHSHanna Nadim Home Help Farmington Hills 11/14/2018 MDHHSHansen Terry Home Help Port Huron 10/31/2014 DCHHardon Dawn Home Help Detroit 4/2/2019 MDHHSHardrick Michael Home Help Detroit 6/26/2018 MDHHSHardrick Tanya Home Help Detroit 10/19/2016 MDHHSHardville Travis C Home Help Detroit 6/2/2015 DCHHardy Andrew Physician 1710101688 Traverse City 4301046774 11/20/2002 HHS 1128(a)(1)

Harper George Home Help Eastpointe 7/22/2015 MDHHS-OIG

Summary Suspension and Termination

Harper Michael Home Help Pontiac 3/13/2019 MDHHSHarper Samuel Home Help Manistee 3/7/2016 MDHHS

Harrell Donald Physician 1164592721 Kalamazoo 4301033947 3/17/2021

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Harrell Ebony Home Help Detroit 5/11/2017 MDHHSHarrell Pamela Home Help Warren 11/10/2014 DCHHarrell William Home Help Detroit 4/19/2016 MDHHSHarrien Brandon Home Help Muskegon 1/4/2016 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Harris Antawan Home Help Muskegon 8/22/2019 MDHHSHarris Camaron Home Help Flushing 4/16/2021 MDHHSHarris Cedrick Home Help Three Rivers 3/20/2015 DCHHarris Frank W. Dentist 1578615209 Detroit 2901008049 5/26/1997 HHS 1128(b)(4)Harris Jwyanza Home Help Detroit 1/8/2019 MDHHSHarris Martinez Home Help Warren 11/30/2015 MDHHSHarris Patrice Home Help Benton Harbor 10/10/2018 MDHHSHarris Tracey Home Help Detroit 4/4/2016 MDHHS

Harris Angela Physician 1093918138 Detroit 4301058258 1/15/2020

MI-Licensing and Regulatory Affairs Suspended

Harris-Ivey Marion Home Help Flint 4/7/2015 DCHHarsten Kidadah Home Help Detroit 10/29/2016 MDHHS

Hartsuff Jenni Physician 1972544518 East Lansing 4704178226 10/28/2008

MI-Licensing and Regulatory Affairs

Summary Suspension

Harvey Kelvin Home Help Detroit 9/26/2017 MDHHSHarvey Tamika Home Help Detroit 1/7/2016 MDHHSHasan Nafeesa Home Help Pontiac 9/19/2017 MDHHSHasberry Michael Home Help Southfield 12/17/2014 DCHHasley Samuel Home Help Westland 2/28/2019 MDHHSHathorne Lakesha Home Help Three Rivers 2/23/2022 MDHHSHatt Justin Home Help Mount Pleasant 3/16/2021 MDHHSHatten Towanda Home Help Grand Rapids 11/7/2016 MDHHS 10/21/2021 MDHHSHAwkins Antorrian Home Help sainaw 4/19/2022 MDHHSHawkins Brittany Home Help Holland 2/22/2018 MDHHSHawkins Dale Home Help Detroit 4/21/2021 MDHHSHawkins Duane Home Help Battle Creek 10/30/2019 MDHHSHawkins Jahmall Home Help River Rouge 5/15/2019 MDHHSHawkins Jamaine L Home Help Kalamazoo 2/4/2022 MDHHSHawkins Mary Home Help Owosso 9/15/2015 MDHHSHayes Antwaune Home Help Saginaw 12/10/2014 DCHHayes Eric Home Help Garden City 5/16/2019 MDHHSHayes Kenneth Home Help Roseville 12/4/2019 MDHHSHayes Norman Home Help Port Huron 1/18/2018 MDHHSHayes William Home Help Detroit 3/7/2016 MDHHSHaynes David Home Help Niles 1/14/2020 MDHHSHaynes Demond Home Help Detroit 4/25/2019 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Head Charles Home Help Detroit 4/15/2019 MDHHS

12/2/2021 01/27/2022 02/28/2022

MDHHS MDHHS MDHHS

Hearns Ben J. Dentist Detroit 2901014305 2/5/1997 HHS 1128(b)(14)Heath Beverly Home Help Detroit 7/6/2016 MDHHSHeath Lucius Home Help Detroit 5/3/2021 MDHHSHedgecorth Julia Anne Physician Albion 4301045086 4/2/2001 HHS 1128(b)(4)Heeren Nancy Home Help Grand Rapids 7/25/2017 MDHHSHeidenga Scott Home Help Holland 2/12/2018 MDHHS

Heiney Jake P Physician 1215081773 Lambertville 35090990 9/15/2015 MDHHS-OIG6/28/2016 02/10/2017

MI-Licensing and Regulatory Affairs MI-Licensing and Regulatory Affairs

Summary Suspension Summary Suapension Revoked

Heinze Adam Home Help Cheboygan 11/28/2016 MDHHSHemphill Robert A. Physician 1073608774 Saginaw 5101006231 8/20/2002 HHS 1128(a)(3)Hendershott Ashley Home Help Cadillac 7/8/2021 MDHHSHenderson Ericka Home Help Mount Morris 4/21/2016 MDHHS

Henderson Judy Physician 1700813227 Niles 4301088108 8/31/2020

MI-Licensing and Regulatory Affairs 6/1/2021 MDHHS-OIG

Summary Suspension Summary Suspension

Henderson Kenny Home Help Detroit 9/6/2022 MDHHSHenderson Malik Home Help Detroit 12/4/2015 MDHHSHenderson Michael Home Help Weidman 10/8/2021 MDHHSHenderson Phillip John Home Help Detroit 4/21/2015 DCHHenderson Richard M. Dentist North Pontiac 2901006073 2/4/1992 HHS 1128(a)(1)Henderson Sean Home Help Clint Twp 12/1/2014 DCHHenley Yvette Home Help Detroit 5/10/2021 MDHHSHennemann Duval Home Help Big Rapids 3/10/2020 MDHHS 6/25/2021 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Hennessy Michael E Dentist 1396820460 Farmington Hills 2901014529 12/12/2011

MI-Licensing and Regulatory Affairs Suspended

Hernandez Jose Home Help Clinton township 5/3/2016 MDHHSHernandez Laureane Home Help Pontiac 2/6/2015 DCH

Herold Arthur D Physician 1982602686 West Bloomfield 5101005640 3/30/2017

MI-Licensing and Regulatory Affairs 7/19/2017 HHS-OIG

Summary Suspension Excluded

Herrero Adelina W Physician 1740340264 Ypsilanti 4301032776 4/15/2014 DCH-OIG

11/22/2014 12/18/20144/10/2015

MI-Licensing and Regulatory Affairs HHS MI-Licensing and Regulatory Affairs

Summary Suspension Summary Suspension Excluded Revoked

Herrick Ebony Home Help Grand Rapids 6/21/2017 MDHHS

Herrick Kirk Hilliard Physician 1942348446 Saginaw 5101004727 12/17/2020

MI-Licensing and Regulatory Affairs

Summary Suspension

Herring Carl L Home Help Grand Rapids 10/21/2021 MDHHS

Hertzfeld Robert James Physician 1932104460 Northwood, OH 4301079137 2/24/2012

MI-Licensing and Regulatory Affairs Suspended

Hester Anitra Home Help Detroit 10/4/2018 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Hethorn Joseph AProfessional Counselor 1114418076 Lansing 6401016668 7/22/2019 MDHHS-OIG

8/15/2019 11/26/2019

MI-Licensing and Regulatory Affairs MI-Licensing and Regulatory Affairs

Summary Suspension Summary Suspension Revoked

Heyer Geoffrey Psychiatrist 1649200692 Columbus, OH 35091474 5/13/2020Ohio Licensing

Permanently Surrendered

Hiatt Rodger Social Worker 1164776225 Onondaga 680100002 4/21/2022

MI-Licensing and Regulatory Affairs Suspended

Hibler Anton Deshon Home Help Saginaw 12/9/2014 DCHHickerson Nicole Home Help Shepherd 2/9/2017 MDHHSHicks Felicia Home Help Detroit 4/4/2017 MDHHSHicks Karena L Home Help Strerling Heights 12/28/2021 MDHHSHicks Lamont Home Help Dearborn Heights 11/26/2019 MDHHSHigdon Karan Home Help Shelby Township 9/15/2020 MDHHSHiggins Charles Home Help Kalamazoo 7/26/2018 MDHHSHiggwe Golden Goye Podiatrist Southfield 5901001783 10/20/2003 HHS 1128(a)(3)Hijazi Mohamad Dentist Dearborn 2901014717 11/11/1992 HHS 1128(a)(1)Hildebrandt Henry Mark Physician 1124021647 Ypsilanti 4301021381 12/20/2005 HHS 1128(b)(1)Hill Bradley Home Help River Rouge 12/6/2016 MDHHSHill Jerry Home Help Saginaw 12/2/2016 MDHHSHill Qunatrell Home Help Inkster 8/29/2016 MDHHSHill Shawn Home Help Detroit 8/14/2018 MDHHS

Tri County Home Help LLC Hill Stephen Home Help Agency Eastpointe 9/10/2019 MDHHS-OIGSummary Suspension

Hill Stephen Home Help Eastpointe 9/10/2019 MDHHS-OIGSummary Suspension

New Era Home Care Inc Hills Robert Home Health Agency 1740225051 Southfield 5/28/2020 MDHHS-OIGSummary Suspension

Hines Derrick Home Help Detroit 6/8/2015 DCH-OIG

Suspended and Terminated

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Hinman Pharmacy (dba Medical Arts Pharmacy) Hinman William Pharmacy Grand Blanc 5301004202 1/3/1989 HHS 1128(a)(1)

Hinton Jamar Home Help Sterling Heights 5/30/2019 MDHHS

Hintz Laura Nurse Practitioner 1528035342 Saginaw 4704195930 2/2/2017 MDHHSVountarily Surrrendered

Hitz Leticia Home Help Saginaw 7/13/2016 MDHHS

Hoard JohnNon-Emergency Transportation Gladwin 6/28/2017 MDHHS

Hoberman Melvin Psychologist 1497812523 Dearborn 6361001441 5/2/2021

MI-Licensing and Regulatory Affairs Suspended

Hoch Jeffrey C. CRNA 1215040589 Jackson 4704146933 3/2/2015

MI-Licensing and Regulatory Affairs

Summary Suspension

Hoda Syed Tanweerul Physician Trenton 4301060045 10/20/2005 HHS 1128(b)(4)Hodge Andrea Home Help Detroit 11/7/2017 MDHHSHodges Carla Home Help Grand Rapids 4/18/2018 MDHHS 0816/2022 MDHHS

Metropolitan Universal Home Care Hodges Telicia Home Help Chicago 1/13/2020 MDHHS-OIG

Hoeltzel Mark F Physician 1801910617 Ann Arbor 4301083829 12/21/2017

MI-Licensing and Regulatory Affairs

6/26/2018 01/15/2020

MI-Licensing and Regulatory Affairs MI- Licensin and regulatory Affairsg

Summary Suspension Revoked Permanently Revoked

Hoffmeister Martin Glenn Physician 1699839365 Grand Rapids 5901001390 2/25/2014 DCH-OIGSummarily Suspended

Hogan Frederick A. Physician 1801974050 Lansing 5101009418 5/24/2010

MI-Licensing and Regulatory Affairs Suspended

Hogue April Home Help Dowagiac 7/8/2015 DCH

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Holata Nadher Home Help Oak Park 9/2/2020 MDHHS

Holbrook AngieNon-Emergency Transportation Cadillac 9/12/2017 MDHHS

Holda Michael Physician 1427029925 Howell 4301036662 10/22/2013 DCH3/26/2013 07/20/2015

MI-Licensing and Regulatiory Affairs

Summary Suspension Suspended

Holen Lawrence Physician 1205936176 Marlette 5101006708 5/31/2018 MDHHS

Disciplinary Limited License

Holet James Home Help Westland 5/8/2015 DCHHoliday Jermaine R Home Help Grand Rapids 11/30/2015 MDHHSHolliday Sharieffe L Home Help Highland PArk 1/28/2017 MDHHSHolloway Lawrence M. Physician Flint 11/19/1997 HHS 1128(b)(4)Holloway Nathaniel Dentist Ypsilanti 2901006451 8/7/1997 HHS 1128(a)(1)Holmes Eveck Home Help Port Huron 9/5/2018 MDHHSHolmes Mary Home Help Saginaw 8/30/2019 MDHHS-OIGHolmes Renee Home Help Flint 9/29/2021 MDHHS 2/15/2022 MDHHSHolston Elizabeth Home Help Warren 8/30/2019 MDHHS-OIG 2/20/2020 HHS-OIG ExcludedHolt Joseph Home Help Detroit 1/15/2019 MDHHSHolt Tahitian Home Help Southfield 7/16/2019 MDHHS

Holyway Craig Taylor Dentist Southfield 2901016274 12/7/1994 HHS 9/7/1994DCH HHS

12/7/94: 1128(a)(1)9/7/94: Violation of Medicaid False Claim Act Excluded

Hooks Jermaine Home Help Pontiac 10/11/2017 MDHHSHooper Bruce Home Help Muskegon 12/3/2018 MDHHS

Hooper Mary K Registered Nurse 1700076684 Ishpeming 4704244897 11/21/2012

MI-Licensing and Regulatory Affairs Suspended

Hopkins Bennett Home Help Ecorse 12/7/2017 MDHHSHopkins Danial Physician Mount Pleasant 4301405717 5/20/2001 HHS 1128(a)(1)Hopkins Danny Home Help Grand Rapids 5/18/2017 MDHHSHopkins Kenneth R Home Help Pinckney 3/27/2015 DCHHornaday Richard Home Help Highland Park 11/21/2019 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Horton Danyela R Home Help Harrison 11/16/2021 MDHHSHorton Kimberly Home Help Benton Harbor 8/20/2018 MDHHSHouston Jeffery Home Help Grand Rapids 5/23/2019 MDHHSHoward Danny Home Help Rives Junction 9/29/2016 MDHHSHoward Demetrius D Home Help Detroit 5/22/2015 DCHHoward Earl Home Help Detroit 11/15/2017 MDHHSHoward Fred Jerome Home Help Gobles 3/25/2015 DCHHoward Lillardo Home Help Flushing 12/12/2016 MDHHSHoward Terrence Home Help Detroit 12/16/2015 MDHHSHoward Timothy Devon Home Help Lansing 3/6/2015 DCH

Howe Clarence G. Physician Detroit 5101003031 3/18/1987 DCH

Violation of Medicaid False Claim Act

Howell Monica Home Help Bay City 9/7/2017 MDHHSHuddleston Shannon Home Help Benton Harbor 5/31/2017 MDHHSHuddleston Sheila Diane Home Help Detroit 10/22/2014 DCHHudgens Rickey T Home Help Detroit 7/8/2021 MDHHSHudson Donald L. Chiropractor 1255488615 East Lansing 2301005765 2/2/2006 HHS 1128(b)(14)Hudson James Home Help East Lansing 5/9/2019 MDHHSHuestis Christina Home Help Bay City 10/20/2014 DCHHughes Timothy Home Help Belleville 11/30/2015 MDHHSHughey Danny Home Help Muskegon 5/1/2014 DCHHugle Alden Home Help Detroit 10/17/2016 MDHHSHulburt Melissa Home Help Jackson 12/27/2016 MDHHSHunter Earnest D Home Help Monroe 12/8/2020 MDHHS

Hunter Elleen E. Physician Mount Clemens 5101004385 3/18/1987 DCH 10/13/1990 HHS

3/18/87: Violations of Medicaid False Claim Act10/13/90: 1128(a)(1)

Hunter Mandell Home Help Jackson 11/5/2020 MDHHSHunter Tyrone R Home Help Warren 12/7/2020 MDHHSHurrle Albert Home Help Dowagiac 12/2/2019 MDHHS

Hush GeorgeNon-Emergency Transportation Afton 1/6/1997 HHS Excluded

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Hussain Murtaza Physician 1043238421 Detroit 4301057047 4/6/2015 DCH-OIG

8/11/2015 05/19/2016 06/02/2016 11/25/2019

MI-Licensing and Regulatory Affairs HHS-OIG MDHHS-OIG

Summary Suspension Summary Suspension Excluded Limited/ Restricted

Hussain Redwan Home Help Hamtramck 3/10/2022 MDHHS

Hussett Earl Pharmacist 1528629706 Canton 5302410793 3/26/2020

MI-Licensing and Regulatory Affairs Suspension

Hussey Clifford Home Help Detroit 8/6/2019 MDHHSHuynh Thanh Home Help Grand Rapids 7/12/2016 MDHHS

Hyde Thomas Dentist 1356402077 Saginaw 2901014309 4/24/2015

MI-Licensing and Regulatory Affairs 6/11/2015

MI-Licensing and Regulatory Affairs

Summary Suspension Summary Suspension

Hydrick Robert H. Physician Grand Rapids 4301019228 5/20/1998 HHS 1128(b)(4)Hyman Samuel J. Physician Wayne 4301012805 6/30/1988 HHS 1156(b)Hysaw Denise Danillie Home Help Muskegon 12/26/2014 DCHImam Bashar Managing Employee Dearborn 9/20/2017 HHS-OIG Excluded

Ingram DeonteNon-Emergency Transportation Detroit 2/20/2019 MDHHS

Ingram Kimberly Home Help Detroit 7/20/2016 MDHHSInman Tonya Home Help Houghton Lake 2/20/2020 MDHHSIrvin Kresha Home Help Detroit 10/2/2018 MDHHS

Isaac Lajuana Dentist Detroit 2901016354 1/12/2022

MI-Licensing and Regulatory Affairs Suspended

Issak Neeran Home Help Sterling Heights 10/8/2018 MDHHS-OIG3/28/20194/18/2019

MDHHS-OIGHHS-OIG

Summary Suspension TerminatedExcluded

Iverson Tracey Lorene Home Help Port Huron 1/12/2015 DCH

Ivory Jackie Home Help Bruceton Mills, WV 6/30/2016 HHS-OIG

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Iwas Hasna Home Help New Baltimore 11/29/2021 MDHHS-OIGSummary Suspension

Iwas Hasna Pharmaist 1144787003 New Baltimore 5302410939 11/29/2021 MDHHS-OIGSummary Suspension

Iyer Ravi Physician 1467493791 Detroit 4301082017 7/30/2013 DCH-OIG3/20/201711/13/2018

MI- Licensing and Regulatory AffairsMDHHS-OIG

Suspended Summary Suspension Terminated

Jackson Cassandra P Home Help Detroit 12/11/2014 DCH

Jackson Chiropractic Clinic Jackson Charles Medical Group 1114111572 Grand Blanc 6/25/2019 MDHHS-OIGSummary Suspension

Jackson Charles Chiropractor 1508985250 Grand Blanc 2301003001 4/19/2019

MI-Licensing and Regulatory Affairs 6/25/2019 MDHHS-OIG

Summary SuspensionSummary Suspension

Jackson Darryl Home Help Detroit 11/9/2017 MDHHS

Jackson Douglas Home Help Lansing 12/25/2019 MDHHS-OIG

Suspension and Termination

Jackson James Home Help Grand Rapids 2/19/2015 DCHJavkson Juanita Home Help Monroe 3/4/2022 MDHHSJackson Latoya Nicole Home Help Detroit 4/13/2015 DCH 11/16/2021 MDHHSJackson Mark Home Help Detroit 2/27/2017 MDHHSJackson Raymond Home Help Detroit 6/3/2020 MDHHSJackson Rodney Home Help Kalamazoo 1/21/2020 MDHHS TerminatedJackson Timeko Home Help Flint 1/30/2017 MDHHSJackson Wanda Home Help Detroit 7/31/2015 MDHHSJackson Yashica Home Help Warren 2/7/2020 MDHHS-OIG TerminatedJacobs Jerome Home Help Detroit 12/28/2016 MDHHSJacobson Suzanne Home Help interlochen 10/20/2017 MDHHS-OIGJadan Raman Home Help Sterling Heights 8/6/2018 MDHHSJakubiak Paul J. Physician Lansing 4301027820 3/20/2003 HHS 1128(b)(4)Jamar Marnez Home Help Eastpointe 11/30/2015 MDHHSJames David Home Help Saginaw 8/17/2017 MDHHSJames Marilyn Home Help Lansing 1/26/2017 MDHHSJames Yakeena K Home Help Detroit 11/30/2015 MDHHSJamison Raymond Home Help Niles 5/22/2018 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Janarthanan Sailajah Physician 1811098247 Troy 4301093872 2/19/2013

MI-Licensing and Regulatory Affairs Suspended

Janviriya Vicha Physician 1174603930 Southfield 4301032436 3/11/2015 DCH-OIG 1/20/2016 HHS-OIG

Summary Suspension Excluded

Jarvis Kassia Home Help Pontiac 6/26/2019 MDHHS

Javellana Eronico Physician 1285677948 Bad Axe 4301033553 1/16/2019

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Pain Stop MD PLC Jayakar Gandam Medical Group 1306371984 Oak Park 7/17/2019 MDHHS-OIG 4/29/2022 MDHHS-OIG

Summary Suspension Terminated

Jayakar Gandam Physician 1720017486 Saint Clair Shores 4301036095 7/17/2019 MDHHS-OIG 4/29/2022 MDHHS-OIG

Summary Suspension Terminated

Jayasundera Victor Physical Therapist 1558488783 Southfield 5501005927 9/10/2012

MI-Licensing and Regulatory Affairs Suspended

Jefferson Lerteatrist Home Help Detroit 12/4/2014 DCHJeffries Caprica Home Help Covert 1/18/2018 MDHHSJeffries Willie Home Help Jackson 1/30/2020 MDHHSJefferson Vonda K Home Help Muskegon 9/27/2021 MDHHSJenkins Corinna Home Help Flint 12/26/2018 MDHHS

Jennings AlonzoNon-Emergency Transportation Westland 1/3/2018 MDHHS

Jennings Gregory Home Help Detroit 1/15/2015 DCHJennings Sophia Loen Home Help Dearborn Heights 11/13/2014 DCH

Jerkins Waymon D.Podiatrist/Medical Supplier Detroit 5901000834 7/6/1993 DCH 7/29/1997 HHS

7/6/93: Violation of Medicaid False Claim Act7/29/97: 1128(a)(1)

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Jimenez Victor Physician 1528045333 Grand Rapids 4301086868 2/9/2021

MI-Licensing and Regulatory Affairs

Summary Suspension

Jimmerson-Lee Carolyn Physician 1831152552 Southfield 5101007802 2/6/2020

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Jirjees (Jiris) Nawar Home Help Farmington Hills 5/20/2022 MDHHSJohnson Alejandro Home Help Detroit 7/31/2018 MDHHSJohnson Angelo Home Help Detroit 6/10/2015 DCHJohnson Ben Home Help Detroit 12/10/2020 MDHHSJohnson Bunny Home Help Kalamazoo 2/10/2018 MDHHS

Johnson Carla Private Duty Nurse 1700397585 Oak PArk 4704195225 2/18/2021

MI-Licensing and Regulatory Affairs 7/16/2021

MI- Bureau of Licensing and Regulatory Affairs

Summary Suspension Suspended

Johnson Charles Home Help Pontiac 10/29/2016 MDHHSJohnson Charles Home Help Muskegon 12/9/2015 MDHHS

Johnson Denise Home Help Detroit 7/22/2019 MDHHS-OIGSummary Suspension

Johnson Dennis Home Help Detroit 11/21/2018 MDHHS8/10/2020 06/23/2021

MDHHS MDHHS

Johnson Eric Home Help Kalamazoo 12/17/2014 DCHJohnson Erick Home Help Detroit 2/28/2019 MDHHSJohnson Falando Home Help Detroit 10/18/2016 MDHHSJohnson Flossie Home Help Detroit 10/3/2017 MDHHSJohnson Jimmy Edward Home Help Roseville 10/20/2014 DCHJohnson Julius A Home Help Detroit 11/30/2015 MDHHSJohnson Keithley E. Physician Dearborn 4301032641 8/14/1995 HHS 1128(b)(3)Johnson Kisha Home Help Detroit 4/30/2015 DCHJohnson Larry Otis Home Help Detroit 10/23/2014 DCHJohnson Lonzarie Home Help Roseville 2/10/2022 MDHHSJohnson Maria Home Help Detroit 8/3/2017 MDHHSJohnson Michael Home Help Kalamazoo 7/17/2018 MDHHSJohnson Robert Home Help Ecorse 4/12/2018 MDHHSJohnson Sandra Nurse Anesthetist 1063440030 Sault Sainte Marie 4704152459 7/5/2019 MDHHS TerminatedJohnson Shannon Home Help Hazel Park 10/5/2021 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Johnson Stephen Home Help Lansing 2/9/2016 MDHHSJohnson Tequila Home Help Three Rivers 2/25/2021 MDHHSJohnson Tiaka Home Help Grand Rapids 8/14/2017 MDHHSJohnson Tracy Home Help Kalamazoo 12/23/2014 DCH

Healthy Home Living Johnson Naomi Home Help Agency West Bloomfield 11/26/2019 MDHHSJones Brandon Home Help Harper Woods 11/25/2019 MDHHS Jones Calvin Home Help Muskegon Heights 3/24/2022 MDHHSJones Courtney home Help flint 1/12/2022 MDHHSJones Derrick Earl Home Help Wayne 11/30/2015 MDHHSJones Dmarcus Home Help Roseville 3/16/2015 DCHJones Geneva Home Help Kalamazoo 5/22/2019 MDHHSJones George Home Help Benton Harbor 3/18/2019 MDHHSJones Helen Home Help Detroit 12/18/2014 DCHJones Henrietta Home Help Port Huron 4/22/2019 MDHHSJones Ivan Home Help Wayne 7/6/2017 MDHHSJones Jacquetta Home Help Benton Harbor 8/23/2017 MDHHSJones Jemien Zardo Home Help Flint 4/3/2015 DCH

Jones Joel Home Help Flint 11/23/2021 MDHHS-OIGSummary Suspension

Jones Julias Home Help Milan 11/24/2014 DCHJones Lisa Home Help Romulus 10/4/2021 MDHHSJones Lynda Home Help Detroit 7/3/2019 MDHHS

Jones Mark Psychologist 1558474585 Port Huron 6301011246 9/5/2017

MI-Licensing and Regulatory Affairs

5/9/2018 3/22/186/8/18

MDHHS-OIG MI- License and Regulatory AffairsMDHHS-OIG

Summary Suspension Summary Suspension Revoked Terminated

Jones Marquett Home Help Detroit 11/30/2015 MDHHSJones Michael Home Help Lannsing 2/18/2020 MDHHSJones Monique Home Help Grand Rapids 9/14/2016 MDHHSJones Susan Home Help Jackson 4/15/2019 MDHHSJones Toberi Home Help Detroit 10/29/2020 MDHHSJones Turquoise Sabrina Home Help Grand Rapids 2/19/2015 DCHJones William Home Help Highland Park 7/1/2019 MDHHSJones- Wert Darlene Home Help Hillsdale 10/6/2016 MDHHSJordan Brandon Home Help Detroit 9/27/2016 MDHHS

Jordan William Physician Assistanr 1144302803 Lansing 5601001389 11/18/2021

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Joseph Edward Physician 1598719809 Mount Clemens 5101012963 4/4/2008

MI-Licensing and Regulatory Affairs

Summary Suspension

Judd David Nurse Practitioner 1508112491 Clinton Township 4704199416 6/29/2022 MDHHS-OIGSummary Suspension

Jude Kevin Home Help Mount Clemens 3/19/2019 MDHHSJudkins Kelvin Home Help Grosse Pointe 9/1/2016 MDHHSJulian Michael Home Help Flint 1/14/2020 MDHHS Terminated

Jurek-D'Andrea Kristina Home Help Macomb 2/19/2014 DCH-OIG 8/26/2015 DCH-OIG

Summary Suspension Terminated

Justice Candy Home Help Mount Clemens 7/23/2018 MDHHSJustice Tyree Home Help Detroit 12/17/2018 MDHHSKafi Alex Physician 1578586772 Southfield 4301043089 1/20/2020 HHS-OIG ExcludedKalinski Shawn Home Help Detroit 6/5/2017 MDHHS

Kam Anthony M. Physician 1407894207 Sheridan 4301033166 5/1/2008

MI-Licensing and Regulatory Affairs

Voluntary Suspension

Kaminski TeresaNon-Emergency Transportation Alpena 2/16/2017 MDHHS

Karas KennethNon-Emergency Transportation Lake 5/31/2017 MDHHS

Kasper Theodore Social Worker 1336271865 Bruce Township 6801059521 11/26/2019

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Kassab Sana Home Help Shelby Township 8/20/2018 HHS-OIGKates Jeremiah Home Help Lansing 1/20/2016 MDHHS

Kaufman, Jack A. DPM, PC (aka Novi Footcare Associates PC) Kaufman Jack A. Podiatry Group Novi 5901000903 9/19/2003 HHS 2/20/2006 HHS

9/19/03: 1128(a)(1) 2/20/06: 1128(a)(1)

Noblecare Pharmacy Kaur Prabhjett Pharmacy 1730480203 Southfield NCPDP 2374750 8/23/2011 DCH 6/2/2016 MDHHS-OIG

Summary Suspension Terminated

Kavalick Julie Home Help Croswell 4/25/2019 MDHHSKay John F. Chiropractor Westland 2301005309 11/8/1994 HHS 1128(b)(14)

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Kaza Sudheer Physician Detroit 4301047113 3/18/1987 DCH

Violation of Medicaid False Claim Act

kazem Hussain Home Help Hazel Park 1/11/2022 MDHHSKazma Robert M. Chiropractor Detroit 2301002964 9/20/2001 HHS 1128(a)(1)Keels Ramone Home Help Saginaw 11/30/2015 MDHHS

Keen-Centofanti Judith R. Chiropractor Imlay City 2301006875 3/6/1997 HHS 1128(b)(14)Kellam Laquinta Home Help Detroit 8/16/2018 MDHHSKelley Cheryl Ann Home Help Muskegon 12/3/2014 DCHKelley Demetric Home Help Detroit 5/12/2016 MDHHSKelley-Manees Cynthia Home Help Eastpointe 2/7/2019 MDHHSKellum Marlon R Home Help Detroit 11/30/2015 MDHHS

Kelly Paul A Physician 1932351715 Southfield 4301051333 7/30/2013 DCH-OIG 9/30/2013 HHSTerminated1128(a)(1)

Kelly, Jr. James J. Physician 1316975386 Troy 4201054938 4/27/2008

MI-Licensing and Regulatory Affairs

Summary Suspension

Kennedy Christopher R Physician 1982665303 Howell 4301076517 7/30/2019

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Kennedy David Roderick Home Help Detroit 11/30/2015 MDHHSKennedy Dominque Home Help Oak Park 4/7/2016 MDHHS

All Care Medical Center Inc. Kennedy Donald R. Physician Flint 5101003922 4/12/1993 HHS 1128(a)(1)Kennewell Robert Physician 1083899850 Bloomfield Hills 5101013786 8/3/2020 MDHHS-OIG SuspendedKenue Lakshmi Physician Detroit 4301050782 3/29/1990 HHS SuspendedKequom Jennifer Home Help Whitehall 11/2/2021 MDHHS

Keri Andrew Physician 1174836571 Warren 5101018617 4/20/2020 MDHHS-OIG 5/20/2021

MI-Licensing and Regulatory affairs

Summary Suspension Suspended

Kern Steven A. Chiropractor 1528199403 Marine City 2301005582 8/25/2013

MI-Licensing and Regulatory Affairs

Summary Suspension

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Kerr Ellen Nurse 1588783484 Bloomfield 4704096047 1/5/2011 DCHVoluntarily surrendered

Kerse Ladon Home Help Detroit 4/18/2019 HHS-OIG Excluded

Ketcham Donn W. Physician 1598742702 Allendale 4301023446 2/24/2012

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Khalil Rami Dentist 1548787997 Northville 2901022252 6/12/2019 MDHHS-OIG 9/2/2019 MDHHS-OIG

Summary Suspension Terminated Excluded

Khan, Walayata MD, PC Khan Walayata A. Physician 1497779649 Ypsilanti 4301042910 2/11/1996 HHS

05/06/20143/30/20156/20/18

DCH-OIGDCH-OIGHHS-OIG

1128(a)(1) Summary Suspension TerminationExcluded

Khanbai Javeed Home Help Lansing 3/23/2017 MDHHS

Khreizat Hassan Pharmacist 1972812352 Warren 5302033116 11/9/2020 MDHHS OIGSummary Suspension

Khurana Suresh P. Physician 1790859205 Harrison Township 4301031380 3/18/2011

MI-Licensing and Regulatory Affairs

Drug diversion

Kiefer Kathryn M CRNA 1629148119 Grosse Pointe 4704170474 6/9/2017

MI-Licensing and Regulatory Affairs

Summary Suspension

Kilpatrick Kerry Chiropractor 1568517225 Grand Rapids 2301004267 10/27/2011

MI-Licensing and Regulatory Affairs Suspended

Kim Dong Irl Physician Holland 4301039383 6/20/2000 HHS 1128(b)(4)Kimbrel Brandy Home Help Grand Rapids 8/6/2018 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Kimbrough Christina Physician 1942525894 Canton 430196825 5/1/2018 MDHHS-OIG

12/21/20183/27/20196/20/2019 12/04/2019

MDHHS-OIG MI- Licensing and Regulatory AffairsHHS-OIG MI-Licensing and Regulatory Affairs

Summary Suspension TerminatedSummary SuspensionExcluded Revoked

Kincaid Shamika Latrice Home Help Southfield 2/17/2015 DCH

King Sharon Home Help Detroit 5/27/2020 MDHHS-OIGSummary Suspension

King III John V Dentist 1528142718 Detroit 2901011657 5/7/2018 MDHHS-OIG

6/6/201811/13/2018 08/05/2019

MDHHS-OIG MI- Licensing and Regulatory Affairs MI-Licensing and Regulatory Affairs

Summary Suspension Terminated Summary Suspension Summary Suspension

King Yolanda Social Worker 1144418898 Roseville 6801086692 5/4/2022 MDHHS-OIGSummary Suspension

J & J Sleep, Inc. Kingen Jack Physician Group Durand 4/8/2004 DCH

Violation of Medicaid False Claim Act

Kingen Kevin Home Help Redford 8/18/2015 MDHHSKinsley Tammy Home Help Saginaw 6/4/2021 MDHHS

Kirchhaine Jr. William Physician 1073558102 Muskegon 4301049279 12/29/2014

MI-Licensing and Regulatory Affairs 5/20/2015

MI-Licensing and Regulatory Affairs

Summary Suspension Voluntarily Surrendered

Kirkland George Home Help Redford 1/17/2018 MDHHSKirkland Steven Home Help Detroit 4/12/2017 MDHHSKiryakoza Mark Home Help Macomb 5/22/2019 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Kitchen Richard Home Help Muskegon 4/12/2021 MDHHSKizer Theoloneus Home Help Benton Harbor 10/24/2017 MDHHS

Kizy Wafid W. Dentist 1366564122 Oak Park 2901017596 1/18/2017 MDHHS-OIG

6/15/2018 7/2/2018 9/20/20186/13/2019

MDHHS-OIG MI-Licensing and Regulatory AffairsHHS-OIGMI-Licensing and Regulatory Affairs

Summary Suspension Terminated Summary Suspension TerminatedSuspended

Klank Eliazabeth A Home Help Bridgman 7/25/2022 MDHHS

Klein Alan Chiropractor Detroit 2301004270 3/18/1987 DCH 12/16/1986 HHS

3/18/87: Violation of Medicaid False Claim Act12/16/86: 1128(a)(1)

Kleinert Kathleen M Physician 1336156231 Detroit 5101013318 11/24/2012

MI-Licensing and Regulatory Affairs

Kleit Kasseem Pharmacist 1245717040 Bloomfield Hills 5302045391 5/3/2022

MI-Licensing and Regulatory Affairs

Summary Suspension

Klutts Paul J Private Duty Nurse 1306305925 Ishpeming 4704244906 10/21/2021 MDHHS SuspendedKnight Eugene Home Help Detroit 10/27/2016 MDHHS

Knight James Physician Assistant 1831129949 Bay City 5601001002 12/7/2020

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Knight Keith Home Help Pontiac 3/22/2017 MDHHSKnott Orlando Home Help Muskegon 12/10/2018 MDHHSKnox Charles Ramon Home Help Detroit 11/30/2015 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Koffeman John Nicholas Chiropractor Ann Arbor 2301004912 12/19/1998 HHS 1128(b)(14)Kohli Jaspal S. Physician Warren 4301038647 8/3/1994 HHS 1128(a)(1)

Kompus, Larry L., MD, PC Kompus Larry L. Physician Group Pontiac 4301026816 3/25/1991 HHS 1128(a)(1)Koop Rose Home Help Waterford 8/7/2015 DCH

Korby Gordon Jay Physician 1801826953 Aubrun Hills 5101012577 6/7/2018

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Korstanje Raymond P Registered Nurse 1851525422 Grand Rapids 4704105538 1/7/2012

MI-Licensing and Regulatory Affairs Suspended

Dixboro Village Pharmacy Kouza Raad Pharmacy 1093002115 Ann Arbor 12/22/2020 MDHHS-OIGSummary Suspension

ER Drugs Kouza Raad Pharmacy 1871674366 Taylor 12/22/2020 MDHHS-OIGSummary Suspension

Food Town Drugs Kouza Raad Pharmacy 1740299460 Monroe 12/22/2020 MDHHS-OIGSummary Suspension

Rockwood Pharmacy Kouza Raad Pharmacy 1609040062 Rockwood 12/22/2020 MDHHS-OIGSummary Suspension

St. Paul Pharmacy Kouza Raad Pharmacy 1528326287 Detroit 12/22/2020 MDHHS-OIGSummary Suspension

Dixboro Village Pharmacy Kouza Ramis Pharmacy 1093002115 Ann Arbor 12/22/2020 MDHHS-OIGSummary Suspension

ER Drugs Kouza Ramis Pharmacy 1871674366 Taylor 12/22/2020 MDHHS-OIGSummary Suspension

Food Town Drugs Kouza Ramis Pharmacy 1740299460 Monroe 12/22/2020 MDHHS-OIGSummary Suspension

Rockwood Pharmacy Kouza Ramis Pharmacy 1609040062 Rockwood 12/22/2020 MDHHS-OIGSummary Suspension

St. Paul Pharmacy Kouza Ramis Pharmacy 1528326287 Detroit 12/22/2020 MDHHS-OIGSummary Suspension

Kozlowski Karie Home Help Warren 2/5/2018 MDHHSKrempel's Pharmacy Krempel William Pharmacy Sault Ste. Marie 9/5/1985 HHS 1128(a)(1)

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Kreuzer Dan Fredrick Physician 1053463646 Wayland 5101008291 3/9/1994 DCH 8/10/1994 HHS

3/9/94: Vioilation of Medcaid False Claim Act8/10/94: 1128(a)(1)

Kreuzer Kevin Physician 1780722710 Grand Rapids 4301053795 4/18/2008

MI-Licensing and Regulatory Affairs Suspended

Kristoff Michael Home Help Allen Park 4/25/2016 MDHHSKrokker Rebecca Home Help Fort Gratiot 11/15/2018 MDHHS

Krol leslie A Counselor 1154652535 Swartz Creek 6401010535 4/23/2020

MI-Licensing and Regulatory Affairs

Summary Suspension

Krusell Cheryl Home Help Rogers City 7/7/2015 DCH

Kucinski Richard C. Physician Utica 4301407406 9/1/2007

MI-Licensing and Regulatory Affairs Suspended

Kufner Ronald Physician 1790764694 Big Rapids 4301079130 1/2/2019 MDHHS-OIGSummary Suspension

Kuhn Brian Home Help Clinton Township 1/21/2020 MDHHSKuhn Virginia Home Help Detroit 5/12/2021 MDHHS

Kuldanek Gregory A Physician 1568410496 Grand Rapids 4301047564 5/19/2015 DCH-OIG5/20/2015 10/19/2015

DCH-OIG HHS-OIG

Summary Suspension Terminated Excluded

Kulp RobertNon-Emergency Transportation Lake City 1/24/2019 MDHHS

Kumar Vijay Physical Therapist 1730133117 West Branch 5501005559 7/24/2015

MI-Licensing and Regulatory Affairs

7/13/2016 02/10/2017

MDHHS-OIG MI- Licensing and Regulatory Affairs

Summary Suspension Summary Suspension Revoked

Kyles William Home Help Detroit 1/30/2020 MDHHS Terminated

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

LaBarrie Sybil Home Help Hantramck 9/29/2016 MDHHSLaBeau Harold Home Help Hart 11/10/2020 MDHHS Ladaga Joseph H. Physician Dowagiac 5101009602 9/11/1996 HHS 1128(a)(2)

Lafata Philip J. Physician 1215037197 Caseville 4301023545 6/24/2008

MI-Licensing and Regulatory Affairs

Summary Suspension

Laframboise Jon Home Help Mount Morris 10/23/2014 DCHLairy Saraya Home Help Detroit 9/8/2015 MDHHSLambert Kandice Home Help Detroit 8/11/2015 MDHHS

Lamoreaux JamesNon-Emergency Transportation Sault Sainte Marie 5/9/2017 MDHHS

Landrum Corliss Home Help Detroit 11/16/2015 MDHHSLane Cheryl Home Help Detroit 12/15/2015 MDHHS

Lane Robert E Physician 1972584159 Almont 5101004855 5/3/2017

MI-Licensing and Regulatory Affairs 10/24/2017

MI-Licensing and Regulatory Affairs

Summary Suspension Summary Suspension

Lanehart Dequetta Home Help Pontiac 5/12/2022 MDHHSLang Germaine Home Help Muskegon 9/5/2018 MDHHS

Lapides David Psychiatrist 1255774311 Charlottesville, VA 43010503397 7/8/2022 MDHHS SuspensionLardell Nicole Home Help Pontiac 10/5/2015 MDHHS

Laster Pamela Home Help Saginaw 6/17/2020 MDHHS-OIGSummary Suspension

Lauchu Carlos M. Physician Saline 4301029754 3/16/1995 HHS 1128(b)(4)Lauderdale Selena Home Help Grand Rapids 5/27/2015 DCH

LaValley William J Social Worker 1912033051 Kalamazoo 6801084791 6/18/2019

MI-Licensing and Regulatory Affairs

1/28/2020 11/30/2021

MI-Licensing and Regulatory Affairs MI-Licensing and Regulatory Affairs

Summary Suspension Limited/ Restricted Voluntarily Surrendered

Lawrence Brian Home Help Warren 2/16/2017 MDHHSLayton Trena HoemHelp Farmington Hills 11/22/2021 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

East Side Pharmacy, Inc. Lazar Calvin R. Pharmacy Flint 12/17/1997 HHS 1/4/1984

12/17/97: 1128(b)(1)1/4/84: 1128(a)(1)

McNichols Drugstore Lazeki Rami Pharmacy 1073878625 Detroit 2/16/2021 MDHHS-OIGSummary Suspension

Leamon Yolanda G. Physician Battle Creek 4704106771 7/20/2000 HHS 1128(b)(4)

LeBaron Troy Optometrist 1124210091 Ada 4901004426 12/6/2019

MI-Licensing and Regulatory Affairs

Summary Suspension

Lee Antoine Home Help Saginaw 12/11/2018 MDHHSLee Deion Home Help Saginaw 3/25/2019 MDHHSLee Edith J. Physician Highland Park 4301022981 8/14/1986 HHS 1128(a)(1)Lee John Home Help Wyoming 11/29/2016 MDHHS

Lee Lessie Social Worker 1275948358 Flint 6801100508 3/19/2018 MDHHSMandatory Exclusion

Lee Sang H. Physician 1679790836 Detroit 4301032091 9/21/2011 DCHSummary Suspension

Cascade Pharmacy Leen Charles J.Pharmacy/Medical Supplier Grand Rapids 5301002313 5/8/1991 HHS 1128(b)(4)

Heartside Pharmacy Leen Charles J. Pharmacy Grand Rapids 5301003879 5/8/1991 HHS 1128(b)(4)Leftridge Mozella Home Help Detroit 2/26/2020 MDHHS TerminatedLeftwich Carl L. Dentist Detroit 2901007003 8/1/1990 HHS 1128(b)(4)Legault Thomas Home Help Roseville 1/18/2018 MDHHS

Legette CassandraNon-Emergency Transportation Detroit 8/15/2019 MDHHS

Legette Danielle Home Help Ypsilanti 10/2/2019 MDHHSLegette Melvin I Home Help Highland Park 10/12/2021 MDHHSLegrand Jessica Home Help Warren 7/19/2018 MDHHS

Lehtinen John Physician Marquette 4301035115 3/15/2021 MDHHS-OIGSummary Suspension

Leitson Marcelino Joel Chiropractor Oak Park 2301005098 2/19/1998 HHS 1128(b)(1)Lenoir Renoir Home Help Detroit 5/15/2019 MDHHS

Lerner Laran Physician 1598713430 Westland 5101008800 7/29/2015 MDHHS-OIG

06/27/20167/20/20163/29/2019

MI- Licensing and Regulatory AffairsHHS-OIGMDHHS-OIG

Summary Suspension Revoked Excluded Terminated

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Lesiewicz Alan Home Help Three Rivers 10/27/2020 MDHHSLesley Jusy Home Help Kalamazoo 3/29/2016 MDHHS

All American Medical Supplies, Inc. Letko James Medical Supply Co. 1972744431 Venice, Florida 1/27/2021 MDHHS-OIG

Summary Suspension

Lewis Andrew L Home Help Detroit 3/4/2015 DCHLewis Chrsitopher A Home Help Detroit 6/1/2022 MDHHSLewis Dorothy Home Help Detroit 12/12/2016 MDHHSLewis Freddie Home Help Detroit 11/26/2019 MDHHSLewis James Home Help Flint 8/19/2022 MDHHSLewis Janet M. Home Help Detroit 1/13/2022 MDHHSLewis Kevin Home Help Detroit 9/29/2015 MDHHSLewis Maurice Home Help Lansing 11/30/2015 MDHHSLewis Nefertari Home Help Pontiac 7/11/2018 MDHHSLewis Pharen Home Help Detroit 9/6/2016 MDHHSLewis Terrance Home Help Highland Park 11/3/2014 DCHLiddell Charlton Home Help Laning 1/11/2022 MDHHSLieberman Ira Stephen Physician North Branch 8/20/2006 HHS 1128(a)(4)Lightfoot Arthur S. Physician Burton 4301023700 3/1/1990 HHS 1128(b)(4)Lile james Ho,e Help Detroit 10/8/2019 MDHHSLilleberg Jessica Home Help Cadillac 7/7/2015 DCHLilly Latoya Home Help Holt 11/30/2015 MDHHSLim Billy Shee Dentist 1942356183 Detroit 2901015899 12/1/2007 HHS 1128(a)(1)

Linares Oscar A Physician 1689641458 Dearborn 4301045607 3/21/2013 DCH

09/20/2016 02/10/2017 04/20/201711/13/18

MI-Licensing and Regulatory Affairs MI- Bureau of Licensing and Regulatory Affairs HHSMDHHS-OIG

Suspended Summary Suspension Revoked Excluded Terminated

Lindeman Craig J Optometrist 1619024965 Lansing 4901002406 3/29/2012

MI-Licensing and Regulatory Affairs Suspended

Lindsey Tommy G. Chiropractor Mount Morris 2301002099 5/20/1998 HHS 1128(b)(4) Little Daniel Home Help Flint 2/9/2017 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Llovet Magalis Physician 1427066646 Grand Rapids 4301075353 1/16/2019

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Lloyd Christopher Home Help Detroit 9/13/2016 MDHHSLloyd Yolanda Home Help Detroit 8/1/2019 MDHHS

Ritecare LLC Lobato Hans Group 1609035104 Livonia 1/19/2012 HHS 1128(b)fRitecare LLC Lobato Hans Group 1508064775 Livonia 1/19/2012 HHS 1128(b)f

Lockwitz Todd A Physician 1861456071 Novi 4301054687 6/26/2018 MDHHS

Disciplinary Limited License

Lofton Anthony Home Help Kalamazoo 12/27/2018 MDHHS

Lofton DonNon-Emergency Transportation Adrian 1/2/2018 MDHHS

Lofton George Home Help Saint Clair 4/22/2020 MDHHSLofton-Jackson Levander Home Help Detroit 3/28/2019 MDHHSLondree Kim Home Help Iron Mountain 4/16/2018 MDHHSLong Lisa Home Help Kalamazoo 1/31/2018 MDHHSLong Tashema Home Help Detroit 11/30/2015 MDHHS

Loomna Vivek Physician 1518277276 Troy 4301096034 3/15/2018

MI-Licensing and Regulatory Affairs 8/1/2018

MI-Licensing and Regulatory Affairs

Summary Suspension Revoked

Looney Samuel Home Help Detroit 3/7/2017 MDHHS

Loop William C. Physician 1710926944 East Tawas 4301042646 9/2/2009

MI-Licensing and Regulatory Affairs Suspended

Lootens Ray Home Help West Branch 10/31/2018 MDHHSLopez Ernest Home Help Bay City 10/18/2016 MDHHS

Lotfi Ahad Chiropractor 1063420529 Hartford 2301006100 6/6/2017 MDHHS-OIG 3/1/2018

MI-Licensing and Regulatory Affairs

Summary Suspension Revoked

Lott Robert Home Help West Branch 4/25/2019 HHS-OIGLove Jarvon Home Help Detroit 8/7/2018 MDHHSLowe Connie Home Help Beulah 12/5/2018 MDHHSLowe Lawrence Home Help Detroit 6/25/2018 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Lowe Melody CRNA 1023026705 Sterling Heights 4704213505 2/6/2021

MI-Licensing and Regulatory Affairs Suspended

Lowe Raphael Home Help Inkster 2/22/2018 MDHHSLowery Danny Home Help Detroit 9/11/2017 MDHHSLoyd Leandrew T Home Help Flint 1/21/2022 MDHHSLucas William A. Physician Dearborn 4704127471 4/20/2000 HHS 1128(b)(4)Lucero Michelle Home Help Battle Creek 10/19/2015 MDHHS

Lugo--Medina Suzette Physician 1922025865 Coldwater 4301078982 11/18/2015

MI-Licensing and Regulatory Affairs

11/29/2018 06/19/2020

MI-Licensing and Regulatory Affairs MI-Licensing and Regulatory Affairs

Suspended Disciplinary Limited Voluntarily Surrendered

Lundquist Jonathan Home Help Marquette 8/30/2019 MDHHS-OIG

Luoma David Physician 1245221076 Marquette 4301042739 2/27/2019

MI-Licensing and Regulatory Affairs 9/18/2019

MI-Licensing and regulatory Affairs

Summary Suspension Voluntarily Surrendered

Lusk Kenyatta Home Help Detroit 5/20/2019 MDHHS

Lustre-Nosal Michelle CRNA 1083693113 Wolverine Lake 4704149936 9/1/2018

MI-Licensing and Regulatory Affairs Suspended

Lyman Winston Home Help Warren 5/6/2016 MDHHS

Lynch AntwanNon-Emergency Transportation Detroit 6/1/2022 MDHHS

Lynn Edward Home Help Idlewild 11/15/2016 MDHHSLynn Jovon Home Help Saginaw 9/13/2016 MDHHS

Lyons HenryNon-Emergency Transportation Westland 2/6/2019 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Maaz Bassam M Physician 1851314314 Dearborn 4301053885 12/1/2016 MDHHS-OIG4/12/2018 5/16/2018

MDHHS-OIG MI-Licensing and Regulatory Affairs

Summary Suspension Terminated Voluntarily Surrendered

Mack Georgio Home Help Oak Park 12/3/2021 MDHHSMacLean Charles A. Physician Owosso 4301025670 8/29/1995 HHS 1128(b)(4)Madden Torrnece Home Help Grand Rapids 11/12/2016 MDHHSMaddox Edward Home Help Detroit 3/26/2020 MDHHSMaddox Juanita Jean Home Help Detroit 3/16/2015 DCH

Madrid Ramon A Physician 1235176637 Farmington Hills 4301028439 7/19/2018

MI-Licensing and Regulatory Affairs 9/19/2018

MI-Licensing and Regulatory Affairs

Controlled Substance License Only Summary Suspended Voluntariy Terminated Controlled Substance and Medical License

Magee Elizabeth Home Help Carsonville 1/20/2016 MDHHS

Magid Larry Physician 1851382972 Milford 5901000741 1/23/2019

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Mahabeer Howard Leslie Physician 1861449696 Reed City 4301048268 8/10/2017

MI-Licensing and Regulatory Affairs

Summary Suspension

Maiville Debra F Home Help Luther 11/30/2021 MDHHS

Park Med Pharmacy Maki Auday Pharmacy 1396253696 Detroit 10/2/2020 MDHHS - OIG

Emergency Summary Suspension

Makki Ali S. Physician 1114032414 Dearborn 4301048780 9/20/2011 HHS 1128(a)(1)

Lifecare Pharmacy of Michigan Makki Wansa Pharmacy 1306228721 Farmington Hills 5301010697 6/4/2019 MDHHS-OIGSummary Suspension

Lakeshore Spine & Pain PC Makwana Rajesh Group 1245260371 Ludington 2/22/2012 DCH Suspended

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Malhotra Rajesh Physician 1891748547 Detroit 4301097855 9/8/2015

MI-Licensing and Regulatory Affairs 6/30/2016

MI-Licensing and Regulatory Affairs

Summary Suspension Summary Suspension

Malik Mukhtar Ahmad Physician Madison Heights 4301033579 9/2/1997 HHS 1128(b)(3)Malik Parveen Physician 1972668630 Bay City 4301065126 4/20/2010 HHS 1128(b)(7)Malone Deandre Home Help Harper Woods 6/20/2019 MDHHSMalone Kevin Louis Home Help Grand Rapids 12/1/2014 DCH 4/19/2018 MDHHSMalviya Vinay Physician 1184623514 Southfield 4301046543 4/5/2022 HHS ExcludedMammo Waleed Dentist 1598939811 Sterling Heights 2901015678 4/10/2007 DCH Terminated

Mangalick Girish C. Physician 1225039522 Wyandotte 4301034377 1/19/2022

MI-Licensing and Regulatory Affairs 7/21/2022 MDHHS-OIG

Voluntarily Surrendered Terminated

Manigault Sean Home Help Highland Park 9/16/2020 MDHHSMann Dejohn Home Help Grand Rapids 5/13/2015 DCH

Manor James P. Nurse Anesthetist 1508912692 Wyandotte 4704136317 4/1/2014

MI-Licensing and Regulatory Affairs Suspended

Mansor Bassam Home Help Warren 7/20/2021 MDHHSMansy Sal Home Help Shelby Township 2/10/2022 MDHHSMape Avelino Marbella Physician Detroit 4301036423 9/23/1983 HHS 1128(a)(1)Marbury Catrina Home Help Inkster 1/13/2022 MDHHS

Marcano Carlos A. Physician 1639125040 Grand Rapids 4301057357 11/24/2008

MI-Licensing and Regulatory Affairs

Summary Suspension

Markowski Stephen Home Help Atlanta 10/13/2016 MDHHSMarnach Richard L Physician 1619923034 Minneapolis -MN 30333-MN 1/2/2013 HHS & DCH SuspendedMarshall Aaron Home Help Detroit 4/7/2021 MDHHSMarshall Kayonn T Home Help GrandRapids 8/3/2022 MDHHSMarshall Tanea Home Help Grand Rapids 11/17/2017 MDHHSMarshall William Home Help Detroit 4/20/2022 MDHHS Mathis Morgan Home Help Saginaw 10/5/2021 MDHHS

Martin Dana Physician 1215019963 Sturgis 5601002180 6/26/2018 MDHHS

Disciplinary Limited License

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Martin Daniel Home Help Detroit 5/5/2016 MDHHSMartin David Home Help Flint 9/3/2019 MDHHSMartin Dennis Home Help Detroit 12/14/2017 MDHHSMartin Fate Home Help Detroit 8/21/2018 MDHHSMartin Jessica Home Help Dearborn 11/26/2019 MDHHS

Martin LenoraNon-Emergency Transportation Detroit 6/8/2017 MDHHS

Martin Markeeta Home Help Detroit 12/5/2018 MDHHSMartin Robert Home Help Detroit 2/13/2018 MDHHS

Martin Robert Physician 1861460420 Milford 5101007975 4/4/2019

MI-Licensing and Regulatory Affairs Suspended

Martin Terrell Home Help Detroit 6/5/2017 MDHHSMartin Michael Home Help Detroit 8/22/2017 MDHHS

Martinez Jacob S. Physician 1124311014 Tecumseh 4301097527 8/23/2020

MI-Licensing and Regulatory Affairs Suspended

Martinez Joseph Home Help Ecorse 1/13/2016 MDHHSMartinez Martin M Home Help Grand Rapids 10/1/2015 MDHHSMason Jamie Home Help Escanaba 11/21/2019 MDHHS Terminated

Mason Marian Y Dentist 1295967438 Detroit 2901011681 8/1/2014

MI-Licensing and Regulatory Affairs Suspended

Mason Stephen B Physician 1528390259 Morgantown, WV 4301097993 2/20/2018 HHS-OIG3/21/20185/15/19

MI-License and Regulatory Affairs

Excluded Summary Suspension Suspended

Mason William B Home Help Greenville 3/22/2021 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Masserant John C. Physician 1669454146 Monroe 4301076801 11/12/2015 MDHHS-OIG

4/5/2016 08/24/2016 08/20/2017 09/20/2017

MI-Licensing and Regulatory Affiars MI- Licensing and Regulatory Affairs HHS MDHHS-OIG

Revoked Summary Suspension Summary Suspension Excluded Terminated

Matthews Alice Home Help Flint 12/19/2016 MDHHSMatthews Deshaun Home Help Detroit 7/8/2019 MDHHSMatthews Julie Home Help westland 12/9/2021 MDHHSMatthewson Dawn Home Help Grand Rapids 10/14/2019 MDHHSMauldin Brandon Home Help Detroit 4/12/2017 MDHHSMaury Nicholas Home Help Inkster 7/23/2019 MDHHSMay Kathleen Home Help Luther 3/31/2015 DCHMay Michael Home Help Grand Rapids 7/21/2020 MDHHS

Parkside Mental Health, Inc. Mayberry Marie Victoria Physician Group Detroit 11/19/1998 HHS 1128(a)(1)Mayers Keith Home Help Vestaburg 1/29/2018 MDHHS

Mayfield Stephanie Marie Physician 1740238286 Flint 4704167920 1/14/2009

MI-Licensing and Regulatory Affairs

9/21/2015 01/09/2016

MI-Licensing and Regulartory Affairs Mi- Licensing amd Regulatory Affairs

Suspended Suspended

Mayhue Terry Home Help Grand Rapids 2/17/2021 MDHHSMaynard Jamie Home Help Midland 6/21/2016 MDHHSMays Sandra D Home Help Detroit 11/30/2015 MDHHS

Mays Thomas D MD PC Mays Thomas D. Medical Group 1508124082 Southfield 7/22/2019 MDHHS-OIGSummary Suspension

Mays Thomas D Physician 1255344339 Southfield 4301043030 9/16/2017

MI-Licensing and Regulatory Affairs 11/20/2019

MI-Licensing and Regulatory Affairs

Voluntarily SurrenderedDisciplinary Limited License

Mazer Joel Allen Optometrist Flint 4901003693 9/20/2004 HHS 1128(a)(2)McCaskell Ruthie Home Help Detroit 3/10/2016 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

McFarlin Helen Home Help Detroit 8/6/2020 MDHHSMcabee Davies E Home Help Lansing 4/14/2015 DCHMcAfee Eleazar Home Help Southfield 2/21/2019 MDHHS

Premier Non-Medical McBride JoshuaNon-Emergency Transportation Wyoming 1/16/2018 MDHHS

McBride Ricky Home Help Garden City 10/18/2018 MDHHSMcBride Stellana M Home Help Lansing 3/25/2015 DCHMcCall Darnell Home Help Detroit 5/13/2016 MDHHSMcCane Ariel Home Help Detroit 3/23/2017 MDHHSMcCartney James R. Physician Bay City 4301041608 7/30/1986 HHS 1128(a)(1)

McCarver Williemendia Home Help Detroit 2/10/2016 MDHHSMcCaster Kenneth Home Help Hazel Park 11/30/2015 MDHHSMcClain Raymond Home Help Mendon 10/4/2017 MDHHSMcClellan Devonte Home Help Detroit 5/2/2019 MDHHSMcClinton Dalon Home Help Detroit 8/14/2019 MDHHS TerminatedMcConnal Catherine Home Help Detroit 7/24/2019 MDHHSMcCovery Sherman Home Help Flint 4/21/2016 MDHHSMcCoy Cedric Home Help Detroit 10/16/2015 MDHHSMcCoy Michael Home Help Decatur 3/22/2021 MDHHS

Samaritan Home Help LLC McCray Antonio Home Help Agency Eastpointe 3/3/2020 MDHHS-OIG TermintaedMcCray Antonio Home Help Owner Harper Woods 3/3/2020 MDHHS-OIG TerminatedMcCray Marcus Home Help Saginaw 3/9/2017 MDHHSMcCullum John Home Help Caro 4/11/2017 MDHHSMcCurtis Dwayne Home Help Detroit 2/25/2020 MDHHS

McCutcheon Cambron Psychologist 1194020271 Kalamazoo 6301014896 8/8/2019 MDHHS- OIG TerminatedMcDermott Lamont M Home Help Lansing 12/17/2020 MDHHSMcDonald Catrina Home Help Pontiac 12/7/2015 MDHHSMcDonald Phyllis Home Help Inkster 12/7/2021 MDHHS

McEwen Timothy Home Help Detroit 7/13/2017 MDHHSMcFall Tracy Home Help South Haven 12/13/2018 MDHHSMcFarland Nicholas Home Help Detroit 1/11/2018 MDHHS

McFarland-Reddick Jill Nurse Midwife 1780827261 Auburn 4704228799 5/24/2018

MI-Licensing and Regulatory Affairs 11/3/2018

MI-Licensing and Regulatory Affairs

Summary Suspension Suspended

McFee Kiemar Home Help Detroit 11/21/2017 MDHHSMcGaughy Asia Home Help Ann Arbor 1/25/2021 MDHHSMcGee Leanon Home Help Detroit 1/9/2019 MDHHSMcGlocton Theresa Home Help Center Line 2/4/2019 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

McKinney Carolyn Home Help Muskegon 6/13/2016 MDHHSMcKinney David W. Physician Detroit 4301031076 8/15/1990 HHS 1128(b)(4)McKinnie Linzell Home Help Wyoming 10/20/2014 DCH

Towne Pharmacy McManaway Donald R. Pharmacy Monroe 5301001358 7/17/1985 HHS 1128(a)(1)McMillan Shawn Kurichan Home Help Burton 1/12/2015 DCHMcMullen Scinicor Home Help Detroit 11/19/2015 MDHHSMcNeil Melody Home Help Redford 7/26/2021 MDHHSMcPhail William L. Physician Detroit 4301030183 7/30/1990 HHS 1128(a)(1)McRae Troy Home Help Detroit 3/16/2020 MDHHS

Ban Mechael MD PC Mechael Ban Medical Group 1033301569 Livonia 9/17/2019 MDHHS-OIG1/18/2021 11/18/2021

MDHHS-OIG HHS -OIG

Summary Suspension Termination Excluded

Mechael Ban Physician 1124095666 Livonia 4301073200 9/17/2019 MDHHS-OIG 1/18/2021 MDHHS-OIG

Summary Suspension Termination

Meeks Ricky Home Help Muskegon 2/18/2015 DCH

Access Care Home Care, Inc Mehood Zafar Home Health Agency 1134174006 Ypsilanti 5/22/2012 DCHSummary Suspension

Mejia-Garagorry Pedro Physician 1497919286 Grand Rapids 4301097908 4/15/2021 MDHHS SuspendedMelchor Arthu Allen Home Help Adrian 2/24/2015 DCHMelton Bradley Home Help Detroit 11/6/2017 MDHHS

Melton Mark R. Physical Therapist 1861504425 Gaylord 5501009879 12/28/2007

MI-Licensing and Regulatory Affairs

Summary Suspension

Mendoza Samuel Physician Dearborn 4301020703 5/6/1997 HHS 1128(b)(4)Merkle Clifton Home Help White Pigeon 4/21/2016 MDHHSMerlau Billie Home Help Syracuse 11/18/2019 MDHHSMerritt Edward Home Help Detroit 3/13/2018 MDHHSMerritt Michael Home Help Detroit 11/30/2015 MDHHS

Mesiwala Kutub H Physician 1548331705 Bloomington Hills 4301040545 3/11/2015 DCH-OIG 4/4/2022 MDHHS-OIG

Summary Suspension Terminated

Messisco Joyce M Nurse Practitioner 1952505760 Macomb 4704164357 4/16/2015 DCH-OIG5/15/2015 08/20/2015

DCH-OIG HHS

Suspended Terminated Terminated

Michael Tara Home Help Grand Rapids 12/13/2018 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Michkovits, John F. PC Michkovits John F. Dental Group South Haven 2901008784 3/19/1999 DCH 6/17/1999 HHS

3/19/99: Violation of Medicaid False Claim Act6/17/99: 1128(a)(1)

Mickel John Home Help Grand Rapids 11/21/2017 MDHHSMickel Kenyatta Home Help Detroit 9/13/2016 MDHHSMiddleton David H. Physician Ann Arbor 4301024480 7/1/1997 HHS 1128(b)(4)

Lakeland Convalescent Center Midenberg David S. Nursing Facility Detroit 83451 9/20/2000 HHS 1128(a)(2)

Mihailoff Nevena M Physician 1740280569 Dearborn 4301039159 1/17/2018

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Fritz the Druggist Milder JosephPharmacy/Medical Supplier Muskegon Heights 5301000030 4/24/1986 HHS 1128(a)(1)

Miles Zekenia Home Help Grand Rapids 1/29/2014 DCH-OIGSummary Suspension

Miller Angie Social Worker 1568400620 Sterling Heights 6801068386 8/7/2019 MDHHS-OIGSummary Suspension

Miller David Home Help Grand Rapids 2/20/2018 MDHHS 5/4/2022 MDHHS

Miller Lloyd Livingston Physician Livonia 4301047699 2/9/1989 HHS 1128(b)(3)Miller Michael E Home Help Grand Rapids 6/30/2022 MDHHS

Miller Ross David Physician 1720086226 Hillsdale 4301056697 4/23/2010

MI-Licensing and Regulatory Affairs Suspended

Miller Theresa Home Help Dewitt 10/7/2015 MDHHSMiller Chrystal Home Help Alpena 8/3/2020 MDHHSMiller Howard Home Help Romulus 4/18/2022 MDHHSMiller Joyce Home Help Madison Heghts 1/4/2016 MDHHS

Miller StephenNon-Emergency Transportation Alpena 3/16/2017 MDHHS

Miller Steven Home Help Saginaw 3/22/2016 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Millette Michael P Physician Assistant 1043259591 McMillian 5601004986 9/29/2017

MI-Licensing and Regulatory Affairs 7/17/2018

MI-Licensing and Regulatory Affairs

Summary Suspension Revoked

Millette Terrence Physician 1740298967 Pascagoula, MS 4301106498 9/19/2018

MI-Licensing and Regulatory Affairs

Voluntarily Surrenderd

Milliner Joel A Physician 1346438140 4301079083 6/19/2014DCH-OIG HHS

3/8/2015 08/20/2015

Summary Suspension

Summary Suspension Excluded

Milton Deborah Denise Home Help Pontiac 6/10/2015 DCH

Miluk Paul R. Physician 1336139740 Niles 5101010370 9/18/2013 DCHSummary Suspension

Minard Ashley L Home Help Roscommon 1/5/2022 MDHHSMiral Leon R. Physician Detroit 5101005657 5/26/1988 HHS 1128(a)(1)Miskell Eric Home Help Musegon 1/12/2017 MDHHSMitchell Chatondra Home Help Detroit 4/19/2018 MDHHSMitchell Glenn E Home Help Redford 12/3/2020 MDHHS

Mitchell Kenneth D Physician 1144390873 Southfield 5901001869 8/15/2018 MDHHS-OIG 9/14/2018 MDHHS-OIG

Summary Suspension Termination

Mitchell Ladarin Q Home Help Detroit 11/12/2014 DCHMitchell Marcella Home Help Detroit 7/8/2015 DCH

Moffit Laura I. Registered Nurse 1669866984 Novi 4704301162 8/16/2018

MI-Licensing and Regulatory Affairs 4/6/2019

MI-Licensing and Regulatory Affairs

Summary Suspension Suspended

Mohamed Abdullahi A Physician 1013009000 Alpena 4301084848 5/18/2013

MI-Licensing and Regulatory Affairs 8/15/2013 DCH

TerminatedSuspended

Mohiuddin Gulam Owner Hamtramck 4/9/2019 MDHHS-OIGSummary Suspension

The Vein Center at Allure Medical Spa Mok Charles Medical Group 1457302051 Shelby Township 5/11/2020 MDHHS-OIG 6/15/2020 MDHHS-OIG

Summary Suspension Summary Suspension

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Mok Charles Physician 1235181876 Shelby Township 5101010912 5/11/2020 MDHHS-OIG 6/15/2020 MDHHS-OIG

Summary Suspension Summary Suspension

Molbrough David Home Help Detroit 6/14/2018 MDHHSMolett Reginald Home Help Pontiac 12/9/2015 MDHHSMonnan Syeed Home Help Warren 8/3/2017 MDHHSMonroe Frederick Home Help Benton Harbor 4/25/2018 MDHHS

Monteleone Melissa M. Nurse 1861439184 Huntington Woods 4704160940 11/8/2010

MI-Licensing and Regulatory Affairs

Summary Suspension

Montgomery LisaNon-Emergency Transportation Mio 5/31/2017 MDHHS

Moody Carthan Lagrant Dentist Kalamazoo 2901014263 1/20/2004 HHS 1128(a)(1)Moore Alisha Marie Home Help Warren 4/7/2015 DCHMoore Allen Home Help Saginaw 3/14/2016 MDHHSMoore Dannetta Marie Home Help Benton Harbor 6/10/2015 DCH

Healthy Hearts Moore Kamitko Group 1093908436 Livonia 7/25/2016 MDHHS-OIG 3/29/2019 MDHHS-OIG

Summary Suspension Terminated

New Beginning Adult Senior Care Center Moore Kamitko Group 1124431580 Livonia 7/25/2016 MDHHS-OIG 3/29/2019 MDHHS-OIG

Summary Suspension Terminated

Moore Kamitko Home Help Taylor 8/31/2017 HHS-OIGMoore Kimberly Home Help Detoit 9/28/2020 MDHHSMoore Ladonna Home Help Detroit 1/9/2019 MDHHSMoore Richard Home Help Highland Park 10/8/2021 MDHHSMoore Season L Home Help Adrian 3/28/2022 MDHHS

Moore Shalescha Home Help Grosse Pointe Farms 1/28/2022 MDHHSMoore Terrell Home Help Kalamazoo 7/6/2020 MDHHSMoore Thelma Home Help Lansing 5/18/2021 MDHHS

Moore Timothy Home Help Detroit 10/13/2014 DCH

Morejon Maribel Home Help etroit 7/16/2021 MDHHS

Moret-Quezada Rodney Physician 1851451819Oak Park Madison Heights 4301064420 12/22/2015 DCH-HHS 3/31/2017 HHS

Summary Suspension

Morgan Hollis Home Help Benton Harbor 8/23/2016 MDHHSMorgan Thomas M Home Help Saginaw 9/29/2021 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Moroschan Joseph E Physician 1760482608 Fort Worth 4301113656 7/20/2020

MI-Licensing and Regulatory Affairs

Summary Suspension

Morrell Javonda Home Help Lansing 6/17/2015 DCHMorris Dawayne Home Help Detroit 6/24/2020 MDHHSMorris Jacqueline Home Help Kalkaska 4/5/2016 MDHHSMorris Laurrie A Home Help Taylor 12/28/2021 MDHHSMorrison Amy Home Help Rapid City 12/12/2018 MDHHSMoses Terrance T Home Help Lincoln Park 3/18/2022 MDHHSMoser carrie Home Help Davison 6/28/2017 MDHHS

Mosimbwa Charles Andrew Physician 1215134408 Berrien Springs 4301089193 3/12/2012

MI-Licensing and Regulatory Affairs Suspended

Mosley Chiante Home Help Westland 2/7/2019 MDHHS

Mosley Mfed Physician 1215403597 Dearborn 4301077255 4/19/2021 MDHHS- OIGSummary Suspension

Moss David Home Help Benton Harbor 7/26/2021 MDHHSMoss Latonya Home Help Detroit 12/4/2014 DCHMoss Mitchell Home Help Detroit 6/25/2015 DCHMount Kevinn Home Help Detroit 3/21/2022 MDHHS

Muhammad Cynthia D Nurse Practitioner 1326489212 Detroit 4704218487 10/28/2021

MI-Licensing and Regulatory Affairs 2/5/2022

MI-Licensing and Regulatory Affairs

Summary Suspension Voluntarily Surrendered

Mull Reta Home Help Fremont 3/11/2019 MDHHS

Mullens Thomas Social Worker 1801978903 Holland 6801089541 8/5/2020

MI-Licensing and Regulatory Affairs

Summary Suspended

Munn Karl Home Help Kalamazoo 5/9/2016 MDHHSMunshey Munir Ahmed Physician Ypsilanti 4301032297 9/11/1996 HHS 1128(a)(1)Murdock Stanley E Home Help Barryton 12/28/2021 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Murphy Rosanne Physician 1245308790 Detroit 4301050350 7/30/2013

MI-Licensing and Regulatory Affairs Suspended

Murray Dwayne Home Help Lansing 2/20/2015 DCHMurrie Tommie Home Help Detroit 3/15/2017 MDHHSMurtuza Atiya Physician Centerline 4301042165 4/12/1993 HHS 1128(a)(1)

Myers Crystal Home Help Detroit 7/22/2015 MDHHS-OIG

Summary Suspension and Termination

Myers Robert Home Help Mattawan 1/23/2019 MDHHS

Mynes Brandon Home Help Adrian 7/17/2019 MDHHS-OIG 4/13/2021 MDHHS-OIG

Summary Suspension Summary Suspension

Mynt Toe Physician 1982618138 Madison Heights 4301084986 7/9/2010

MI-Licensing and Regulatory Affairs Suspended

Care for You Pharmacy Naeem Rana Pharmacy 1073743282 Detroit NCPDP 2373114 8/23/2011 DCH 7/11/2016 MDHHS-OIG

Summary Suspension Termination

Preferred Care Pharmacy Naeem Rana Pharmacy 1467787770 Pontiac NCPDP 2373328 8/23/2011 DCH 5/25/2016 MDHHS-OIG

Summary Suspension Terminated

Taylor Apothecary Naeem Rana Pharmacy 1801026158 Taylor NCPDP 2373126 8/23/2011 DCH 5/30/2016 MDHHS-OIG

Summary Suspension Terminated

Nagy Laurence W Dentist 1093910911 Canton 2901009367 8/9/2012

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Nakhle Janet Home Help Dearborn 5/31/2018 HHS-OIG

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Nali Frank Physician Warren 4301047701 2/3/1994 DCH 8/10/1994 HHS

2/3/94: Violation of Medicaid False Claim Act8/10/94: 1128(a)(1)

Nallani Surya C. Physician 1801838651 Birmingham 4301073842 3/6/2013 DCH-OIG

3/6/2013 01/24/201710/29/2018

DCH MI- Licensing and Regulatory AffairsMDHHS-OIG

Summary Suspension Temination Summary SuspensionTerminated

Namy Jonathan Home Help West Bloomfield 10/19/2016 MDHHS

Nandamudu Deepali Social Work 1316361967 Fort Gratiot 6801068852 10/11/2019

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Napier Luther Home Help East Pointe 1/19/2016 MDHHSNapier Tyrone Home Help Detroit 7/6/2015 DCHNash Elliott Home Help Kalamazoo 12/10/2014 DCHNash Johnathan l Home Help Detroit 4/27/2015 DCH

Nassar Lawrence Physician 1912011594 East Lansing 5101012213 2/7/2017 MDHHS-OIG

04/25/2017 1/24/2017 07/19/2017 4/20/18 5/20/18 4/5/18

Mi-Licensing and Regulatory Affairs MI Licensing and Regulatory Affairs HHS-OIG MDHHS-OIG HHS-OIG MI-LARA

Revoked Suspended Suspended Excluded Terminated Excluded Permanently Revoked

Nasser Omar Home Help Sterling Heights 8/23/2016 MDHHSNavyac Debbie Home Help Madison Heights 6/13/2016 MDHHSNeal Robert Home Help Detroit 1/10/2017 MDHHSNeal Shamonte Home Help Flint 10/30/2019 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Neal Tiffany Home Help Lansing 7/25/2017 MDHHSNeal Vernell Home Help Detroit 3/17/2021 MDHHS

Neale Jerry Social Worker 1750921318 Flint 6801097494 5/20/2020 MDHHS-OIGSummary Suspension

Nealy Stephen Lamar Home Help Eastpointe 11/30/2015 MDHHSBella Rose Rehabilitation & Aquatic Services LLC Nederhood Esther Group 1568741767 Lake City 7/13/2019 MDHHS Terminated

Neeley Phillip Home Help Detroit 1/25/2017 MDHHS

Neely Richard Physician 1013908797 Durand 5101004783 9/18/2013 DCH10/18/2013 02/23/2017

DCH MI- Licensing and Regulatory Affairs

Summary SuspensionTerminated Summary Suspension

Neely Takshia Home Help Detroit 11/26/2018 MDHHS

Nelson Barbara G. Physician 1700981040 Eastpointe 4301041753 5/22/2013 OTHER STATE6/6/2017 5/16/18

MI-Licensing and Regulatory affairs

Voluntarily Surrendered Summary Suspended Voluntarily Surrendered

Nelson Deacon Home Help Sault Ste. Marie 2/17/2021 MDHHSNelson Emmett Home Help Inkster 11/23/2021 MDHHSNelson Patrick Home Help detroit 5/24/2016 MDHHSNelson Roger Wayne Chiropractor Pontiac 2301006600 10/10/1995 HHS 1128(b)(14)Nelson Ronnie Home Help Kalamazoo 5/5/2016 MDHHSNelson Tekeshon Home Help Grand Rapids 2/2/2016 MDHHS

Neri, Jr. Jesus C. Physician 1730109539 Rogers City 4301045742 4/4/2016

MI-Licensing and Regulatory Affairs 5/18/2016

MI-Licensing and Reegulatory Affairs

Summary Suspension Volunmtarily Surrendered

Nesbitt Gregory Home Help Oak Park 11/14/2017 MDHHS

Nesbitt Renee Private Duty Nurse 1588147409 Waterford 4704337833 2/10/2020

MI-Licensing and Regulatory Affairs

Summary Suspension

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Neumeier Thomas C. Dentist 1619918687 Menominee 2901008867 7/10/2016

MI-Licensing and Regulatory Affairs 6/9/2018

MI-Licensing and Regulatory Affairs

Suspended Revoked

Neves Ekra Home Help Detroit 11/10/2014 DCHNwborn Brian Home Help Eastpointe 9/1/2022 MDHHSNewbury Harvey Home Help Three Rivers 7/12/2021 MDHHSNewcombe Arthur Home Help Lansing 6/4/2019 MDHHSNewman Christopher Home Help Detroit 8/5/2022 MDHHSNewton Jermaine Home Help Detroit 6/10/2015 DCHNichols Christian Home Help Flint 5/16/2019 MDHHSNichols Rachel A Home Help Owosso 5/19/2015 DCH

Nicholson III Robert M. Physician 1447225347 Kalmazoo 4301046860 1/17/2018

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Nicklosovich James Home Help Charlotte 6/20/2018 MDHHSNikodem Heith Home Help Niles 11/14/2018 MDHHSNix Edna Home Help Detroit 11/17/2016 MDHHSNoble Tabitha Home Help Berrien Springs 7/25/2022 MDHHSNordman Ashley Home Help Lansing 12/13/2018 MDHHS 5/8/2022 MDHHSNorman Joseph Home Help Auburn Hills 1/14/2017 MDHHSNorman Willie Home Help Detroit 12/15/2020 MDHHSNorman Eric Home Help Detroit 1/10/2018 MDHHSNosal Leonard Dentist 1427254069 White Lake 2901011174 7/20/2004 HHS 1128(a)(4)Notley Jammie L Home Help White Cloud 11/5/2014 DCHNwankwo Portia Home Help Detroitq 5/17/2017 MDHHS

Nydorf Ethan Physician 1174601207 West Bloomfield 4301064988 1/16/2019

MI-Licensing and Regulatory Affairs Suspended

Obert Amy B. Registered Nurse 1427371210 Grand Rapids 4704236200 10/7/2011

MI-Licensing and Regulatory Affairs

Summary Suspension

Odinma Moses Home Help Detroit 11/19/2016 MDHHSOdle Richard Home Help Ithaca 2/12/2015 DCH

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Oesterling Joseph E Physician 1538136353 Saginaw 4301063677 12/9/2016

MI-Licensing and Regulatory Affairs

2/13/2017 01/17/2018 8/31/2018 02/20/2020

MI-Licensing and Regulatory Affairs MDHHS-OIG MDHHS-OIG HHS-OIG

Suspended Summary Suspension Suspension Terminated Excluded

Ojeda Angela Home Help Southfield 8/2/2017 MDHHSOldham Ira Home Help Detroit 12/26/2018 MDHHSOliver Ashley L Home Help Lansing 11/26/2014 DCHOliver Eric E Home Help Detroit 11/30/2015 MDHHS

Olson Alicia Physician 1669603171 Kirkland 4301095224 10/29/2018

MI-Licensing and Regulatory Affairs 2/15/2019

MI-Licensing and Regulatory Affairs

Summary Suspension Suspended

Olson Julie Home Help Bangor 10/13/2017 MDHHSO'Neil Edward Home Help Harrison 1/9/2017 MDHHSOng George Hansing Physician Kalamazoo 4301030442 12/12/1995 HHS 1128(a)(1)

Oniango Tete Physician 1629267133 Dearborn 4301091134 9/5/2018 MDHHS-OIG 6/13/2019

MI-Licensing and Regulatory Affairs

Summary SuspensionRevoked

Ononuju Chidozie J Physician 1316984750 Saginaw 5101013295 11/2/2016

MI-Licensing and Regulatory Affairs

12/5/2016 02/09/2017 08/20/2017

MDHHS-OIG MDHHS-OIG HHS

Suspended Suspended Terminated Excluded

Onuoha Kenneth Physician 1902114424 East Lansing 5101019040 6/11/2019 MDHHS-OIGSummary Suspension

Orzame & Orzame, MD, PLLC Orzame Gabriel Sagun Physician Group Watervlite 4301044937 8/20/1998 HHS 1128(a)(1)Osher Francis M. Physician Birch Run 5101005370 6/29/1992 HHS 1128(b)(3)Oshiyoye Adekunle Physician 1780723064 West Bloomfield 4301060924 1/2/2022 MDHHS Suspension

Osterhout Ann Home Help Bay City 7/18/2016 MDHHS-OIG6/29/20179/29/17

MDHHS-OIGHHS-OIG

Suspended Terminated Excluded

Ostrand Mary Home Help Snover 2/8/2018 MDHHSOuro Noor Home Help West Bloomfield 12/11/2019 MDHHSOberall David Home Help Jackson 5/6/2022 MDHHSOwdish William Home Help Oak Park 8/13/2018 MDHHS-OIG

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Owens Christian Home Help Detroit 7/8/2022 MDHHSOwens Cornelius Home Help Saginaw 10/31/2017 MDHHSOwens Kristina Home Help Detroit 2/10/2016 MDHHSPaige Tommy Darnell Home Help Grand Rapids 7/15/2021 MDHHSPalmer Kathy Home Help Saginaw 6/27/2017 MDHHS

Pamatmat Adelfo N Physician 1285676734 Detroit 4301034892 7/30/2013 DCH-OIG6/20/201811/13/18

HHS-OIGMDHHS-OIG

SuspendedExluded Terminated

Pannell Larjuan Home Help Detroit 1/17/2017 MDHHS

Pannu Baljinder S Physician 1518011451 Oak Park 4301066542 9/5/2012

MI-Licensing and Regulatory Affairs Suspended

Papachristou Marios Radiologist 1366765323 Detroit 4301109449 6/25/2018 MDHHS-OIG

3/28/20195/03/2019 10/01/2019

MDHHS-OIGMI-Licensing and Regulatory Affairs MI-Licensing and Regulatory Affairs

Summary Suspension TerminatedSummary Suspension Revoked

Pappas Spilios Physician 1649202250 Detroit 4301052677 11/12/2017 MDHHS-OIGSummary Suspension

Pappas William John Home Help Madison Heights 12/23/2014 DCHPaquette Andre Home Help Millington 3/2/2020 MDHHSParis Rashaan Home Help Detroit 4/18/2017 MDHHS

Park James Physician 1144258971 Owosso 4301024053 8/4/2010

MI-Licensing and Regulatory Affairs

Criminal Conviction

Parker Amanda Home Help Detroit 3/29/2016 MDHHSParker Antoine Home Help Detroit 10/29/2016 MDHHS

Parker Candice Home Help Inkster 3/16/2022 MDHHS-OIGSummary Suspension

Parker Johnnie Home Help Pontiac 1/18/2018 MDHHSParkhurst Laura Home Help Carrolton 4/26/2015 MDHHSParks Joe Home Help Flint 2/25/2019 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Parrett Sarah Home Help Kalamazoo 8/11/2015 MDHHSParris Gregory Home Help Detroit 1/27/2022 MDHHSPartridge Darrell Home Help Detroit 11/27/2018 MDHHS

Patel Arvind Physician 1437217601 Detroit 4301034282 7/4/2016 MDHHS-OIG1/9/2017 04/20/2017

MDHHS-OIG HHS

Summary Suspension Terminated Excluded

Levan Pharmacy Patel Baba/Jyotsna Pharmacy 1861513194 Grand Blanc NCPDP 2367781 8/19/2011 DCH 7/11/2016 MDHHS-OIG

Summary Suspension Termination

Caring Pharmacy Patel Jyotsna Pharmacy 1407861347 Detroit NCPDP 2368202 8/19/2011 DCHSummary Suspension

Detroit Care Pharmacy Patel Jyotsna Pharmacy 1295908069 Detroit NCPDP 2371019 8/19/2011 DCH 7/11/2016 MDHHS-OIG

Summary Suspension Termination

Prestige Drugs Patel Jyotsna Pharmacy 1174787766 Hazel Park NCPDP 2371590 8/19/2011 DCH 5/30/2016 MDHHS-OIG

Summary Suspension Terminated

Rapid Pharmacy Patel Jyotsna Pharmacy 1871625004 Warren NCPDP 2369494 8/19/2011 DCHSummary Suspension

Eastpoint Pharmacy PatelKamuben/Jyotsnaben Pharmacy 1760643076 Roseville NCPDP 2371336 8/19/2011 DCH

Summary Suspension

Bestcare Pharmacy Patel Kiran Pharmacy 1114124260 Warren NCPDP 2369898 8/23/2011 DCHSummary Suspension

Rapid Drugs Patel Kiran Pharmacy 1063605954 Southfield NCPDP 2370271 8/23/2011 DCHSummary Suspension

Patel Rameshbhai F. Physician Huntington Woods 4301036995 7/15/1987 DCH 12/23/1991 HHS

7/15/87: Violationf of Medicaid False Claim Act12/23/91: 1128(a)(1)

Patel Rohane Avind Physician 1114049343 Rochester Hills 4301052678 11/21/2008

MI-Licensing and Regulatory Affairs

Summary Suspension

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

PatelSharadchandra D. Physician Saginaw 4301033216 5/21/1999 DCH 6/17/1999 HHS

5/21/99: Violation of Medicaid False Claim Act6/17/99: 1128(a)(1)

Rx Now Pharmacy Patel Vijay Pharmacy 1619297553 Livonia NCPDP 2374116 8/19/2011 DCH 6/2/2016 MDHHS-OIG

Summary Suspension Terminated

Tri-City Apothecary Patel Vijay Pharmacy 1144554106 Saginaw NCPDP 2373265 8/19/2011 DCH 5/23/2016 MDHHS-OIG

Summary Suspension Termination

Responsible Care Pharmacy Patel Virabhai Pharmacy 1861668089 Detroit NCPDP 2371160 8/19/2011 DCH 5/23/2016 MDHHS-OIG

Summary Suspension Termination

FDRS Diagnostics PLLC PatinoFrancisco (Frank) Medical Group 1962837815 Livonia 8/8/2018 MDHHS-OIG

Summary Suspension

Patino Laboratories LLC PatinoFrancisco (Frank) Laboratory 1235520313 Livonia 8/8/2018 MDHHS-OIG

Summary Suspension

Renaissance Age Management Institute LLC Patino

Francisco (Frank) Medical Group 1285895912 Livonia 8/8/2018 MDHHS-OIG

Summary Suspension

PatinoFrancisco (Frank) Physician 1538147723 Livonia 4301051672 8/8/2018 MDHHS-OIG

Summary Suspension

Patman Darnell Home Help Saginaw 7/31/2019 MDHHSPatrick Mark Home Help Detroit 4/11/2016 MDHHSPatrick Michelle Home Help Detroit 10/21/2015 MDHHSPatterson Andre Home Help Detroit 7/21/2016 MDHHSPatterson Steve Home Help Hastings 6/29/2017 MDHHS

Paupore Joseph Thomas Physician 1841285467 Livonia 5101012057 4/21/2008

MI-Licensing and Regulatory Affairs

License Revocation

Payea Richard Paul Physician 1124019674 East Tawas 4301047848 9/2/2009

MI-Licensing and Regulatory Affairs Suspended

Payne KAren Home Help Romulus 2/23/2022 MDHHSPayne Laron Home Help Battle Creek 3/23/2017 MDHHSPayne Ulie Home Help Lansing 12/23/2014 DCH

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Payton Christopher Home Help Detroit 12/20/2017 MDHHSPear Michael Home Help Sterling 5/17/2018 MDHHS

Pearce Edwin T. Physician 1114977618 Clinton Township 4301021837 10/7/2008

MI-Licensing and Regulatory Affairs

Summary Suspension

Pearson Sarah Home Help Grand Rapids 7/14/2016 MDHHS

Peek Aaron Home Help Westland 3/6/2019 MDHHS-OIGSummary Suspension

Peeples- Jones Angela Home Help Westland 9/26/2017 MDHHSPeneger Kevin Home Help Flint 4/18/2016 MDHHSPennell Alan Home Help Idlewild 11/30/2015 MDHHSPeoples Leonora Home Help Detroit 9/18/2015 MDHHSPeoples Terence Home Help Wayne 4/8/2020 MDHHSPerez Gilberto Home Help Grand Rapids 2/23/2017 MDHHS

Perkins Kim Home Help Port Huron 10/25/2016 MDHHS

Perkins Margaret Home Help Grand Ledge 11/20/2019 MDHHS- OIG TerminatedPerkins Yvette Home Help Detroit 4/12/2018 MDHHSPernell Demar Home Help Detroit 12/17/2021 MDHHSPeterson Dwight Home Help Highland Park 9/21/2017 MDHHSPetipren David J. Dentist Capac 2901008794 6/13/1990 HHS 1128(b)(4)

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Petre Paul M. Physician 1023145232 Warren 4301078751 9/26/2011 DCH

2/15/2015 12/29/2015 07/20/2016

MI-Licensing and Regulatory Affairs MDHHS-OIG MI- Licesning and regulatory Affairs

Summary Suspension Summary Suspension Termination Revoked

Petroelje Glenn E. Dentist Holland 2901007127 7/28/1986 HHS 1128(a)(1)Pettes Jalen Home Help Flint 8/6/2019 MDHHSPfeifer Lauren Joan Physician Caro 4301056619 5/20/2004 HHS 1128(b)(4)Philip Pinkie Home Help Detroit 11/30/2017 HHS-OIGPhillips David Chaffee Physician Allegan 4301046887 3/20/2003 HHS 1128(b)(4)Phillips Jonathan Home Help Grand Rapids 10/13/2014 DCHPhinn Leamon Home Help Detroit 12/19/2016 MDHHS

Piazza Richard Physician 1598914194 Stanton 5101018019 6/11/2019 MDHHS-OIG3/26/2021 04/20/2022

MDHHS-OIG HHS-OIG

Summary Suspension Terminated Excluded

Pickens Jr Alex Physician 1649226507 Detroit 4301038348 3/12/2017

MI-Licensing and Regulatory Affairs 8/23/2017 MDHHS-OIG

SuspendedSummary Suspension

Pickett LaronNon-Emergency Transportation Detroit 5/13/2019 MDHHS

Pickett Shirley Home Help Dearborn Heights 5/6/2020 MDHHS

Piechocki Joseph J Physical Therapist 1548370034 Macomb Twp 5501004900 5/27/2017

MI-Licensing and Regulatory Affairs Suspended

Pierce Darrin Home Help Roseville 8/23/2018 MDHHS

Pierce Shivon Nurse Practitioner 1922504265 Detroit 470426473 4/13/2022

MI-Licensing and Regulatory Affairs

Disciplinary Limited License

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Pilato Frank Physician 1093707101 Chesterfield 5601003978 4/5/2022 MDHHS-OIGSummary Suspension

Pilot Loretta Home Help Detroit 6/15/2015 DCH-OIG

Suspension and Termination

Pinkard Jean Nurse Practitioner 1972970838 Farmington Hills 4704164057 8/3/2020 MDHHS-OIG SuspendedPinkins Deandre Home Help Detroit 12/21/2016 MDHHSPinkston Jamol Home Help Saginaw 11/29/2018 MDHHSPittman Antonio Home Help Lansing 10/20/2016 MDHHS

Pittman Venise Jamison Physician 1720037260 Westland 4704145670 2/20/2009

MI-Licensing and Regulatory Affairs Suspended

Pitts Joseph A. Physician Detroit 5101006636 10/18/2001 HHS 1128(b)(15)Pitts Mark Home Help Detroit 7/17/2017 MDHHS

Pitts Timperance Home Help Ionia 5/22/2020 MDHHS-OIGSummary Suspension

Pleasants Maurice Home Help Detroit 4/6/2017 MDHHS

Plucer, Mark G., DO, PC Plucer Mark G. Physician Group Flint 5101006481 9/13/2002 DCH 1/20/2003 HHS

9/13/02: Violation of Medicaid False Claim Act1/20/03: 1128(a)(1)

Polk Alphonozo Home Help Flint 2/13/2017 MDHHSPollard Seneca M. Home Help Highland Park 9/29/2021 MDHHS

Tri-Cities Care LLC Pollard Tina Home Help Agency Saginaw 7/22/2019 MDHHS-OIGSummary Suspension

Interventional Pain Management Associates PC Pompy Lesly Medical Group 1538113964 Monroe 8/6/2018 MDHHS-OIG

Summary Suspension

Pompy Lesly Physician 1174578801 Monroe 4301058720 8/4/2017

MI-Licensing and Regulatory Affairs

Summary Suspension

Ponce Fernando Chiropractor 1669681508 Lansing 2301005828 5/28/2008

MI-Licensing and Regulatory Affairs

License Revocation

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Poole Portia Home Help Detroit 3/29/2016 MDHHSPoole Richard Home Help Jackson 10/30/2018 MDHHS

Poonpanij Sonjai Physician 1891895462 Southfield 4301032562 3/6/2013 DCH10/20/2016 8/9/2016

HHS-OIG MDHHS-OIG

Excluded Termination Summary Suspension Termination

Pore Philip M. Home Help Detroit 3/24/2022 MDHHS

PornpichitSethavarangura Physician Detroit 4301033113 9/27/2007 DCH

Summary Suspension

Porter Alexis Home Help Detroit 2/9/2017 MDHHSPorter Leroy Home Help Detroit 11/30/2015 MDHHSPorter James Home Help Battle Creek 7/20/2017 MDHHS

Harbor Medical Diagnostic Clinic, Inc. Povlitz Robert H. Physician Group Keego Harbor 4/11/1991 HHS 1128(a)(1)

Powell Jerry Home Help Westland 8/2/2018 MDHHSPowell Kimani home Help inkster 6/4/2020 MDHHSPowell Robert Home Help Clinton Township 9/19/2017 MDHHSPowers Jermaine Home Help Southfield 12/11/2018 MDHHS

Prais Maureen CRNA 1497792717 Manchester 4704102142 6/1/2016

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Premeau John Home Help Marquette 8/2/2017 MDHHSPrice Calvin U. Physician Flint 5101004559 7/22/1991 HHS 1128(a)(1)Price Daryl L Home Help Clinton Township 3/1/2022 MDHHS

Price Jacklyn Home Help Shelby Township 6/20/2019 HHS-OIG 9/30/2019 MDHHS-OIGExcluded Termination

Price Tony Home Help Detroit 2/20/2015 DCH

Pritchet-Hill BrendaNon-Emergency Transportation Wayne 12/27/2018 MDHHS

Pritchett Steven Social Worker 1083002471 Redord 6801101345 5/24/2018 MDHHS 6/12/2018 MDHHSMandatory Exclusion

Proby Keith Home Help Muskegon 4/28/2015 DCHProfit Dontez L Home Help Detroit 7/26/2022 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Proctor Vernon E Physician 1225215783 Baldwin 4301089365 12/30/2017

MI-Licensing and Regulatory Affairs

2/27/2020 07/02/2020

MI-Licensing and Rgulatory Affairs MI-Licensing and Regulatory Affair

Disiciplinary Limited License Suspended Suspended

Pruitt Marcel Home Help Detroit 3/7/2016 MDHHSPryor Lawrence Home Help Jackson 7/31/2019 MDHHSPuente Karen A Home Help Melvindale 1/26/2015 DCHPugh Dylan Home Help Detroit 2/6/2019 MDHHSPugh Henry Home Help Detroit 7/21/2016 MDHHSPugh timothy Home Help Burr Oak 5/3/2017 MDHHSPullen Kenneth Home Help Detroit 12/18/2014 DCHPullian Yuolanda E Home Help Benton Harbor 12/5/2014 DCHPurnell Linda Home Help Mount Morris 12/14/2015 MDHHS

Putman CourtneyNon-Emergency Transportation Southfield 11/29/2018 MDHHS

Detroit Plaza II Pharmacy Pylar George Pharmacy Detroit 5301003640 6/8/1988 HHS 1128(b)(3)

Qadir Rizwan Physician 1427136043 Sterling Heights 4301062248 7/29/2015 MDHHS-OIG4/20/2016 10/05/2017

MI- Licensing and Regulatory Affairs MI-Licensing and Regulatory Affairs

Summary Suspension Summary Suspension Summary Suspension

Qandil Basil A Physician 1720288749 Hamtramck 4301087756 1/22/2013

MI-Licensing and Regulatory Affairs

5/21/2013 06/19/2014 10/08/2015

DCH-OIG DCH-OIG MI-Licensing and Regulatory affairs

Suspended & Summary Suspension Termination Revoked

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Quick jessica M. Counseling 1275998510 Farmington Hills 6401015045 1/18/2022

MI-Licensing and Regulatory Affairs

Summary Suspension

Quinlan James T Physician 1730272592 Traverse City 4301093587 11/5/2012

MI-Licensing and Regulatory Affairs Suspended

Quinn Brian Patrick Physician 1104028828 Royal Oak 4704234655 6/18/2009

MI-Licensing and Regulatory Affairs

Summary Suspension

Quinn Donald R. Dentist 1417102492 Farmington Hills 2901013192 11/9/2014

MI-Licensing and Regulatory Affairs 3/4/2015

MI- Licensing and Regulatory Affairs

Suspended Revoked

Quinn Eric Home Help River Rouge 10/27/2020 MDHHS

Inkster Community Pharmacy Quisenberry Charles P.Pharmacy/Medical Supplier Inkster 10/20/1998 HHS 1128(a)(1)

Southfield Family Pharmacy Quisenberry Charles P.Pharmacy/Medical Supplier Southfield 5301003940 10/20/1998 HHS 1128(a)(1)

Weisel Drug Company Quisenberry Charles P.Pharmacy/Medical Supplier Monroe 10/20/1998 HHS 11/14/1995 HHS

10/20/98: 1128(a)(1)11/14/95: 1128(a)(1)

Weisel Newport Pharmacy Quisenberry Charles P. Pharmacy New Port 5301004763 10/20/1998 HHS 1128(a)(1)Weisel Pharmacy, Inc. (aka Cross Drug Store) Quisenberry Charles P. Pharmacy Menomiee 5301004621 10/20/1998 HHS 1128(a)(1)

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Quizon Roberto G Physician 1538237482 Detroit 4301033614 6/14/2016 MDHHS-OIG

8/31/20189/20/2018 10/23/2018 01/28/2020

MDHHS-OIGHHS-OIG MI- Licensing and Regulatory Affairs MI-Licensing and regulatory Affairs

Summary Suspension Terminated Terminated Summary Suspension Revoked

Racette, Wendell A. DDS, PC Racette Wendell A. Dental Group Lansing 2901010020 6/13/2001 DCH HHS

6/13/01: Violation of Medicaid False Claim Act10/18/01: 1128(a)(1)

Rademacher Thomas Home Help Middleton 3/16/2021 MDHHSRaheem Ahmad Home Help Grand Rapids 2/25/2021 MDHHSRaheem Ali Home Help Wayne 3/19/2020 MDHHS

Associated Physicians of Southeast Michigan P.C. Rahim Mahmoud Group 1336240951 Dearborn 8/3/2016 MDHHS-OIG 10/30/2018 MDHHS-OIG

Summary Suspension Terminated

Dearborn Internist P.C. Rahim Mahmoud Medical Group 1023314341 Dearborn 3/14/2017 MDHHS-OIG 10/30/2018 MDHHS-OIG

Summary Suspension Terminated

Rahim Mahmoud Physician 1982706941 Dearborn 4301065143 8/3/2016 MDHHS-OIG

4/23/2018 8/1/201810/30/20186/20/2019

MI-Licensing and Regulatory AffairsMDHHS-OIGHHS-OIG

Summary Suspension Summary Suspension Summary Suspension Disolved Revoked TerminatedExcluded

Physicians Choice Home Health Care LLC Rahman Tausif Home Health Agency 1578689386 Livonia 237636 5/29/2012 DCH

Summary Suspension

Raines JasonNon-Emergency Transportation Detroit 1/4/2018 MDHHS

Rainey James Home Help Grand Rapids 3/19/2019 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Rainwater Jesse Home Help Detroit 9/9/2019 MDHHS

Rama Kumara Physician 1487641148 Grosse Pointe 4301040250 5/19/2021

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Ramadan Ogus K. Physician Grand Blanc 4301030567 7/12/1992 HHS 1128(a)(1)

Rambo Joseph Jean Physician 1447242789 Bridgman 4301023443 10/16/2015

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Ramirez Maria Home Help Wyoming 8/20/2020 HHS-OIG SuspendedRamsey Moriba Home Help Detroit 2/6/2017 MDHHS

Rasool Kashif Physician 1629287461 Detroit 4301083619 12/18/2017 MDHHS-OIGSummary Suspension

Ratcliff Christopher Home Help Pontiac 1/25/2016 MDHHS

Lakeshore Home Health Care Inc Rathod Babubhai Group 1396858775 Ludington 2/22/2012 DCH 8/1/2013 DCH-OIGTerminated Suspended

Lakeshore Spine & Pain PC (Accessible Urgent Care) Rathod Babubhai Group 1699043299 Ludington 2/22/2012 DCH 8/3/2013 DCH-OIG

Terminated Suspended

Lakeshore Home Health Care Inc Rathod Shaila Group 1396858775 Ludington 2/22/2012 DCH 8/3/2013 DCH-OIGTerminated Suspended

Rauschenberger Joseph C Home Help Fairview 5/4/2022 MDHHS

Raval Pramod Physician 1386612612 Hamtramck 4301043240 3/29/2010 DCH 7/18/2013 DCH-OIG

Terminated Summary Suspension

Raval Sumanray Home Help Farmington Hills 6/16/2021 HHS-OIG Suspended

Glendale Pharmacy Raval Vijay Kumar Pharmacy 1366765083 Highland Park NCPDP 2373809 8/19/2011 DCH 7/11/2016 MDHHS-OIG

Summary Suspension Termination

Ray Marquetta Home Help Detroit 4/11/2016 MDHHSRayshon Craig D Home Help Detroitq 9/17/2021 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Rea Lauralee Social Worker 1407155534 Grand Rapids 6801089086 3/31/2020

MI-Licensing and Regulatory Affairs

7/28/2020 10/22/2021

MI-Bureau of Licensing and Regulatory Affairs MI-Bureau of Licensing and Regulatory Affairs

Suspended Suspended Limited Restricted

Redd Clara C Home Help Allen Park 1/28/2015 DCHReed Chance Home Help Detroit 3/26/2019 MDHHSReed Lawanda Lorena Home Help Grand Rapids 12/15/2014 DCHReed Vira Home Help Detroit 12/17/2019 MDHHSReed David Home Help Detroit 11/21/2016 MDHHSReed-Davenport Deshawn Home Help Saginaw 8/1/2019 MDHHSReid Jaronn Home Help Taylor 6/5/2017 MDHHSReid John Andrew Home Help Canton 3/16/2015 DCHReid Larry Home Help Detroit 12/19/2016 MDHHS

Reid Larry Physician 1801008727 Oak Park 5101007021 1/2/2021

MI-Licensing and Regulatory Affairs Suspended

Reitz Robert Home Help Three Oaks 4/19/2021 MDHHS-OIG 4/21/2022 MDHHS-OIG

Suspended Terminated

Rejano Crispo Garcia Physician 1043379530 Trenton 4301033625 10/8/2009

MI-Licensing and Regulatory Affairs Revoked

Personal Care Home Services Rembert Carmen Home Help Agency Southfield 3/20/2019 MDHHS-OIG 5/22/2020 MDHHS-OIG

Summary Suspension Terminated

Rembert Carmen Home Help Detroit 3/20/2019 MDHHS-OIG 5/22/2020 MDHHS-OIG

Summary Suspension Terminated

Resterhouse Sandra Home Help Muskegon 9/1/2022 MDHHSReyes Janice Renee Home Help Detroit 11/30/2015 MDHHSReynolds Don Home Help Detroit 12/7/2017 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Reynolds January Home Help Grand Rapids 6/8/2017 MDHHSReynolds Stacey Home Help Pontiac 11/9/2017 MDHHS

Reznick Terry Physician 1295874451 Fenton 5101009942 4/20/2017

MI-Licensing and Regulatory Affairs

Summary Suspension

Ribbentrop Paul H. Physician St. Clair Shores 5101003921 5/20/2003 HHS 1128(a)(4)Rice Brandy Home Help Clinton Township 1/15/2019 MDHHSRice Darlene Home Help Detroit 8/7/2018 MDHHSRice William Home Help Portage 7/13/2020 MDHHSRichard Lawrence B. Podiatrist 1972565448 Northville 5901001176 4/19/2015 HHS Excluded Richardson Angela Home Help Detroit 9/20/2017 MDHHSRichardson Neil James Chiropractor Grand Rapids 2301006727 7/6/1997 HHS 1128(b)(14)Richey Linda Home Help Lewiston 12/30/2019 MDHHSRichmond Adam Home Help Wyoming 1/16/2018 MDHHS 6/16/2020 MDHHS

Richter Daniel Social Work 1578905402 Lowell 6801086657 12/26/2019

MI-Licensing and Regulatory Affairs

Summary Suspension

Ridal DavidNon-Emergency Transportation Grayling 12/4/2018 MDHHS

Riddle Edward Home Help Kalamazoo 2/16/2017 MDHHSRider Janis Home Help Ludington 11/8/2018 MDHHSRidgell Sabrina Home Help Detroit 8/22/2019 MDHHSRidout Jermaine Home Help Detroit 7/1/2019 MDHHS

Harper Pharmacy Rifai Mahmoud Pharmacy 1295166759 Harper Woods 5301010253 7/15/2019 MDHHS-OIGSummary Suspension

Riker Paul Dentist 1750402137 Allen Park 2901014570 1/12/2019

MI-Licensing and Regulatory Affairs 6/5/2019

MI-Licensing and Regulatory Affairs

Discplinary LimitedSuspended

Riley Bertlyn (Bert) Home Help Ypsilanti 9/5/2018 MDHHSRiley Donzell Home Help Detroit 2/13/2019 MDHHSRiley Shandell Lapep Home Help Grand Rapids 4/6/2015 DCH

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Ringley Pamela Ann Nurse Practitioner 1134539281 Howell 4704165210 9/8/2015

MI-Licensing and Regulatory Affairs

Summary Suspension

Riplett James E Home Help East Pointe 8/9/2022 MDHHSRoach Legina D Home Help Detorit 12/15/2021 MDHHSRobart Nicole Home Help Muskegon 12/18/2017 MDHHSRobb Casey Home Help Mount Morris 7/10/2018 MDHHSRoberts Alyssa Home Help Carleton 4/24/2018 MDHHS

Roberts David Social Worker 1063079838 Westland 6851104575 4/21/2022

MI-Licensing and Regulatory Affairs

Limited/ Restricted License

Roberts Patrick Home Help Detroit 11/7/2016 MDHHSRoberts-Bey Wesley Home Help Flint 11/18/2014 DCHRobertson Antoine Home Help Detroit 5/31/2016 MDHHS

Robertson Jonathan G Physician 1366710816 MArquette 5101019483 9/11/2018

MI-Licensing and Regulatory Affairs 12/18/2018

MI-Licensing and Regulatory Affairs

Summary Suspension Revoked

Robins Diana Nurse Practitioner 1568529618 Shelby Township 4704157677 10/6/2018

MI-Licensing and Regulatory Affairs

Disciplinary Limited

Robinson Arthur Home Help Detroit 3/3/2016 MDHHSRobinson Betty Home Help Detroit 1/23/2020 MDHHSRobinson Corinne Home Help Clarkston 5/22/2018 MDHHSRobinson Demelle Home Help Detroit 10/16/2019 MDHHSRobinson Donald Home Help Detroit 9/21/2016 MDHHSRobinson Harold Home Help Southfield 8/2/2017 MDHHSRobinson Joyce Home Help Detroit 9/25/2018 MDHHS-OIGRobinson Kinte Home Help Ypsilanti 1/2/2018 MDHHSRobinson Laurence Home Help Detroit 2/24/2015 DCH 1/30/2018 MDHHSRobinson Leondre Home Help Benton Harbor 5/16/2018 MDHHSRobinson Philip Home Help Detroit 8/31/2015 MDHHSRobinson Phyllis Home Help Port Huron 4/19/2018 MDHHSRobinson Rosland Home Help Pontiac 2/8/2021 MDHHSRobinson-Crowell D'ett L Home Help Roseville 2/24/2015 DCH

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Roby Thomas Home Help Detroit 10/29/2016 MDHHSRochefort Rocky Home Help Oscoda 5/17/2017 MDHHS

Rockafellow Bradley Psychologist 1558342378 Oxford 6301014045 7/6/2016 MDHHS-OIG

4/20/20177/19/20181/10/2019

HHSMI-Licensing and Regulatory AffairsMDHHS-OIG

Summary Suspension Excluded Revoked Terminated

Rodgers Kennie Home Help East Jordan 11/23/2021 MDHHSRodriguez Pete Home Help New Era 12/10/2018 MDHHSRoe-Carney Treka Home Help Clarkston 6/11/2015 DCHRogers Kyla Home Help Lansing 8/24/2020 MDHHSRogers Michele Home Help Gaylord 4/7/2022 MDHHSRojas Humberto Physician Owosso 4301044894 10/20/2002 HHS 1128(a)(4)Rollins Jawanne J Home Help Detroit 11/3/2014 DCHRollins Jerry Home Help Highland Park 5/17/2017 MDHHSRollins Kevin Home Help Detroit 10/13/2014 DCHRone Alvin D Home Help Muskegon Heights 11/30/2015 MDHHS 3/12/2018 MDHHS-OIGRone Jimmy Home Help Muskegon 1/9/2015 DCHRosa Blanca Home Help Detroit 9/18/2017 MDHHSRose Edward Allen Physician 1750354106 Novi 4301046183 10/31/2013 HHS 1128(b)(4)

Rose Jermaine Home Help Detroit 1/26/2021 MDHHS-OIGSummary Suspension

Rose Karen Eileen Physician 1568406007 Novi 4301066589 10/31/2013 HHS 1128(b)(4)Roshy Gary L. Chiropractor Ludington 2301005366 12/7/2004 HHS 1128(b)(14)Ross Deaundray Home Help Detroit 4/25/2019 MDHHSRoss Guy Home Help Detroit 11/2/2016 MDHHSRoss Joseph Home Help Detroit 10/21/2019 MDHHS

Roth Michael A Physician 1396893061 Famington Hills 4301028327 8/9/2016 MDHHS-OIG10/13/2017 8/31/18

MI- Licensing and Regulatory Affairs MDHHS-OIG

Summary Suspension Summary Suspension Terminated

Roth Steven J Physician 1538123609 Waterford 5101006341 11/4/2017

MI-Licensing and Regulatory Affairs Suspended

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Roumayah Najah Dental Group 1255419958 West Bloomfield 2901014824 8/15/2017 MDHHS-OIG11/29/20188/20/2019

MDHHS-OIGHHS-OIG

Summary Suspension TerminatedExcluded

Roundtree Shawn Home Help Grand Rapids 11/21/2019 MDHHSRouser Cherrie Home Help Lansing 11/12/2016 MDHHSRouser Kendrick Home Help Pontiac 11/14/2018 MDHHS

Roy Simon P Physician 1497851380 Chesnut Hill, MA 4301500478 1/19/2022

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Roy Tracie L Home Help Baldwin 1/30/2015 DCHRucker Demetrious Home Help Detroit 9/24/2015 MDHHSRuffin Leonard Home Help Detroit 7/10/2015 DCH 4/18/2018 MDHHSRuiz Aaron Home Help Ottawa 4/7/2020 MDHHSRunyon Betty Lou Home Help Whittemore 5/31/2017 MDHHSRunyon Hillary Home Help Ypsilanti 5/6/2019 MDHHSRushing Kamesha Home Help Pontiac 9/9/2019 MDHHSRushing Tony Home Help Kalamazoo 6/7/2018 MDHHSRussell Carlesia Home Help Pontiac 11/8/2017 MDHHSRussell Ekeem M Home Help Pontiac 6/1/2022 MDHHS

Trio-Camburn Drugs Russell James W. Pharmacy Flint 4/20/1998 HHS 1128(b)(1)

Russell Jeffrey S Physician 1497799654 Coldwater 5101011799 1/27/2014

MI-Licensing and Regulatory Affairs Suspended

Russell Renarad E Home Help Adrian 12/12/2014 DCH

Russo Christopher Physician 1033442231 Warren 4301064161 3/7/2019

MI-Licensing and Regulatory Affairs

01/28/2020

MI-Licensing and Regulatory Affairs

Summary Suspension Suspended

Rutherford John W. Physician River Rouge 5101005008 7/24/1986 HHS 1128(a)(1)Rutherford Willie Home Help Detroit 7/22/2020 MDHHSRyan Carla Home Help Prudenville 2/15/2018 MDHHSRyans Larry Home Help Saginaw 11/5/2014 DCHRyniak Jessica Home Help Clinton Township 7/30/2019 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Sabit Aria Physician 1659510972 Southfield 4301097955 3/10/2015 DCH-OIG4/19/2015 04/26/2017

HHS-OIG MDHHS-OIG

Summary Suspension Excluded Terminated

AGSS Properties LLC Sadeghi Azar Home Help Agency Ann Arbor 8/29/2017 MDHHS-OIGSummary Suspension

Sadeghi Azar Home Help Ann Arbor 8/29/2017 MDHHS-OIG 11/19/2021 HHS-OIG

Summary Suspension Excluded

Saeed Jalal Home Help Dearborn 4/22/2015 DCHDetroit New Hope Pharmacy Saiyad Maksudali Pharmacy 1861911208 Detroit 5301009534 8/5/2020 MDHHS-OIG Suspended

Saladino April Managing Employee Grand Rapids 2/28/2019 MDHHS ExlcudedSalame Ali Home Help Dearborn 4/21/2021 MDHHS

City Limit LLC Salamey Tarick Group 1689130056 Detroit 12/18/2019 MDHHS-OIGSummary Suspension

Saleh Saeed Physician Dearborn 4301031271 6/19/2003 HHS 1128(b)(4)Salinas Fabian Physician Ann Arbor 4301076437 9/20/2005 HHS 1128(a)(2)Salter Norris Home Help Mount Clemens 11/30/2015 MDHHS

Samaan Mark Physician 1154550622 Troy 4301094957 9/8/2022 West Virginia TerminatedSamuel Louis Home Help Detroit 9/13/2018 MDHHSSamuel Tyrus Phillip Home Help Eastpointe 4/9/2015 DCH

Rochester Hills Medical Center PC Samy Chris Medical Group 1700094687 Rochester Hills 8/6/2018 MDHHS-OIG 9/5/2018 MDHHS-OIG

Summary Suspension Terminated

Samy Chris D Physician 1740211655 Rochester Hills 4301061131 11/21/2016

MI-Licensing and Regulatory Affairs

11/21/2016 03/21/2017

Mi- Licensing and Regulatory Affairs MI - Licensing and Regulatory Affairs

Suspended Summary Suspended Voluntarily Surrendered

Sanchez Christina Louise Home Help Perrinton 10/20/2014 DCHSanchez Manuel Home Help Lansing 7/23/2020 MDHHSSanders Celestine Home Help 1700040110 Ypsilanti 6801064039 5/20/2019 HHS-OIG ExcludedSanders Darrell Home Help Detroit 5/8/2018 MDHHSSanders Deshawn A. Home Help Detroit 3/3/2021 MDHHSSanders Jarett Home Help Detroit 9/29/2015 MDHHSSanders Phillip Home Help Harperwoods 12/16/2019 MDHHS 1/12/2022 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Sanford Eugene Home Help Detroit 2/28/2019 MDHHSSantana Henry Home Help Detroit 7/27/2017 MDHHSSantos rafael Home Help Lansing 6/12/2017 MDHHS

Sapala, James A., MD PC Sapala James A. Physician Group 1720086374 Detroit 4301030372 5/4/1992 HHS 1128(a)(1)

Saperstein Glenn S Physician 1770637670 Commerce Township 5101011716 2/1/2017

MI-Licensing and Regulatory Affairs

3/15/2017 08/03/2017 04/21/2022

MDHHS-OIG MI - Licensing and Regulatory Affairs MDHHS-OIG

Summary Suspension Summary Suspension Summary Suspension Termination

Saunders-Davenport Khadisha

Counselor Home Help 1447422860 Southfield 6401009009 3/30/2021 MDHHS-OIG 4/1/2022 MDHHS-OIG

Summary Suspension Termination

Sawaf Ali H. Physician Escanaba 4301033342 8/19/2004 HHS 1128(a)(4)Sawyer Amber Home Help South Lyon 8/3/2017 MDHHSSaxton Kodi Home Help Detroit 11/30/2015 MDHHSSayen Tara Home Help Imlay City 4/18/2016 MDHHS

Scalici Tony F. Physician Wyoming 5101007093 12/23/1990 HHS 5/5/1994 HHS

12/23/90: 1128(b)(3)5/5/1994: 1128(b)(3)

Schaffer Malena Home Help Fenwick 9/27/2016 MDHHS

Schanzenbaker Sherrie Counselor 1427471036 Battle Creek 6401017043 8/12/2020 MDHHS-OIG12/6/2020 11/18/2021

MDHHS-OIG HHS-OIG

Termination Summary Suspension Excluded

Schef Debra Home Help Port Huron 5/27/2016 MDHHS

Schiefelbein Arthur J. Podiatrist Highland Park 5901000899 2/4/1999 DCH 5/20/1999 HHS

2/4/99: Violation of Medicaid False Claim Act5/20/99: 1128(a)(1)

Schillio Serge Paul Physician 1194761940 Saint Jospeh 4301051134 8/16/2013

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Schneck Michael Home Help Gaylord 9/14/2017 MDHHSSchooler Eunice Home Help Barryton 3/28/2019 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Schrade Moichael Home Help Warren 8/27/2021 MDHHSSchreier Steven M. Podiatrist Southfield 5901400211 11/19/1998 HHS 1128(a)(1)

Schrock Lauralee Physician Assistant 1952738189 Dearborn 5601006841 9/27/2017

MI-Licensing and Regulatory Affairs

Disciplinary Limitd License

Howard City Plaza, Inc. Schroeder Bruce Pharmacy Howard City 5301002282 12/23/1991 HHS 1128(a)(1)Schroeter David B. Dentist Macelus 2901011501 11/20/1997 HHS 1128(b)(4)Schubpack Tara Home Help Bay CIty 11/3/2017 MDHHSSchudel Jenny Home Help Roscommon 3/1/2017 MDHHS

Schultz Nancy L Nurse Practitioner 1588638589 Montague 4704218106 8/14/2016

MI-Licensing and Regulatory Affairs Suspended

Schultz Yvonne Home Help Port Huron 9/16/2015 MDHHS

Schutte Natalie Physician Assistant 1295982189 Mount Pleasant 5601005332 2/22/2012 DCH 8/7/2013 DCHTerminatedSuspended

Schwartz Gary J. Chiropractor 1326249624 Jackson 2301002137 6/8/1994 DCH

Violation of Medicaid False Claim Act

Schwarz Bernard C. Chiropractor 2301005101 12/7/1994

Schwarzmedics Schwarz Daniel Group 1073959615 Saginaw 12/25/2019 MDHHS-OIG1/18/2021 04/20/2022

MDHHS-OIG HHS-OIG

Summary Suspension Termination Excluded

Schwarz Daniel Physician 1669665154 Southfield 4301062570 12/25/2019 MDHHS-OIGSummary Suspension

Scott Dante J Home Help Muskegon 1/14/2015 DCHScott Eliza Home Help Zeeland 3/29/2016 MDHHSScott Karla Jean Home Help Benton Harbor 6/17/2015 DCHScott Karley Home Help Roseville 6/28/2017 MDHHSScott Mary Home Help Detroit 6/17/2015 DCHScott Ricky Home Help Detroit 11/30/2015 MDHHSScott Terry Junior Home Help Bangor 5/15/2015 DCH

Scott Van Edward Physician 1164575031 Muskegon Heights 4301044463 1/10/2014 DCH-OIG 2/9/2014 DCH-OIG

1/10/14 Summarily Suspended2/9/2014 Terminated

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Scranton Steven E Physician 1578543476 Grand Rapids 4301043798 3/5/2018 MDHHS-OIG 3/23/2018

MI-Licensing and Regulatory Affairs

Summary Suspension Summary Suspension

Seay Dawn Home Help Lansing 8/19/2015 MDHHSSelf Freeman Home Help Detroit 1/18/2017 MDHHSSellers Roqueena Home Help Detroit 9/27/2018 MDHHS 1/13/2022 MDHHS

Sennish John C. Physician 1750350286 Coldwater 4301043259 6/26/2018 MDHHS

Disciplinary Limited License

Sewell Franklin Home Help Detroit 7/20/2020 MDHHS-OIGSummary Suspenion

Shader Joseph Physician 1972804193 North Liberty, IA 4301111585 4/29/2018

MI-Licensing and Regulatory Affairs Suspended

Shadon Dwight Home Help Hamtramck 1/29/2020 MDHHS

Shafinia Sohrab Physician 1588614606 Farmington Hills 5101012201 5/6/2014 DCH-OIG 12/20/2014 HHS

Summary Suspension Excluded

Shah Rajesh P Physician 1376595272 Jackson 4301048647 5/17/2017

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Shaheen Michael G Physician 1285732073 Flint 5101006847 8/31/2017

MI-Licensing and Regulatory Affairs 5/5/2018

MI-Licensing and Regulatory Affairs

Summary Suspension Voluntarily Surrendered

Shamoon Jivry Home Help Warren 5/8/2017 MDHHS

Shanidze Irakly Home Help Grosse Pointe Park 9/20/2006 HHS-OIG ExcludedShannon Larry Home Help Detroit 10/31/2016 MDHHS

SharifDiaa AL Dien Ayoub Physician 1487919296 Grand Blanc 4301100775 10/10/2016

MI-Licensing and Regulatory Affairs 2/10/2017

MI-Bureau of Licensing and Regulatory Affairs

Summary Suspension Summary Suspension

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Sharma Dana Home Help Sterling Heights 2/20/2017 HHSSummary Suspension

Tawas Bay Family Practice PC Sharma Devendra Rural Health Clinic 1275509036 Tawas City 11/19/2018 MDHHS-OIG 7/16/2022 MDHHS-OIG

Summary Suspension Terminated

Sharma Devendra Physician 1396740817 Tawas City 4301033122 11/19/2018 MDHHS-OIG4/8/2019 07/16/2022

MI-Licensing and Regulatory Affairs MDHHS-OIG

Summary Suspension Summary Suspension Terminated

Sharow Debbie Lynn Home Help Prudenville 12/2/2014 DCH

Sharp Michael J Dentist 1245316785 Ann Arbor 2901010733 10/11/2012

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Sharp Veronica Home Help Detroit 3/1/2018 MDHHSSharrak Christopher Home Help Bloomfield 12/10/2015 MDHHSShaw TImothy Home Help Detroit 11/12/2020 MDHHSShaya Stevonna Home help Sterling Heights 6/18/2018 MDHHSSheard Donna Home Help Saginaw 9/29/2015 MDHHSSheard Shannon Home Help lansing 3/10/2022 MDHHSSheffield Kwame Home Help Taylor 11/30/2015 MDHHS

Sheikh Zahid Physician 1720045586 Madison Heights 4301058357 11/14/2017 MDHHS-OIG 4/15/2022 MDHHS-OIG

Summary Suspension Terminated

St. Claire Shores Medical PLLC Shelton Bernard Group 1316194640 Saint Claire Shores 3/26/2019 MDHHS-OIGSummary Suspension

Shelton Bernard Physician 1417032491 Saint Claire Shores 4301088798 1/13/2017

MI-Licensing and Regulatory Affairs 7/12/2017

MI-Licensing and Regulatory Affairs

Summary Suspension Suspended

Shelton Jennifer Home Help Benton Harbor 9/4/2019 MDHHSShepherd Anthony Eugene Home Help Detroit 11/30/2015 MDHHSShepherd Christine Home Help Sturgis 11/16/2020 MDHHSShepherd Nikyta Home Help Ypsilanti 1/27/2018 MDHHSShepherd Rorey Home Help Grand Rapids 8/8/2018 MDHHSSheppard-Morris Malissa Home Help Battle Creek 11/13/2018 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Sherman Bryan R Physician Assistant 1346458130 Ann Arbor 5601004136 1/13/2016

MI-Licensing and Regulatory Affairs 6/2/2016

MI-Licensing and Regulatory Affairs

Suspension Revoked

Sherman Errol Podiatrist 1154344117 Oak Park 5901000864 4/27/2011

MI-Licensing and Regulatory Affairs

Summary Suspension

Sherman, Errol DPM PC Sherman Errol Podiatrist 1770507147 Oak Park 5901000864 4/27/2011

MI-Licensing and Regulatory Affairs 6/9/2015 DCH - OIG

Summary Suspension Terminated

Sherman Lawrence Physician 1407996820 Shelbt Township 4301086729 11/30/2021 MDHHS -OIGSummary Suspension

Sherman Matthew Home Help Ferndale 10/25/2017 MDHHS

Sherwood Craig Physician 1588628564 Saint Jospeh 5901001102 11/20/2018

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Shields Siobham Home Help Grand Rapids 12/15/2015 MDHHSSholes Carlton Home Help Alpena 4/16/2018 MDHHSShort Gary Home Help Hart 9/29/2017 MDHHS Shufford Luvenia Home Help Kenosha 12/15/2014 DCHShumaker Ryan Home Help Kalamazoo 11/21/2019 MDHHS

Siebert John W. Physician 1063594521 Madison, WI 50002 6/13/2013 Other State

Suspension by the State of New York

Siegel Barry G MD PC Siegel Barry Group 1164625687 Rochester Hills 6/11/2019 MDHHS-OIG 9/13/2019 MDHHS-OIG

Summary Suspension Terminated

Siegel Barry Physician 1619967197 Birmingham 4301045655 6/11/2019 MDHHS-OIG 9/13/2019 MDHHS-OIG

Summary Suspension Terminated

Sigger Menard Home Help Detroit 7/14/2016 MDHHSSiggers Rochi Home Help Grand Rapids 10/6/2021 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Silber Alan Physician 1366447260 West Bloomfield 4301085080 6/20/2011

MI-Licensing and Regulatory Affairs

Summary Suspensions

Silvia Kimberly Home Help Niles 11/20/2018 MDHHSSimila Denise Home Help MArquette 3/8/2018 MDHHS

Simmons KimNon-Emergency Transportation Detroit 12/14/2017 MDHHS

Simmons Tara Wokeim Home Help Detroit 11/26/2014 DCHSimon Elvea Home Help Detroit 11/17/2017 MDHHSSimpson James Vernon Dentist St. Helen 2901015390 11/8/1994 HHS 1128(b)(3)Simpson Jessica Home Help Southfild 10/8/2020 MDHHSSimpson Kauba Home Help Detroit 9/18/2017 MDHHSSimpson Lonnie Home Help Detroit 5/3/2017 MDHHSSimpson Tanja Home Help Saginaw 9/21/2021 MDHHSSimpson Williw Home Help Eastpointe 2/9/2022 MDHHSSims Arlester Home Help Muskegon 8/4/2016 MDHHSSims Utasha R Home Help Muskegon 4/27/2020 MDHHSSingleterry JAson M Home Help Detroit 3/2/2022 MDHHS

Sirajuddin James Physician 1306997325 South Haven 4301039518 9/7/2014

MI-Licensing and Regulatory Affairs Suspended

Sirois Cindy Physician 1093791733 Fort Lauderdale, FL 4301090877 3/20/2019

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Siryani Mervat Home Help Warren 10/31/2019 MDHHS-OIG TerminatedSiterlet Felipa T. Home Help Algonac 3/9/2021 MDHHS

Siudara Jerome Physician 1598941346 Cheboygan 5101005875 4/4/2016 MDHHS-OIG 1/10/2019 MDHHS-OIG

Summary Suspension Terminated

Skinner Charelene Home Help Lansing 5/19/2015 DCH-OIGSummary Suspension

Skinner Michael W Home Help Lansing 3/10/2015 DCHSklar Eugene Dentist Gaylord 2901008434 11/4/1990 HHS 1128(b)(4)Slan Gerri Home Help Burt 5/17/2022 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Slater Blake Physician 1134188733 Cedarville 5101007998 10/10/2018

MI-Licensing and Regulatory Affairs 2/7/2019

MI-Licensing and Regulatory Affairs

Summary SuspensionVoluntarily Surrendered

Slusher Stephen L. Chiropractor Escanaba 2301007042 1/20/2003 HHS 1128(a)(4)Smakal Gary Home Help Lake George 4/29/2015 DCH

Smeltzer Brandon Physician 15588894998 Niles 5101025282 3/2/2022

MI-Licensing and Regulatory Affairs 6/2/2022

MI-Licensing and Regulatory Affairs

Suspended Voluntarily Surrendered

Smith Alice Home Help Detroit 4/16/2018 MDHHS 8/23/2021 MSHHASmith Anthony Home Help Kalamazoo 8/7/2018 MDHHSSmith Antonio Home Help Detroit 1/7/2016 MDHHSSmith Bobby Home Help Detroit 10/28/2015 MDHHS 3/24/2021 MDHHSSmith Calvin Home Help Detroit 10/7/2020 MDHHSSmith Carl Home Help Detroit 3/2/2022 MDHHS

Smith Carlos A Psychologist 1811270895 Livonia 6301017313 8/13/2018 MDHHS-OIG10/18/2019 06/25/2020

MI-Licensing and Regulatory Affairs MI-Licensing and Regulatory Affairs

Summary Suspension Summary Suspension Voluntarily Surrendered

Smith Chrismoul Home Help Detroit 9/2/2021 MDHHS

Smith Dwight E Physician 1114942562 Detroit 4301046520 5/29/2012 DCHSummary Suspension

Smith Eric W Home Help Detroit 10/31/2017 MDHHSSmith Franzora Home Help Detroit 12/15/2014 DCHSmith Gregory Andre Home Help Detroit 5/18/2015 DCHSmith Jamal Home Help Detroit 5/12/2022 MDHHSSmith Jamila Home Help Detroit 12/22/2015 MDHHSSmith Jennie Home Help Pontiac 3/9/2016 MDHHS 8/3/2020 MDHHSSmith Joe Home Help Saginaw 3/25/2015 DCHSmith Johnell Home Help Detroit 4/25/2018 MDHHSSmith Kenneth Home Help Detroit 7/11/2019 MDHHSSmith Krista Marie Home Help Saint Helen 2/7/2019 MDHHSSmith Kyron Home Help Inkster 3/8/2018 MDHHSSmith Lindsie Home Help Houghton Lake 3/5/2019 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Smith Michael D Home Help Jackson 10/31/2017 MDHHS 11/4/2021 MDHHSSmith Mirthus T Home Help Newport 11/30/2015 MDHHSSmith Raelynn Home Help Grand Rapids 2/20/2015 DCHSmith Ray Home Help Farwell 5/26/2015 DCH

Smith Rodney W Physician 1871533554 Ann Arbor 4301063441 8/23/2019

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Smith Ronald Physician 1881642999 Las Vegas 1178 6/22/2020 MDHHS-OIGSummary Suspension

Smith Sandra Home Help Beaverton 1/25/2016 MDHHSSmith Shannon Home Help East China 9/14/2016 MDHHS

Smith Sheila Home Help Detroit 6/10/2020 MDHHS -OIG Suspension

Smith Stephen Physician 1457429987 Birmingham 4301044365 1/25/2022

MI-Licensing and Regulatory Affairs Suspended

Smith Steven Home Help Holt 10/2/2018 MDHHSSmith Stevonna Home Help Detroit 4/4/2017 MDHHSSmith Tandre Home Help Flint 6/27/2016 MDHHSSmith Thomas E Home Help Detroit 11/30/2015 MDHHSSmith Victoria Home Help West Branch 3/29/2021 MDHHSSmith William Lee Home Help Detroit 11/30/2015 MDHHSSmith Yvette Home Help Grand Rapids 1/28/2017 MDHHSSmith Robert Home Help Algonac 2/17/2017 MDHHS

Sneed Lamyia Home HElp Detroit 6/16/2020 MDHHS-OIGSummay Suspension

Sneed Miykiah Home Help Jackson 4/13/2020 MDHHS Snyder Jonathan Home Help Kalkaska 8/29/2017 MDHHSSoarks Lisa Home Help Manistee 10/31/2019 MDHHS

Sokoll William C Physician 1639181753 Standish 4301046279 5/6/2014 DCH-OIG9/20/2017 11/01/2019

HHS-OIG MDHHS-OIG

Summary Suspension Exclusion Terminated

Soliman Mikhayl Physician 1356536460 Wayne 4301086758 7/3/2013 DCH-OIG Suspended

Solo Robert Home Help Kalkaska 1/26/2021 MDHHS-OIGSummary Suspension

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Sonaglia Catherine S Physician 1275644601Grosse Pointe Woods 4301058067 7/2/2020

MI-Licensing and Regulatory Affairs Suspended

Sood Usha Physician 1255447215 Roseville 4301039212 3/5/2018 MDHHS-OIG

8/6/2019 11/01/2019 06/19/2020

MI-Licensing and Regulatory Affairs MDHHS-OIG

Summary Suspension Summary Suspension Terminated Voluntarily Surrendered

Sorensen Phillip M. Physician Lansing 4301031657 4/20/2003 HHS 1128(a)(3)

Sorongon Marcelino Physician Saginaw 4301031149 4/30/1999 DCH 5/18/2000 HHS

4/30/99: Violation of Medicaid false Claim Act5/18/00: 1128(a)(1)

Sorrell Michael Home Help lansing 1/4/2018 MDHHSSouvenir Kaye A. Dentist Detroit 2901012399 8/15/1993 HHS 1128(a)(1)Spann Darlene Home Help Grand Rapids 8/16/2022 MDHHSSparkman Garry Home Help Clinton Township 7/23/2018 MDHHSSparks Sirena Home Help Manistee 5/14/2019 MDHHSSpears Dersell Home Help Detroit 1/9/2018 MDHHSSpeed Kenneth Home Help Lansing 11/30/2015 MDHHSSpeller Kevin S Home Help Ecorse 2/13/2015 DCHSpencer Demarcus Home Help Holland 10/14/2019 MDHHSSpencer Jarvis Home Help Detroit 5/19/2021 MDHHSSpiller Valerie Home Help Oak Park 10/13/2021 MDHHS

Spires Ricky Home Help Madison Heights 4/13/2020 MDHHS-OIGSummary Suspension

Spresser Aidana M Social Work 1780775411 Port Huron 6801060154 8/25/2021

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Sripinyo Veera Physician Warren 4301031589 5/6/1997 HHS 1128(b)(4)

St. Amor Stephen Home Help Romulus 12/2/2015 MDHHS 1/6/2016Suspended Terminated

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Stachulski Holly C Home Help Taylor 4/20/2017 HHS ExcludedStalling Alonzo Home Help Detroit 3/28/2019 MDHHSStanfill Octavious A. Home help Detroit 7/21/2022 MDHHSStanford Donna Home Help Southfield 11/5/2014 DCHStanford Kemonta Home Help Detroit 10/3/2017 MDHHSStang Robert Martin Physician Monroe 5101012881 10/19/2006 HHS 1128(a)(2)Stanley Darius Home Help Southfield 5/20/2019 MDHHSStarks DeAndre Home Help Detroit 6/11/2021 MDHHSStarks Jodie Home Help Detroit 5/6/2015 DCHStarks Ladonna Home Help Highland Park 12/15/2016 MDHHSStarks Sandra Home Help Kalamazoo 5/19/2015 DCHStarr Veronica Home Help Warren 2/11/2014 DCH-OIG 7/1/2015 MDHHS-OIG TerminatedStatler Erin Home Help St. Joseph 9/14/2016 MDHHSSteele Coszetta Home Help Jackson 4/27/2015 DCHStephens Dontrail Dwayne Home Help Benton Harbor 11/2/2015 MDHHSSterling Precious Ebony Home Help Benton Harbor 6/10/2015 DCHSterner Patricia Home Help Auburn 1/25/2021 MDHHSStetz Michael N. Chiropractor Lansing 2301006648 4/20/2003 HHS 1128(a)(3)Stevenson Michael Home Help Eastpointe 4/12/2021 MDHHSStevenson William Home Help Detroit 9/16/2019 MDHHSSteward Eric Home Help Detroit 1/21/2020 MDHHSSteward Travis Home Help Detroit 11/24/2014 DCHStewart Frederick Home Help Saginaw 9/29/2015 MDHHSStewart LaToya Home Help Warren 2/10/2020 MDHHSStewart Perry Home Help Detroit 11/20/2018 MDHHSStewart Ronald Home Help Detroit 1/30/2015 DCHStewart Tequila Home Help Grand Rapids 8/5/2015 DCHStewart Yvette Home Help Pontiac 4/27/2021 MDHHSStimmer Leonard Home Help Gaylord 5/18/2017 MDHHSStokes Juston Home Help Shelby Township 7/15/2022 MDHHSStone Dontae Home Help Detroit 7/16/2018 MDHHSStoneburgh Michael Home Help Port Huron 1/17/2019 MDHHSStoutermire Josua Home Help Chesterfield 8/10/2022 MDHHS

Strampel William Physician 1114954286 Dewitt 5101014110 8/22/2019

MI-Licensing and Regulatory Affairs 12/5/2019

MI-Licensing and Regulatory Affairs

Summary Suspension Voluntarily Surrendered

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Strausbaugh C Jay Physician Assistant 1780777953 Southgate 5601004882 12/3/2013 DCH-OIG 1/2/2014 DCH-OIG

12/03/2013 Summarily Suspended01/02/2014 Terminated

Strivklnd Anthony L Home Help Portage 7/21/2022 MDHHSStrickland Ronald Home Help Atlanta, GA 5/16/2019 MDHHSStringfellow Terry Home Help Dearborn Heights 3/12/2018 MDHHSStrouse Kim Home Help Grand Rapids 2/8/2017 HHS-OIGStrugach Vitality Home Help West Bloomfield 9/21/2016 MDHHS

Stuenkel Terri M Physician 1568511426 Deckerville 5101012732 10/24/2015

MI-Licensing and Regulatory Affairs

Summary Suspension

Sturm Brandon Chiropractor 1295815223 Brighton 2301007506 1/21/2011

MI-Licensing and Regulatory Affairs

Suspended, failure to meet cont. ed. Requirement

Complete Family Health Care Subnani Madhu Group 1861662967 Imlay City 1/12/2021 MDHHS-OIG 1/12/2021Summary Suspension

Subnani Madhu Physicain 1609920354 Rochester Hills 4301055014 1/12/2021 MDHHS-OIGSummary Suspension

Sullivan Frank Home Help Midland 12/12/2019 MDHHSSullivan Themelian Home Help Detroit 11/30/2017 MDHHSSullivan Timothy Home Help Detroit 10/9/2018 MDHHSSummerfiled Claudia Home Help Warren 8/24/2015 MDHHSSummers Darrell Home Help Bridgman 7/8/2020 MDHHS-OIG TerminatedSummers Tobias Home Help Detroit 4/15/2021 MDHHSSumner Brian Home Help Jackson 10/16/2019 MDHHS

Surapipith Pongchayut Physician 1003877481 Flint 4301044139 2/27/2009 DCHVoluntarily surrendered

Surya Nallani C Physician 1801838651 Birmingham 4301073842 3/6/2013 DCHSummary Suspended

Suttles Barbara Home Help Detroit 11/30/2015 MDHHSSutton Marion David Physician Sanford 4301033071 7/8/1993 HHS 1128(a)(2)Sutton Robin Home Help Detroit 1/13/2022 MDHHSSwan John Physician 1003269911 Saint Claire Shores 5101022858 8/3/2020 MDHHS-OIG Suspended

Swayngim Dowzell Physician 1427035757 Sandusky, OH 35041426 9/4/2021Ohio Licensing Revoked

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Syed Sami Physician 1023345782 Canton 4301092959 6/30/2022 MDHHS-OIGSummary Suspension

Sylvester Tyie Home Help Detroit 5/12/2020 MDHHS-OIGSummary Suspension

Szott Christophere M Home Help Saginaw 6/17/2022 MDHHSTaliaferro Maurice Home Help Kalamazoo 5/19/2016 MDHHSTallo Sumoud Home Help Sterling Heights 6/19/2018 MDHHSTansil Ginger M Home Help Kent City 3/12/2015 DCHTapert Richard E. Physician Detroit 10/20/1999 HHS 1128(b)(4)Tashjian James S. Physician Birmingham 4301028804 4/30/1992 HHS 1128(b)(1)Tate Corey Home Help Lincoln Park 1/9/2015 DCHTate Kyona Social Worker 1770030991 Detroit 6851100178 7/27/2022 MDHHS SuspendedTatum Michael Lawrence Home Help Detroit 11/30/2015 MDHHSTaylor Anastacia J. Home Help Battle Creek 12/20/2020 MDHHSTaylor Angelique Home Help Westland 7/31/2019 MDHHSTaylor Arkisha Home Help Detroit 8/8/2018 MDHHSTaylor Clark E. Physician Cheboygan 5101005560 12/18/1997 HHS 1128(b)(4)Taylor Dario Home Help East Lansing 6/15/2017 MDHHS

Taylor Delitha Dentist 1275695991 Dearborn 2901016772 7/6/2022

MI-Licensing and Regulatory Affairs Suspended

Taylor Jackie Home Help Muskegon 12/20/2016 MDHHSTaylor Jimmie Home Help Detroit 1/11/2018 MDHHSTaylor Kreighton Home Help Detroit 2/4/2021 MDHHSTaylor Rashad Home Help Detroit 2/27/2017 MDHHSTaylor Robert Home Help Detroit 2/5/2018 MDHHSTaylor Roosevelt Physician Flint 5101004568 6/28/1992 HHS 1128(b)(3)Teague Dennette Elaine Home Help Port Huron 12/1/2014 DCHTemple Frederick Home Help Saginaw 6/17/2015 DCHTerrell Gregory Home Help Eastpointe 1/12/2017 MDHHSTerrell Joann Home Help Detroit 4/25/2019 HHS-OIGTerrell Jose Home Help Southfield 4/9/2018 MDHHS

Terrell Kyekyenika Home Help Ypsilanti 5/27/2020 MDHHS-OIGSummary Suspension

Terrell Timothy Home Help Highland Park 3/20/2019 MDHHSTerry Antonio Home Help Detroit 1/15/2015 DCHTerry Maurice Home Help Detroit 4/11/2016 MDHHSThepveera Kraingsak Physician 1922167246 Saginaw 4301032947 12/6/2016 MDHHS-OIGTherrien Jeremy Home Help Escanaba 5/19/2016 MDHHSThomas Charmaine Home Help Ann Arbor 5/16/2019 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Thomas Darrell Home help Detroit 2/11/2022 MDHHSThomas Devin Home Help Detroit 1/23/2020 MDHHS TerminatedThomas Donald Home Help Sterling Heights 4/16/2018 MDHHSThomas Ernest Home Help Detroit 1/23/2020 MDHHSThomas Fred Home Help Flint 8/26/2021 MDHHSThomas Keyanna M Home Help Saginaw 11/20/2014 DCHThomas Larry Home Help Detroit 4/15/2020 MDHHSThomas Maurice Home Help Detroit 2/19/2019 MDHHSThomas Monica Home Help Westland 5/23/2019 MDHHSThomas Omar Home Help Detroit 8/19/2022 MDHHSThomas Tami Home Help Caseville 10/9/2018 MDHHSThomas Terry Home Help Detroit 6/15/2016 MDHHS

Thomas Timothy M Chiropractor 1205909660 Southgate 2301005050 8/25/2016

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Thomas Tony Lamar Home Help Detroit 5/22/2015 DCHThomas Tonyetta Home Help Niles 11/30/2015 MDHHSThomas Tawana Home Help Muskegon 1/7/2016 MDHHSThomas-Flowers Jamie Home Help Muskegon Heights 10/2/2018 MDHHSThompkins Kenneth Home Help Detroit 3/16/2018 MDHHSThompson Andre K Home Help Flint 11/30/2015 MDHHSThompson Andrea Home Help Kalamazoo 10/26/2020 MDHHSThompson Audry Gale Home Help Detroit 4/1/2015 DCHThompson Harrel Home Help Mt Clemens 10/17/2016 MDHHSThompson Jamie Home Help Midland 6/23/2021 MDHHSThompson Lee Home Help Grand Rapids 12/5/2019 MDHHSThompson Lynzie Home Help Niles 6/5/2018 MDHHSThompson Robert Eugene Physician 1447399720 Alpena 4301071670 12/20/2009 HHS 1128(b)(4)Thornton Mario Home Help Sterling Heights 4/10/2018 MDHHSThrelkeld Kenyatta Home Help Grand Blanc 2/10/2020 MDHHSThurman Deborah Home Help Detroit 12/1/2014 DCHThurman Leroy Home Help Lansing 5/1/2017 DHHS

TIGAY Judith H Nurse Practitioner 1598046526 Bloomfield Hills 4704239481 2/5/2022

MI-Licensing and Regulatory Affairs Suspended

Tika Lovin Home Help Macomb Township 7/20/2015 DCHTillery Terrence Home Help Detroit 11/16/2015 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Tipton Patricia Home Help Flint 6/8/2015 DCH-OIG

Suspended and Terminated

Tisdell Craig Home Help Bentoin Harbor 9/9/2015 MDHHSTobias Angela Home Help Port Huron 5/11/2017 MDHHSTocco Peter Physician Pontiac 5101006837 3/8/1994 HHS 1128AaTolbert Jesse Home Help Iron Mountain 3/8/2018 MDHHSTolbert KaShanka HomeHelp Pontiac 8/30/2021 MDHHSToles marchetta Home Help Jackson 1/17/2018 MDHHSTolton Shirley Home Help Detroit 9/15/2016 MDHHSTombo Jose M. Physician Detroit 4301033662 1/10/1991 HHS 1128(b)(4)Toronjo Betty Home Help Midland 5/4/2017 MDHHSTornes Eddrick Home Help Ypsilanti 6/4/2021 MDHHS

Torre Eduardo E Social Work 1073862454 Carrollton 6801093308 8/20/2019

MI-Licensing and Regulatory Affairs 7/28/2020

MI-Bureau of Licensing and Regulatory Affairs

Summary Suspension Suspended

Tossa Edward Home Help Warren 11/7/2016 MDHHSTouchstone Jontae Home Help Detroit 1/16/2020 MDHHS TerminatedTown Gary Home Help Otsego 3/28/2016 MDHHS

Townsend Robert L Physician 1376537316 Gaylord 5101016296 12/18/2015

MI-Licensing and Regulatory Affairs

Summary Suspension

Toya Sophie Physician 1225367147 West Bloomfield 4301111559 1/11/2021 MDHHS-OIGSummary Suspension

Trainor Charles Home Help Lansing 1/13/2020 MDHHS-OIGTrammell Howard Home Help Detroit 7/23/2019 MDHHS

Comprehensive Foot & Ankle Health, PC Tran Anmy Group 1942450127 Macomb 8/15/2013 DCH

TerminatedSummary Suspension

Tran-Lee Foot & Ankle Specialty Center, PC Tran Anmy Group 1720201015 Clinton Township 8/15/2013 DCH

TerminatedSummary Suspension

Tran Anmy Podiatrist 1184654188 Clinton Township 5901001910 9/26/2011 DCH 8/7/2013 DCH

09/26/2011 Terminated08/07/2013 Summary Suspension

Transor Johnnathan Home Help Dertroit 10/7/2019 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Trepanier Carol Dentist 1932265899 Detroit 2901016776 5/21/2010

MI-Licensing and Regulatory Affairs Suspended

Trevino Esther Home Help Pontiac 4/18/2017 MDHHSTrice Yolanzo Home Help Kalamazoo 8/14/2018 MDHHS

Tringali Anita L Nurse Practitioner 1851585228 Eastpointe 4704114479 8/16/2020

MI-Licensing and Regulatory Affairs Suspended

Tripp Jessica S. Socail Worker 1477194595 Ferndale 6801086858 2/11/2021

MI-Licensing and Regulatory Affairs

Summary Suspension

Trosclair Wanda Home Help Sault Sainte Marie 12/20/2017 MDHHSTrotter Alice Home Help Lansing 10/28/2015 MDHHSTrotter Anthony Home Help Grand Rapids 9/15/2016 MDHHSTrowell Lawrence Home Help Detroit 5/4/2016 MDHHSTruman Glasper Home Help Jackson 2/10/2020 MDHHS

Trumble Kristine Home Help Alpena 4/6/2020 MDHHS-OIGSummary Suspension

Truschke Daniel Home Help White Cloud 10/28/2020 MDHHS

Tschirhart James Michael Physician 1174559991 Saginaw 4301048766 5/16/2009

MI-Licensing and Regulatory Affairs Suspended

Tubbs Craig Physician 1609892116 Alma 4301407461 6/11/2011

MI-Licensing and Regulatory Affairs

Summary Suspension

Tucker Anthony Home Help Wayne 8/29/2019Tucker Darryl Home Help Detroit 12/5/2018 MDHHSTucker Detuaine Deshawn Home Help Jackson 11/6/2014 DCHTucker Juanita Home Help Detroit 9/17/2019 MDHHSTunis Jonathan D. Physician Carson City 4301065350 3/20/2000 HHS 1128(b)(4)Tupper Jamal Home Help Detroit 9/9/2019 MDHHSTurner Eligha Home Help Detroit 8/16/2021 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Turner Angela Home Help Muskegon 1/6/2016 MDHHS

Turner Geoffrey K Physician 1912004102 Benzonia 4301051763 10/6/2021

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Turner Tamon Terrance Home Help Benton harbor 11/24/2014 DCHTurner-Comer Latiosha Home Help Detroit 1/30/2020 MDHHS Terminated

Tyler April Physician 1598789422 Fenton 5101011859 10/9/2018 MDHHS-OIG 4/28/2022 MDHHS-OIG

Summary Suspension Teriminated

Tyler Mario Home Help Grand Rapids 6/11/2018 MDHHSTyner Shawntesse Home Help Detroit 10/22/2018 MDHHSUcer Erol Physician Flint 4301031131 6/4/1995 HHS 1128(b)(1)Uithol Winifred Home Help Gladwin 11/30/2015 DCHUmphrey Samantha Home Help Alger 1/14/2017 MDHHS

Urbanik Michael S. Dentist Detroit 2901013979 5/6/2003 DCH 5/20/2013 DCH-OIG

5/6/03: Violation of Medicaid False Claim Act5/20/03: 1128(a)(1)

Ureta III Sotero M Physician 1174545271 Cadillac 4301070002 1/13/2017 HHS Excluded

Utarnachitt Richard V Physician 1962539619 Clinton Township 4301033666 2/15/2015

MI-Licensing and Regulatory Affairs

05/21/20134/19/2015 01/26/2016

DCH-OIG HHS MDHHS-OIG

Summary Suspension Summary Suspension Excluded Terminated

Vader Cheryl A Nurse Practitioner 1437196284 Escanaba 4704143343 12/2/2021

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Vaid Mustak Y. Physician 1982619649 Livonia 4301085038 9/26/2011 DCH2/11/2016 01/20/2020

MDHHS-OIG HHS-OIG

Summary Suspension Terminated Excluded

Valdez Jose V. Physician Detroit 4301030159 9/2/1997 HHS 1128(b)(2)

Covenant Neurological Services Valentine Charise Medical Group 1669611059 Southfield 9/25/2018 MDHHS-OIGSummary Suspension

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Valentine Charise Physician 1366485039 Southfield 4301053752 7/19/2018

MI-Licensing and Regulatory Affairs

9/25/20183/20/2019

MDHHS-OIGMI-Licensing and Regulatory Affairs

Summary Suspension Summary SuspensionSuspended

Vallad Randall Home Help Hersey 6/28/2017 MDHHS

Van Der Weide Arie Physician 1679512966 Fremont 5101010310 1/19/2009

MI-Licensing and Regulatory Affairs

Summary Suspension

Van Gelder, MD Leonard Physician 1467447557 4301044632 9/4/2018 MDHHS-OIG

10/4/2018 10/29/20182/6/20193/20/2019

MDHHS-OIG MI- Licensing and Regulatory AffairsHHS-OIG

Summary Suspension Terminated Summary Suspension SuspendedExcluded

Vance Phillip Home Help 11/7/2019 MDHHSVance Robert Home Help Benton Harbor 2/22/2017 MDHHSVanhatten Amber Home Help Ypsilanti 1/31/2018 MDHHSVanHorn LaToya Home Help Kalamazoo 8/14/2018 MDHHSVanner Kenneth Home Help Inkster 1/10/2018 MDHHSVanspriell Amberlyn Home Help Lakeview 1/14/2022 MDHHSVanzant Armar Home Help saginaw 9/6/2022 MDHHSVargas Dominic Home Help Onaway 4/7/2015 DCH

Varney Michael W Psychologist 1861693848 Caspian 6301013523 7/3/2018

MI-Licensing and Regulatory Affairs 6/27/2019

MI-Licensing and Regulatory Affairs

Summary SuspensionVoluntarily Surrendered

Vartapev Alexander Home Help Hamtramck 4/7/2015 MDHHSVaughn David Home Help Saginaw 8/24/2021 MDHHSVaughn Paul Home Help Hastings 2/16/2017 MDHHSVeal JAmes Home Help Mout Clemons 3/19/2020 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Velez-Ruiz Wanda E. Physician 1023123858 Detroit 4301045752 11/10/1993

MI-Licensing and Regulatory Affairs

11/10/93: Violation of Medicaid False Claim Act8/10/94: 1128(a)(1)

Velez-Ruiz Wanda Enid Physician 1023123858 West Bloomfield 4301045752 1/17/2009 DCH 8/10/1994 Suspended

Verbovsky John R Physician 1528171774 Southfield 5101006690 3/10/2015 DCH-OIG

4/17/2015 12/14/2015 05/19/2016

MI-Licensing and Regualtory Affairs MDHHS- OIG HHS-OIG

Summary Suspension Summary Suspension Termination Excluded

Vernia Dawn Home Help Battle Creek 2/8/2016 MDHHSVillarta Antonio Q. Physician Adrian 4301033470 2/20/2001 HHS 1128(b)(4)Vineyard Robert Home Help Saginaw 6/29/2017 MDHHS

Vinson Nyiema Hoem Help Southfield 11/24/2021 MDHHS-OIGSummary Suspension

Vivano David Physician 1508816539 Birmingham 4301060296 2/20/2020 MDHHS-OIG 3/2/2020

MI-Licensing and Regulatory Affairs

Terminated Suspended

David Viviano MD Orthopaedic Surgery LLC Viviano David Group 1710219407 Troy 2/20/2020 MDHHS-OIG Terminated

Vlcko Peter B. Physician Oak Park 5101009612 6/4/1995 HHS 1128(a)(2)Vock Kellie Home Help Grayling 6/6/2018 MDHHSVogel Peter Home Help Dimondale 12/5/2017 MDHHS

Vora Kandarp K Physician 1023119898 Gladwin 4301037407 1/20/2016

MI-Licensing and Regulatory Affairs 11/30/2016 HHS-OIG

Excluded Voluntarily Surrendered

Vorhies Paul E CRNA 1740246578 Scottville 4704103969 11/8/2012

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Wade Doreen Home Help Eastpointe 9/26/2019 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Wadood Shazia Physician 1861439788 Streling Heights 4301079852 2/15/2022 MDHHS-OIGSummary Suspension

Wagner Gwendolyn Home Help Detroit 11/30/2015 MDHHS

Wagner Jack W Physician 1588694004 Midland 4301041291 6/26/2018 MDHHS

Disiciplinary Limited License

Wagner John R Physician 1396737086 Warren 4301061192 7/13/2012

MI-Licensing and Regulatory Affairs 3/27/2013

MI-Licensing and Regulatory Affairs

Summary Suspension Suspended

Wagoner Eddie Home Help Detroit 6/21/2018 MDHHSWaldron Teddi Irene Home Help Jackson 4/14/2015 DCHWalker Adrian Home Help Inkster 2/17/2016 MDHHSWalker Armond Home Help Farmington Hills 4/17/2018 MDHHSWalker Corey Home Help Detroit 12/17/2019 MDHHSWalker Cory Home Help Westland 3/8/2018 MDHHSWalker LaShawandra Home Help Muskegon 1/6/2016 MDHHSWalker Latonya Home Help Detroit 5/13/2015 DCH

Walker Mark Physician 1306819321 Marshall 4301056472 1/15/2020 MDHHS-OIG

MI- Licensing and Regulatory Affairs

Summary Suspenion Suspended

Walker Susan Home Help Warren 6/8/2020 MDHHS-OIGSummary Suspension

Walker Tangia Home Help Detroit 1/13/2016 MDHHSWalker Victoria Home Help Detroit 1/10/2022 MDHHS

Walker Wallace Dentist 1780712109 Okemos 2901012881 7/6/2016 MDHHS-OIGSummary Suspension

Wallace Debra Home Help Harper Woods 7/21/2022 MDHHSWallace Debra Home Help Detroit 4/10/2019 MDHHSWallace Diamond Home Help Lansing 6/8/2016 MDHHSWallace Julius Home Help Wayne 4/6/2020 MDHHS

Victor Smith Home Walls Annie Home Help Ypsilanti 1/24/2018 MDHHS-OIG 4/10/2020 MDHHS-OIGSuspended Terminated

Walls Quintina Home Help Detroit 6/10/2020 MDHHSWalmsley Michael Home Help Oscoda 5/21/2020 MDHHSWalters Angela Home Help Ropgers City 5/11/2021 MDHHSWalton Delois Home Help fraser 8/15/2019 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Dr. Waltz Denture Service Waltz Robert I. Dental Group Beaverton 2901006537 9/5/2002 DCH 9/19/2002 HHS

09/05/2002 Violation of Medicaid False Claim Act09/19/2002 1128(a)(1)

Ward Thomas Home Help Warren 5/8/2018 MDHHSWard-Robinson Jamal Home Help Detroit 4/11/2019 MDHHSWares Robert Home Help Dowagiac 10/3/2019 MDHHS TerminatedWarren Eric Home Help Detroit 2/14/2018 MDHHSWarren Linda F. Home Help Detroit 11/30/2015 MDHHSWarren Misty Home Help Detroit 6/26/2017 MDHHSWarrens Shareese Home Help Grand Rapids 11/19/2016 MDHHS 5/12/2021 MDHHSWashingotn Meosha Home Help South Haven 9/10/2019 MDHHS-OIGWashington Alonzo Home Help Lansing 11/14/2017 MDHHSWashington Anthony Home Help Ecorse 12/4/2014 DCHWashington Antwone Home Help Detroit 3/13/2017 MDHHSWashington Ervin Home Help Saginaw 11/24/2014 DCHWashington Herman L Home Help Hesperia 3/5/2015 DCH

Washington Jaime Home Help Kalamazoo 9/2/2020 MDHHS-OIGSummary Suspension

Washington Joyce Home Help Mount Morris 7/19/2021 MDHHSWashington-Williams Valarie Home Help Lexington, KY 8/20/2018 HHS-OIG

Wasnich Tricia Home Help Miidland 4/8/2020 MDHHS-OIGSummary Suspension

Watkins Kelli Home Help Detroit 10/24/2016 MDHHSWatkins Shannon Home Help Muskegon 8/27/2015 MDHHS

Watkins-Smith Ayanna Home Help Vassar 6/12/2019 MDHHS-OIGSummary Suspension

Watson Linda Home Help Port Huron 11/17/2016 MDHHSWatson Paula Home Help Midland 10/13/2017 MDHHSWatson Shon Home Help Muskegon 5/7/2020 MDHHSWatts Alonzo Home Help Detroit 1/25/2016 MDHHSWatts Eddie Home Help Detroit 11/5/2018 MDHHS

Watts Javen Home Help Detroit 3/7/2022 MDHHS-OIGSummary Suspension

Watts Samuel G. Physician Detroit 4301030543 3/18/1987 DCH

Violation of Medicaid False Claim Act

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Watts Tamica Home Help Detroit 9/25/2019 MDHHSWatts Tyric Home Help Lansing 11/12/2019 MDHHS

SMART Lab LLC

WayneWayneWayne

EthanH. HamiltonJustin Laboratory 1770980062

Palm Beach Gardens FL

10D2092502 (CLIA) 1/8/2019 MDHHS-OIG 2/7/2019 MDHHS-OIG

Summary Suspension Terminated

Weatherspoon Derick Home Help Flint 12/17/2014 DCH

Weaver David Physician 1720067606 Farmington Hills 5101008321 1/18/2021 MDHHS-OIG4/6/2022 04/04/2022

MDHHS-OIG MI - Licensing and Regulatory Affairs MDHHS-OIG

Summary Suspension Terminated Summary Suspension

Weaver Latonya Home Help Pontiac 8/23/2016 MDHHSWebber Barbra Home Help Grand Rapids 11/15/2018 MDHHS

Wehr Barbara Valutis Dentist 1700917762 Dexter 2901011361 2/5/2009

MI-Licensing and Regulatory Affairs Suspended

Weinblatt Howard B Physician 1760450191 Ann Arbor 4301037809 5/17/2012

MI-Licensing and Regulatory Affairs Suspended

Weiner Samuel Dentist 1326100611 Huntington Woods 2901007772 12/13/2009

MI-Licensing and Regulatory Affairs Suspended

Weisenfeld Michael S. Physician Marshall 4301029508 6/18/1998 HHS 1128(a)(1)

Weiss Michael D Physician 1376596726 Southfield 5101007574 8/29/2016 MDHHS-OIG

8/20/2017 10/16/2017 12/21/2018

HHS DCH MI-Licensing and Regulatory Affairs MDHHS-OIG

Summary Suspended Excluded Revoked Termianted

Welch Chante Home Help Saginaw 11/22/2016 MDHHSWelford Eduardo Home Help Comstock Park 3/16/2020 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Wells Eden Physician 1124394663 Ann Arbor 4301080277 3/8/2021 MDHHS-OIGSummary Suspension

Wells Michael Home Help Farwell 5/15/2019 MDHHSWells Tanesha Home Help Detroit 4/19/2018 MDHHS

Wenger William Social Worker 1710993886 Kalamazoo 6801019406 2/26/2019

MI-Licensing and Regulatory Affairs

Voluntarily Surrendered

Wesley Jake Home Help Detroit 5/8/2015 DCHWessels David Home Help Harbor Beach 11/30/2015 MDHHSWest Alex Podiatrist 1619165412 Dearborn Heights 5901001051 9/19/2003 HHS 1128(a)(3)West Keith A. Dentist 1598805798 Wyandotte 2901012345 10/20/2004 HHS 1128(a)(3)West Latasha Home Help Kalamazoo 8/23/2018 MDHHSWest-Ware Keela Home Help Battle Creek 6/30/2015 DCHWhaley Robert Home Help Benton Harbor 9/3/2019 MDHHSWheaton Rudolph D. Dentist Flint 2901011646 8/6/1997 HHS 1128(b)(4)Wheeler Shannon Home Help Pontiac 2/22/2016 MDHHS

C & M Compassionate Care PLLC Whitaker Christinia Group 1760881726 Coldwater 9/4/2018 MDHHS-OIG 10/4/2018 MDHHS-OIG

Summary Suspension Terminated

Whitaker Jelekeco Home Help Detroit 9/14/2016 MDHHSWhitby Milton Home Help Wyoming 10/18/2014 DCHWhite Bernard Torrell Home Help Detroit 11/30/2015 MDHHSWhite Brian Home Help Redford 12/13/2016 MDHHS

White Christine Home Help Detroit 5/12/2020 MDHHS-OIGSummary Suspended

White Dana Home Help Niles 6/11/2018 MDHHS

White Daniel D. Dentist Grand Rapids 2901011156 10/8/1999 DCH 10/20/2002 HHS

10/8/1999 Violation of Medicaid False Claim Act10/20/2002 1128(a)(1)

White John Arthur Dentist 1407066244 Detroit 2901012365 1/11/2008

MI-Licensing and Regulatory Affairs

License Suspended

White Karl Home Help Detroit 2/10/2022 MDHHSWhite Lamount Home Help Detroit 10/19/2016 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

White Mitchell Home Help River Rouge 3/14/2016 MDHHSWhite Renee Home Help Detroit 12/29/2015 MDHHSWhite Shamika Home Help Detroit 9/20/2018 MDHHSWhite Vandalyn Home Help Detroit 1/11/2021 MDHHSWhite Raymond Home Help Lansing 11/27/2017 MDHHSWhitehead Jesse L Home Help Grand Rapids 4/15/2022 MDHHS

Whitemore Ronald Home Help Commerce Township 9/22/2015 MDHHSWhiteside Magalena Home Help Muskegon 3/20/2017 MDHHS

Whiteus Timothy Physician 1174543342 Detroit 4301406556 7/30/2014 DCH-OIG

10/23/2015 12/14/2015 01/20/2016

MI-Licensing and Regulatory Afairs MDHHS-OIG HHS-OIG

Summary Suspension Summary Suspension Terminated Excluded

Whitfield Jacqueline Home Help Davison 5/15/2019 MDHHSWhitley Varnell Home Help Grand Rapids 1/12/2017 MDHHSWible Richard Home Help Muskegon 1/27/2021 MDHHS 3/2/2022 MDHHSWicker Yondina Home Help Saginaw 4/16/2018 MDHHS

East Michigan Family Care Wiggins Shannon Group 1508875840 Lansing 9/30/2013 DCH-OIG 4/15/2014 DCH-OiIG

Summary Suspension Terminated

East Michigan Family Care PLLC Wiggins Shannon Group 1124135116 Lansing 9/30/2013DCH HHS 4/15/2014 DCH-OIG

Summary Suspension Terminated

Wiggins Shannon Georgean Physician 1295744530 Lansing 5101013727 9/30/2013 DCH 4/15/2014 DCH-OIG

Summary Suspension Terminated

Wilcox Carl Home Help Madison Heights 5/3/2017 MDHHSWiley Heather L Home Help Battle Creek 11/16/2021 MDHHSWiley Kenneth Home Help Detroit 8/9/2018 MDHHS

Wiley Tia Home Help Detroit 11/19/2018 MDHHS-OIG 12/19/2018 MDHHS-OIG

Summary Suspension Terminated

Williams Belinda Home Help Detroit 9/15/2015 MDHHSWilliams Benshamiel Home Help Detroit 1/18/2017 MDHHSWilliams Craig Home Help detroit 10/4/2017 MDHHSWilliams Damron Michael Home Help Detroit 11/3/2014 DCHWilliams Dannel Home Help Detroit 7/11/2019 MDHHS

Williams DerekNon-Emergency Transportation Idlewild 4/6/2017 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Williams Derrell Home Help Clinton Township 9/20/2018 MDHHSWilliams Etroy Home Help Flint 6/1/2022 MDHHSWilliams James Home Help Saginaw 10/28/2016 MDHHSWilliams Javone Home Help Southfield 6/2/2021 MDHHSWilliams John T. Home Help Marion 11/12/2014 DCHWilliams Kapone Home Help Lansing 2/18/2016 MDHHSWilliams Kennion Home Help Benton Harbor 5/16/2022 MDHHSWilliams Laverne Home Help Detroit 6/28/2021 MDHSWilliams Laquan Home Help Norton Shores 2/14/2019 MDHHSWilliams Marcus Home Help Lansing 10/3/2019 MDHHSWilliams Melvin Home Help Detroit 2/5/2019 MDHHS

Williams Monita Home Help Detroit 7/23/2019 MDHHS-OIG 8/22/2019 MDHHS-OIG

Summary SuspensionTerminated

Williams Montele Home Help Saginaw 8/16/2021 MDHHSBlessed Dayz Adult Day Program Inc Williams Nicole Medical Group 1255602793 Westland 1/29/2020 MDHHS-OIG

Summary Suspension

Williams Ollie Home Help Grand rapids 9/10/2019 MDHHSWilliams Owina Home Help Detroit 11/30/2015 MDHHSWilliams Rasheedah Home Help Detroit 10/1/2019 MDHHSWilliams Raulow Home Help Pontiac 12/6/2018 MDHHSWilliams Sammie Home Help Detroit 1/14/2020 MDHHSWilliams Sean Home Help Saginaw 2/5/2020 MDHHSWilliams Sean Home Help Detroit 12/10/2020 MDHHSWilliams Terina Home Help Detroit 9/16/2015 MDHHSWilliams Tywone Home Help Detroit 11/21/2019 MDHHS TerminatedWilliams Veronica Home Help Bay CIty 6/11/2018 MDHHSWilliams Victor L Home Help Detroit 9/16/2021 MDHHSWilliams William Home Help Detroit 9/7/2017 MDHHSWilliams Willie Home Help Inkster 11/3/2017 MDHHSWilliams Felicia Home Help Ludington 3/16/2015 DCHWilliams Joey Home Help Flint 4/28/2016 MDHHS

Williamson Paula E Physician 1275588873 Warren 4301041206 7/3/2013DCH-OIG HHS- OIG 4/19/2015

Suspended Excluded

Willis-Pitts Fred Lee Home Help Detroit 2/27/2015 DCH

WIlson Alan N Physician 1629029004 Lincoln Park 4301031392 8/4/2016

MI-Licensing and Regulatory Affairs

Summary Suspension

Wilson Ashley Home Help Lansing 7/22/2022 MDHHSWilson Carlos Home Help Inkster 6/25/2018 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Wilson Clarence W. Physician Flint 5101004539 9/2/1997 HHS 1128(b)(3)Wilson Ieisha Home Help Grand Rapids 1/26/2021 MDHHSWilson Jonathan Home Help Detroit 11/30/2015 MDHHSWilson Kim Home Help Detroit 8/28/2018 MDHHSWilson Mardell Home Help Inkster 12/20/2016 MDHHSWilson Martez Home Help Detroit 11/30/2017 MDHHS

Wilson Sebastian T Chiropractor 1093773343 Coldwater 2301008079 4/29/2015 DCH-OIG

7/13/201612/21/169/26/2018

MI-Licensing and Regualtory Affairs MDHHS-OIG

Summary Suspension Summary Suspension Suspended Terminated

Orthopedic Medical Building Inc. Winchester Iris Medical Group 1154679587 Oak Park 9/25/2018 MDHHS-OIGSummary Suspension

Wingfield James Home Help Battle Creek 6/7/2021 MDHHS

Winkler Clarice ACertified Nurse Midwife 1457344426 Lansing 4704120674 9/13/2013

MI-Licensing and Regulatory Affairs Suspended

Winter Christopher Home Help Kalamazoo 6/6/2019 MDHHS

Med One Mobile LLC Wireman Gregory Medical Group 1982076550 Knox, Indiana 1/19/2021 MDHHS-OIGSummary Suspension

Witcher Harvell Home Help Detroit 3/20/2017 MDHHS

Witt Kevin Sterling Physician 1619996220 Lansing 5101012167 2/22/2012 DCH1/20/2013 08/07/2013

HHS DCH

Suspended TerminatedSuspended

Wittmus David Home Help Saginaw 4/7/2016 MDHHS

Wolf Anthony Physician 1033233838 Ann Arbor 4301085709 5/18/2018

MI-Licensing and Regulatory Affairs

10/12/2018 09/23/2020

MI-Licensing and Regulatory Affairs MI-Licensing and Regulatory Affairs

Summary Suspension Suspended Limited/ Restricted

Wolin Jessica A Physician 1881735173 Muskegon 4301030663 2/13/2020

MI-Licensing and Regulatory Affairs 7/15/2020

MI-Licensing and Regulatory Affairs Suspended

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Woodard Charles Home Help Lansing 11/5/2018 MDHHS

Woodburn Jack Counselor 1306009196 Port Huron 6401000326 2/21/2020

MI-Licensing and Regulatory Affairs 5/14/2020

MI-Bureau of Licensing and Regulatory Affairs

Summary Suspension Revoked

Woodring Travis Home Help Ludington 11/14/2019 MDHHSWoodruff Shawn Home Help Deckerville 8/14/2017 MDHHSWoods David Wayne Home Help Detroit 11/13/2014 DCH

Woods Glanda Home Help Dearborn Heights 1/11/2021 MDHHS-OIGSummary Suspension

Woods Kenneth Home Help Detroit 4/7/2021 MDHHSWoods Lasonia Home Help Detroit 9/17/2019 MDHHSWoods Markease Home Help Port Huron 8/16/2022 MDHHSWoollams Stanley J. Physician Ann Arbor 4301023228 5/6/1996 HHS 1128(b)(4)Wooten Marquet Home Help Grand Rapids 3/30/2017 MDHHSWorth Lori Home Help Evart 7/18/2019 MDHHS

Woudstra David J. Social Work 1124455100 Kalamazoo 6801093440 9/4/2021

MI-Licensing and Regulatory Affairs Suspended

Wright Darrin Home Help Detroit 11/17/2016 MDHHSWright Ebony Home Help Detroit 6/16/2020 MDHHS-OIG 6/16/2020Wright Jessica Home Help Wyoming 6/25/2018 MDHHSWright Johnny E Home Help Grand Rapids 11/30/2015 MDHHSWright Larry Home Help Detroit 12/26/2015 MDHHSWright Priscilla Home Help Detroit 12/4/2018 MDHHSWright Stacy Home Help Detroit 9/6/2016 MDHHS

Wright Susan Nurse Practitioner 1720063431 Paw Paw 4704098998 6/8/2020 MDHHS-OIG 1/19/2021 MDHHS-OIG

Summary Suspension Termination

Wyatt Kimberly Home Help Wilson 6/21/2016 MDHHS

Wysocki Edith LOccupational Therapist 1760982227 Plymouth 5201003501 4/7/2022

MI-Licensing and Regulatory Affairs

Summary Suspension

Believe Home Care LLC Xiong Vai Home Help lansing 10/16/2018 MDHHS-OIGSummary Suspension

Yancy Damian Home help Saginaw 8/17/2015 MDHHSYarbrough Tanzer Home Help Detroit 11/7/2018 MDHHS

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Yasin Fares Physician 1255427472 Dearborn 4301087049 7/11/2018 MDHHS-OIGSummary Suspension

Detroit Visiting Physicians PLLC Yasin Faris Medical Group 1801085022 Dearborn 7/11/2018 MDHHS-OIGSummary Suspension

Michigan Home Visiting Physicians PC Yasin Faris Group 1346419223 Dearborn 7/11/2018 MDHHS-OIG

Summary Suspension

Yasin Nura Physician 1265518567 Canton 4301092485 3/4/2020 MDHHS-OIGSummary Suspension

Yearling Anthony Home Help Vicksburg 10/17/2017 MDHHS Yeo Judith Home Help Grand Rapids 11/30/2017 MDHHSYouhan Randy Home Help West Bloomfield 5/12/2016 MDHHSYoung Arstell Home Help Warren 1/30/2015 DCH

Young David K Physician 1548230329 Lansing 5101009173 11/6/2021

MI-Licensing and Regulatory Affairs

Disciplinary Limited License

Young GeorgeConrad-Spencer Chiropractor 1902953326 Munising 2301008758 3/1/2014 DCH-OIG 12/18/2014 HHS

Summary Suspension Excluded

Young Ida Home Help Standish 6/21/2016 MDHHS

Young Lawrence Podiatrist 1881664498 Dearborn 5901000652 12/3/2017 MDHHS-OIG

12/26/201812/12/20185/20/20196/20/2019

MDHHS-OIGMI-Licensing and Regulatory AffairsHHS-OIG

Summary Suspension Terminated Summary SuspensionRevokedTerminated

Young Michael Home Help Detroit 11/18/2014 DCHYoung Randy Home Help Vandalia 6/21/2018 MDHHSYousif Aysin Home Help Sterling Heights 3/14/2022 MDHHS

Yousif Layla R Dentist 1831309228 Shelby Township 2901017121 2/19/2015

MI-Licensing and Regulatory Affairs Suspended

Yufa Irina Home Help West Bloomfield 1/11/2021 MDHHS-OIGSummary Suspension

Entity Name Last Name First NameMiddle Name Provider Category NPI# City License#

Sanction Date1

Sanction Source

Sanction Date2

Sanction Source Reason

Medicaid Michigan Sanction Provider ListSeptember 13, 2022

[email protected]

Seaway Pharmacy Zaher Hani Pharmacy 1457525818 Taylor 5301008838 5/10/2018

MI-Licensing and Regulatory Affairs 6/13/2018 MDHHS-OIG

Controlled Substance license suspended Summary Suspension

Zahoor Mohammad Physician 1922096452 Novi 4301062300 10/15/2017 MDHHS-OIG 4/21/2022 MDHHS-OIG

Summary Suspension Terminated

Zahraie Kirsta Home Help Ortonville 9/1/2022 MDHHSZaragoza Carlos Home Help Saginaw 11/30/2015 MDHHSZaya Raied Home Help Sterling Heights 7/11/2022 MDHHSZeliasko Steven David Home Help Indian River 11/13/2014 DCH

Zerby Kristin Pharmacist 1497249569 Mackinac 5315110839 2/19/2020

MI-Licensing and Regulatory Affairs Suspended

Zieger Harvey Physician 1528050267 Detroit 5101006597 3/24/2015

MI-Licensing and Regulatory Affairs Suspended

Zimmerman Katherine Home Help Mt. Pleasant 9/23/2015 MDHHS