+ All Categories
Home > Documents > Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction...

Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction...

Date post: 12-Feb-2020
Category:
Upload: others
View: 0 times
Download: 0 times
Share this document with a friend
70
Sanctioned Providers and Entities Excluded From Participation In Maryland Medicaid Program LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE ADDRESS CITY/STATE /ZIP LICENSE # A&E Home Care I, II Corporation HD 5/26/2005 1234 Cathedral Drive Glen Burnie Aalai Mehrdad M.D. F 8/15/1994 10524 Democracy Blvd Potomac MD D 26712 Abbas Muhmoud F M.D. F 6/10/1992 5411 Old Frederick Road Baltimore MD 21229 D 12722 Abundant Life Center, Inc. Corporation HHS 7/5/1989 30 South Broadway Baltimore MD 21231 Acree Virginia V. Nurse HHS 12/20/2009 FPC Alderson, Glen Ray Road, Box A Alderson, WV 24910 R088060 Adams Charlotte PCP HD 10/24/1994 5313 Barbara Avenue Baltimore MD 21206 Adams Hakki B. M.D. F 8/24/1983 6172 Oxon Hill Road Oxon Hill MD 20715 D 00472 Addison Denise PCP HD 9/9/1998 P.O. Box 6014 Baltimore MD 21231 Adedapo Abosede Aide HHS 2/11/1999 1471 Hadwick Drive Baltimore MD 21221 Adefolaju Adebowale Nurse HHS 7/20/2009 6405 Seta Drive Lanham MD LP41140 Adelanwa Gabriel W. LCPC F 2/18/2007 7100 Chesapeake Road Landover Hills MD LC 1235 Aderibigbe Victoria O. Citizen HHS 5/22/1998 11380 Cherry Hill Road; #20 Beltsville MD 20705 Adewale Soloman P.D. HHS 6/19/2008 4046 Warner Avenue, Apt. D1 Landover Hills, MD 01198 Adeyemi Nancy Citizen HHS 8/20/2008 7758 Finns Lane, Apt. 2 New Carrollton Monday, October 18, 2010 Page 1 of 70 Sanction Type: MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction HHS = Department of Health and Human Services - Medicare Exclusion LB - Licensing Board F = Individual or Entity Convicted of Medicaid Fraud HD = Health Departments
Transcript
Page 1: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

Sanctioned Providers and Entities Excluded FromParticipation In Maryland Medicaid Program

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

A&E Home Care I, II Corporation HD 5/26/2005 1234 Cathedral Drive Glen Burnie

Aalai Mehrdad M.D. F 8/15/1994 10524 Democracy Blvd Potomac MD

D 26712

Abbas Muhmoud F M.D. F 6/10/1992 5411 Old Frederick Road Baltimore MD 21229

D 12722

Abundant Life Center, Inc. Corporation HHS 7/5/1989 30 South Broadway Baltimore MD 21231

Acree Virginia V. Nurse HHS 12/20/2009 FPC Alderson, Glen Ray Road, Box A

Alderson, WV 24910

R088060

Adams Charlotte PCP HD 10/24/1994 5313 Barbara Avenue Baltimore MD 21206

Adams Hakki B. M.D. F 8/24/1983 6172 Oxon Hill Road Oxon Hill MD 20715

D 00472

Addison Denise PCP HD 9/9/1998 P.O. Box 6014 Baltimore MD 21231

Adedapo Abosede Aide HHS 2/11/1999 1471 Hadwick Drive Baltimore MD 21221

Adefolaju Adebowale Nurse HHS 7/20/2009 6405 Seta Drive Lanham MD

LP41140

Adelanwa Gabriel W. LCPC F 2/18/2007 7100 Chesapeake Road Landover Hills MD

LC 1235

Aderibigbe Victoria O. Citizen HHS 5/22/1998 11380 Cherry Hill Road; #20 Beltsville MD 20705

Adewale Soloman P.D. HHS 6/19/2008 4046 Warner Avenue, Apt. D1

Landover Hills, MD

01198

Adeyemi Nancy Citizen HHS 8/20/2008 7758 Finns Lane, Apt. 2 New Carrollton

Monday, October 18, 2010 Page 1 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Office
Underline
Page 2: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Adeyemi Mukaila Citizen F 2/28/1997 25 Strawhat Road; 1-C Owings Mills MD

Adger Rossanna PCP HD 9/9/1998 2140 Boyd Street Baltimore MD 21223

Adler Jane M. M.D. HHS 9/20/2001 9812 Falls Road; Ste 114 Potomac MD 20854

Advanced Clinical Associates

Inc. Corporation F 10/2/1997 201 North Charles Street Baltimore MD 21201

Aggroia Abhay V. M.D. HHS 7/20/2006 13168 Kinnicut Drive Woodbridge MD

0101-055856VA; D-53013(MD)

Aiken Stuart DPM HHS 5/5/2006 16 Dartmoor Court Olney MD 20832

5440

Aikens-Afful Nathaniel M.D. F 4/18/1983 3706 Collier Road Randallstown MD

D 13607

Ajumobi Chukwudi Citizen HHS 8/19/2010 5404 85th Avenue, Apt. T3 New Carrollton

Akande Dwanus Nurse HHS 1/20/2008 10849 N. Central Expressway

Dallas, TX 75231-

LP31007

Akhigbe Ehigiator M.D. HHS 10/20/2010 FCI Morgantown P.O. Box 1000

Morgantown WV

D 45218

Aksoy Yasar M.D. LB 7/17/2001 1423 Cedarcroft Road Baltimore MD 21239

D 19223

Akthar Waheed U. M.D. LB 9/9/2004 301 S. Theodore Green Blvd White Plains MD

D 31675

Alalouf Ophir D.D.S. LB 5/2/2008 9812 Falls Road, Suite 118 Potomac MD 20854

12149

Al-Attar Ali M.D. LB 4/22/2009 4900 Silver Hill Road Suitland MD 20746

D50098

Albers Nancy Citizen HHS 1/20/2008 750 Farnham Place Bel Air MD 21014

Albrecht Frank M. Counselor HHS 8/20/2003 P.O.Box 877; 725 Elwood Ave

Easton MD 21601

001160

Monday, October 18, 2010 Page 2 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 3: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Al-Khatib Susan Nurse HHS 2/20/2008 13014 Winchester Road, SW

Cumberland, MD

R103787

Ally Azad M. D.D.S. F 7/21/2004 1643 Agnes Avenue, S.E. Palm Bay FL 32909

11430

Almeida Carlos M.D. LB 5/23/2005 7900 Old Branch Avenue Clinton MD 20735

D 08275

Alperstein Arnold R.Ph HHS 1/20/2004 3202 Walnut Avenue Owings Mills MD

07356

American Diagnostic Laboratories

Corporation HHS 10/28/2008 15749 Crabbs Branch Way Rockville MD 20855

01079

Amirgholi Mohammed H. M.D. LB 3/23/1988 9401 Indian Head Hwy Ft. Washingto

D 00133

Anderson Morris PCP HD 7/21/1995 11 W. Baltimore; #1012 Hagerstown MD

Anderson Richard H. M.D. LB 5/26/2001 13 Cedar Waxwing Road Hilton Head

D 00634

Anderson Susan Nurse HHS 12/19/2002 11554 Buckskin Court Lusby MD

Andreadis Barbara L. LCSW F 5/20/2003 47 E. Main street Hancock MD 21750

08278

Andrews Lorenzo Nurse HHS 7/20/2004 8341 Canning Terrace Greenbelt MD 20770

561064

Angel Square Corporation HD 6/28/2005 2306 Breton Drive District Heights

Ann's Loving Care Corporation HD 9/5/2007 1536 Northgate Road Baltimore MD 21218

30AL128

Appel Lawrence W. R.Ph HHS 12/20/2004 4 Coachman Ct; Apt. 202 Randallstown MD

08351

Arbogast Rebecca PCP F 1/6/2007 36856 Danny Lane Chaptico MD 20621

ARG Associates, Inc. Corporation HHS 5/20/2002 8314 Glenmar Road Ellicott City MD 21045

Monday, October 18, 2010 Page 3 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 4: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Arrey Pamela P.D. HD 8/15/2008 13850 Kennard Drive Glenelg MD 21737

11345

Arrington James PCP HD 4/17/1996 4138 Woodhaven Avenue; Apt. 1 FL

Baltimore MD 21216

Arroyo Ruy Dan M.D. HHS 9/20/1996 1215 Evesham Ave Baltimore MD 21239

D 27436

Arroyo Jose C. M.D. HHS 6/18/1998 6400 Baltimore Nat'l Pike #512

Baltimore MD

D 02422

Asemani Ghafour B. D.D.S HHS 7/18/2002 8667 Town & Country Blvd; F

Ellicott City MD 21043

Ashburn Timothy M. M.D. HHS 12/20/2004 9890 Washington Blvd; #803

Gaithersburg MD

Ashimi Karen Aide MFCU-A 5/24/2007 2424 Bridgehampton Drive, #J

Parkville MD 21234

Askins Annie Delois PCP HD 5/4/2006 3301 Ripple Road Baltimore MD 21244

Askins Private Care Home Corporation HD 5/4/2006 3301 Ripple Road Baltimore MD 21244

Atlantic Health Care, Inc. Corporation HHS 10/7/2007 7640 Fullerton Road Springfield VA 22153

Aurora Hlth Care Services, Inc.

Coppedge, Debra A. Corporation HD 5/4/2005 14004 Silver Teal Way Upper Marlboro

Austin Dan E. M.D. LB 4/4/1999 12164 Central Ave Mitchelleville MD

D 46605

Automated Billing Service Corporation HHS 6/12/1997 4701 Randolph Road Rockville MD

Averi Robert M. D.P.M. LB 5/9/1991 P.O. Box 230544 Montgomery AL

Averi Robert P.D. LB 7/21/1993 P.O. Box 667 Johnstown PA 15907

Awele Treatment and Rehab.Clinic

Corporation HD 2/27/2007 2300 North Calvert Street Baltimore MD 21218

Monday, October 18, 2010 Page 4 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 5: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Ayers George J. PT HHS 2/20/2006 75 Beatrice Street Cumberland MD

14444-MD; PT 10641-FL; PT 1606-

Aziz Ahmed D.D.S. LB 11/26/2003 6117 Marlboro Pike District Heights

09548

Azzato Nicholas M. M.D. HHS 10/4/1989 333 University Blvd; West Kensington MD 20895

Babaturk Hidir M.D. HHS 9/30/1988 6578 Gulford Avenue Clarksville MD 21029

Backmon Marquil D. Citizen HHS 2/15/1997 830 N. Kenwood Avenue Baltimore MD 21205

Bagby Victoria Citizen HHS 10/20/2008 435 N. Curley Street Baltimore MD 21224

Bagheri Farhad D.D.S. LB 8/15/2005 13529 Clopper Road Germantown MD

11037

Bagwell Polla Darlene Aide HHS 2/1/1999 3127 Artaban Place Baltimore MD 21216

Bah Haja Aide HHS 6/20/2005 3207 Toleda Place; Apt. 203 Hyattsville MD 20782

Baker Cynthia Nurse HHS 6/19/2008 5753 Hazelwood Circle, Apt. F

Baltimore MD 21206

LP 19154

Baker Betty PCP HD 9/9/1998 524 W. Preston Street Baltimore MD 21202

Baltazar Rodney D.O. HHS 2/6/2009 319 Maloney Road Elkton MD 21921

H52021

Banks Evelyn Citizen F 10/28/1987 2140 Pine Avenue Baltimore MD 21207

Baptiste Donna D.D.S. HHS 5/20/1998 4205 Liberty Heights Ave Baltimore MD 21207

09943

Barahona Leonel M.D. LB 11/19/2009 1101 Maiden Choice Lane Baltimore MD 21229

D 21928

Barb's Mason Dixon Home

Corporation HD 7/31/2006 29233-A West Line Road Delmar MD 21875

Monday, October 18, 2010 Page 5 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 6: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Barnes Georgia PCP HD 4/14/2003 12 Garrisonridge Court Owings Mills MD

Barnette Dawn PCP HD 4/1/1994 SR6; Box 277-13 LaPlata MD 20646

Barr Alvin Scott Nurse HHS 4/20/2004 8336 Evergreen Drive Lusby MD 20657

R 140640

Bass Mitzi Lucille Nurse HHS 7/18/2002 804 W. Nash Street Terrell TX 75160-

TX 6564777

Bassett David W. M.D. LB 3/29/2006 CPC Health, Inc; 500 W. Montgomery Avenue

Rockville MD 20850

D 32444

Bates Robert E. Optician HHS 7/7/1997 11511 Lockhardt Place Silver Spring

Battaile William G. M.D. LB 9/29/1996 Box 273 Gibson Island MD

D 14392

Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn MD 21221

LP 07072

Baxter Steven Aide HHS 8/19/2010 1928 Rochell Avenue, Apt. 1213

Forestville MD 20747

Beachley Carroll L. Aide HHS 5/13/1998 10420 Bailey Road Hagerstown MD

Beaverbrook Corner Corporation HD 2/1/2006 4994 Beaverbrook Road Columbia MD 21044

Beck Charlene PCP HD 9/9/1998 Route 1; Box 237 Rock Hall MD 21661

Beck Zina Yvonne PCP HD 6/19/1998 3925 Clark Lane, Apt. D Baltimore MD 21215

Beck Jeffrey R. D.O. LB 7/13/2006 22 S. Greene Street Baltimore MD 21201

H 55156

Bell Guy Citizen F 2/27/2008 2712 Tallow Tree Drive Woodstock, MD 21163

Bell Vadney Aide HHS 8/20/2000 16 Brubar Court; Apt. 2-C Gwynn Oak MD

Monday, October 18, 2010 Page 6 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 7: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Benchasil Sakda M.D. LB 10/30/1998 9 Slate Mills Ct Baltimore MD 21228

D 16940

Benchoff Richard R.Ph HHS 9/20/2009 139 E. Baltimore Street Hagerstown MD

10514

Benn Stanley Junious Citizen F 7/14/2005 16 Arrowood Court Baltimore MD 21237

Benson, Jr. Fred D.D.S. HHS 6/6/1993 8055 13th Street Silver Spring

Bernhard Larry DPM HHS 10/30/2007 446 Colonial Ridge Land Arnold MD 21012

00591

Best Morris D.D.S. F 9/15/1986 11409 Soward Drive Kensington MD 20795

Beverly Clarence E. M.D. HHS 6/27/1991 PO Box 786 Middletown NY 10940

D 27732

Biscoe Charles M.D. LB 1/26/2007 2200 Garrison Blvd, Ste. 303 Baltimore MD 21216

D 42230

Blackmon Robert C. M.D. LB 7/26/1996 3230 Sequoia Ave Baltimore MD 21215

D 00860

Blancaflor Othneil Citizen HHS 5/22/1985 36 S. Charles Street Baltimore MD 21201

Blizzard Judy PCP HD 9/30/1993 1326 Deer Park Road Westminster MD

Blue Star Assisted Living Corporation HD 8/31/2006 5415 Lincoln Street Bethesda MD 20817

Bockover Carol Nurse HHS 8/20/2002 29180 Naylor Mill Road Salisbury MD 21811

Body Energetics, Inc. Corporation HHS 9/20/2001 9051 Baltimore Nat'l Pike; Ste 3-E

Ellicott City MD 21042

Boesen Peter V. M.D. HHS 3/20/2008 07705-030, USP, P.O. Box 1000

Leavenworth KS 66048

D41757

Boggess Deland Michelle Toney Nurse HHS 9/20/2005 1789 Roxalana Road Dunbar WV 25064

R 156872-MD;40698-WV; 0001181933-VA

Monday, October 18, 2010 Page 7 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 8: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Bohannon Wayne E. Ph.D. LB 9/30/2002 Behavioral Science Assoc; 10751 Falls Road

Lutherville MD 21093

01601

Bolshinsky Igor PCP HHS 5/19/2005 10948 Whiterim Drive Potomac MD 20854

Bordley Thomas Citizen HHS 12/20/1995 1531 Gleneagle Road Baltimore MD 21239

Bowens Michelle PCP HD 7/30/2002 600 N. Bentz St.; Apt. 8 Frederick MD 21701

Bowie, Jr. Charles Douglas D.D.S. F 3/20/2003 4205 Liberty Heights Avenue

Baltimore MD 21207

04969

Boyce Jesse Marvin DPM HHS 1/16/2002 1714 Peachtree Lane Bowie MD 20721

01000

Boyd Seward D.O. LB 2/11/1991 556 Ingraham St Washington DC

H 36148

Boykins Loretta Penny Citizen HHS 12/20/2001 1212 Whitelock Street Baltimore MD 21217

Bradbard Steven L. Ph.D. HHS 7/14/1993 8804 Saddle Lane Potomac MD 20854

Bradford Brenda Aide HHS 1/20/2004 2706 Gresham Way; Apt. 303

Baltimore MD 21244

Bradley William R. M.D. LB 6/27/1997 7505 E. Brushfield Ct Baltimore MD 21237

D 33173

Branch Kelly Citizen HHS 3/25/1998 749 Linnard Street Baltimore MD 21229

Branch Freddie Citizen HHS 2/15/1997 35 Loring Court; D Baltimore MD 21219

Branch Bernadette PCP HD 3/20/1993 P. O. Box 33354 Baltimore MD 21218

Braud Joseph M.D. HHS 1/20/2010 P.O. Box 5010 Oakdale LA 71463

MD01895(LA)

Breakfield James E. Citizen HHS 11/19/2009 954 Forrest Street Baltimore MD 21202

Monday, October 18, 2010 Page 8 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 9: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Brenner Myron M.D. LB 10/22/2008 14025 Cuba Road Hunt Valley MD

D 21657

Bresslerman Mark J. D.D.S. LB 5/2/1990 6232 Montrose Road Rockville MD 20852

05180

Brice Charlene PCP HD 6/20/1995 8 Patamoke Way Cambridge MD 21613

Brigance Troy B. RCP HHS 11/20/2003 851 Park Avenue Baltimore MD 21201

L 03089

Britos-Bray Anibal M.D. F 7/29/1995 16 Aberdeen Shopping Pl Aberdeen MD 21001

D 16953

Brock Deon M. Citizen F 5/29/2008 1127 N. Gilmor Street Baltimore MD 21217

Bronder Rosemary Nurse HHS 5/18/2000 4421 Saddle River Drive Mitchellville MD

Brooks Wanda PCP HD 6/27/1990 6870 Sturbridge Drive; Apt. B

Baltimore MD 21234

Brooks Latosha N. Aide MFCU-A 2/2/2005 3809 Bonview Avenue Baltimore MD 21213

Brooks Myrtle Citizen HD 7/17/2005 1501 Bayly Road Cambridge MD 21613

Brooks Care Home Corporation HD 7/17/2005 1501 Bayly Road Cambridge MD 21613

Brown Luwahn PCP HD 3/31/1994 Rt. 2; Box 2259 La Plata MD 20646

Brown Louise PCP HD 9/9/1998 5414 Gist Avenue Baltimore MD 21215

Brown Shantay T. Aide HHS 7/13/2000 3520 Milford Mill Road Baltimore MD 21207

Brown Cynthia A. M.D. LB 2/23/1990 16816 5th Ave, SE Buthell WA 98012

D 26655

Brownstein Steven A. D.P.M. LB 3/11/1999 420 S. Crain Hgwy Glen Burnie

00374

Monday, October 18, 2010 Page 9 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 10: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Bryant Tonya PCP HD 9/6/1995 3505 Carsdale Avenue Baltimore MD 21207

Bryson Rick Van DPM HHS 3/20/2006 15608 Henrietta Drive Accokeek MD 20607

P-0486 (D.C.); 01186 (M.D.)

Buchanan Elizabeth PCP HD 1/9/1992 4114 Buckingham Road Baltimore MD 21207

Buchar Chris R. R.Ph HHS 5/10/2003 26114 Pelham Avenue Baltimore MD 21213

15040

Budnichuk Alfred D. Radiation Tech

HHS 6/19/2003 1539 Redfield Road Bel Air MD 21015

Budnick Jean Citizen HHS 6/30/1994 4700 Leyden Way Ellicott City MD 20142

Burge Lisa M. Citizen HHS 2/6/1998 7934 Mayfair Circle Ellicott City MD 21043

Burks Teman L. M.D. HHS 2/19/1998 251 N. Fourth St Oakland MD 21550

D 45191

Butts Shayrie PCP HD 7/19/1991 306 Bishop Avenue Baltimore MD 21225

Calhoun Marvita PCP HD 8/19/1994 96 College Park Terrace Annapolis MD 21401

Calon Antonino H. M.D. LB 11/6/1998 611 S. Union Ave Havre De Grace MD

D 20655

Caltrider Robert S. P.A. HHS 5/20/1998 212 Juniper Drive Glen Burnie

Campbell Darlene CRT HHS 11/20/2000 3010 Spaulding Avenue Baltimore MD 21215

L 00984

Cannon Anthony Citizen HHS 8/20/2000 Lewisburg Fed Prison, 5 Lewisburg PA 17837

Cardiotel Inc. Laboratory HHS 6/20/2002 19636 Club House Road; Ste 120

Gaithersburg MD

Care Plus Ambulance Service, Inc Corporation F 9/13/1999 4 Woostream Court; #9 Owings Mills MD

Monday, October 18, 2010 Page 10 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 11: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Caregivers, LLC Corporation HD 10/20/2008 11405-103 Little Patuxent Parkway

Columbia MD 21044

Carpenter Gene P. Aide HHS 5/20/1999 7328 Church Hill Road Chestertown MD

Carroll Candy PCP HD 1/5/2007 P.O. Box 151 Park Hall ND 20667

Carter Janet Citizen F 8/30/2009 11400 Falcon Ridge Court Beltsville MD 20705

Carter Thomas N. M.D. LB 7/6/1994 9127 Georgia Ave Silver Spring MD

D 01152

Caruana Patricia LCSW LB 9/12/2008 6611 Marietta Avenue Baltimore MD 21214

08427

Caulker Alex Nurse HHS 8/20/2002 5445 N. Morgan Street; #203

Alexandria VA 22312

Certeza Humberto V. M.D. LB 7/31/1998 8946 Satyr Hill Rd Baltimore MD 21234

D 04364

Chaiet Melvin R.Ph HHS 1/18/2001 4606 Barbara Drive Beltsville MD 20705

05958

Chalk Ella PCP HD 3/18/1996 1707 N. Patterson Park Avenue

Baltimore MD 21213

Chalkley Walter Citizen HHS 11/11/1993 8645 Oak Road Baltimore MD 21234

Chalom Albert I. M.D. HHS 8/14/1990 6002 Eastern Ave Baltimore MD 21224

D 01891

Chan Brian Citizen HHS 8/1/1997 8542 Hill Spring Drive Lutherville MD

Chan AKA (Ng Fong) Cynthia Citizen HHS 8/1/1997 8542 Hill Spring Drive Lutherville MD

Chance Irma Rivera M.D. LB 10/23/2002 405 Ireland Way Eastham MA 02642

D 31138

Chaney Marlo Citizen HHS 4/20/2010 523 Kerby Parkway Fort Washingto

Monday, October 18, 2010 Page 11 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 12: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Chang Samuel M.D. F 10/28/1987 10005 Hall Rd Potomac MD 20854

D 14746

Charms One, LLC Corporation HD 9/28/2009 2021 Kennicott Road Baltimore MD 21244

Chase, Jr. Charles L. Citizen HHS 4/10/1996 912 S. Baylis Street Baltimore MD 21214

Chavez Juan M. M.D. F 6/1/1988 4123 Frederick Ave Baltimore MD 21229

D 04370

Chavis Darlene PCP HD 6/8/1993 619 Carlton Court Cambridge MD 21613

Cheeves Deborah Nurse HHS 8/19/2010 4206 Forsythia Lane Pasadena MD 21122

R 096908

Chellappa Mariam Audiologist LB 1/20/2001 7840 Eastern Avenue Baltimore MD 21224

03511

Chen Cecella A. M.D. LB 5/26/2001 603 Stags Head Ct Towson MD 21204

D 14193

Chertkov Lynn S. LCSW F 4/25/1991 400 East/West Highway Bethesda MD 20814

01585

Chigbue Brian M.D. LB 1/14/2008 7943 Central Avenue Capitol Heights

D 50457

Chorbajian James P. D.D.S. HHS 10/6/1994 1410 Peartree Lane Bowie MD 20721

7671

Chu Peter L. Corporation HHS 11/4/1988 12450 Parklawn Drive Rockville MD 20852

Chu and Chu, Inc. Corporation HHS 7/20/1988 1200 Annapolis Road Odenton MD 21113

Clair Michael J. D.D.S. LB 10/7/1999 104 Plum Tree; Ste, 100 Belair MD 11014

8472

Clark Ann PCP HD 11/27/2006 4509 Wakefield Road Baltimore MD 21216

Clark Marva J. D.D.S. HHS 9/3/1997 3900 Bel Pre Road; Ste 1 Silver Spring

09986

Monday, October 18, 2010 Page 12 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 13: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Clark Timothy P.D. HHS 2/4/1997 4510 Springdale Avenue Baltimore MD 21207

Clark Norman L. M.D. LB 1/23/2002 Univ of MD Hosp; 22 S. Greene St

Baltimore MD 21201

D 42095

Clayton Edith PCP HD 9/9/1993 10518 Marriottsville Road Randallstown MD

Cleary Edward Paul PCP HD 11/10/2005 6723 Eldorado Road Federalburg MD

Cleveland Tamara Jane Nurse HHS 2/19/2004 1003 Girard Street; NE Washington DC

R 108856

Clopin Wanda PCP HD 9/9/1998 9214 Victoria Drive Ellicott City MD 21043

Coar Jemal PCP HD 6/11/2009 1652 Candlewood Court Edgewood MD 21040

Cochran Timothy Citizen HHS 3/31/1999 639 Riverside Drive Annapolis MD 21403

Cochran Cheryl Citizen HHS 3/31/1999 639 Riverside Drive Annapolis MD 21403

Cockeysville Pharmacy Pharmacare, Inc. Corporation F 7/25/2000 10255 York Road Cockeysville MD

Cohen Adrian M. M.D. LB 3/15/1997 1404 Dennis Avenue Silver Spring

D 04365

Coleman Angela PCP HD 9/9/1998 112 Big Chimney Branch Upper Marlboro

Coleman Rita M.D. HHS 2/23/1994 PO Box 9751 Baldwin MD 21013

D 15258

Collins Shireen Citizen HHS 8/20/2009 MR 9121 Autoville Drive College Park MD

R05854

Colston Burley Phyllis Citizen HHS 2/15/1997 2859 Woodbrook Avenue Baltimore MD 21217

Comeau John PCP HD 5/19/2010 218 Philos Avenue Westernport MD

Monday, October 18, 2010 Page 13 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 14: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Commodore Patricia W. Citizen F 6/23/1997 1910 Barclay Street Baltimore MD 21218

Commodore Josephine PCP HD 11/3/1992 722 E. Preston Street Baltimore MD 21202

Community Care Pharmacy

Pharmacy LB 10/19/2006 2730 Pennsylvania Avenue Baltimore MD 21217

P 04358

Compassionate Nursing & Health Care

Corporation HD 2/14/2007 8115 Fenton Street, Suite 301

Silver Spring

Conerly Rex A. P.D. HHS 6/6/1993 6114 Breezewood Drive; #101

Greenbelt MD 20770

Connine Tad M.D. HHS 5/20/2007 395 N. Perry Parkway, Apt. M6

Perry GA 31069

D 45752

Consistent Care Ambulance

Service Corporation F 1/21/2000 21 Govenor Court Baltimore MD 21244

Cook Elmer E. D.D.S. HHS 7/20/1999 2300 Paper Mill Road Phoenix MD

Cooke, II Arthur Aide HHS 4/27/1992 1100 Bolton Way; Apt 1408 Baltimore MD 21201

Coombs Clarence M.D. F 10/15/1985 7410 Village Road Sykesville MD 21784

D 04111

Coplan Robert S. M.D. HHS 12/22/1988 407 Crain Hwy, SE Glen Burnie

D 02097

Cordova Edmund M.D. HHS 3/22/1995 PO Box 1296 Pasadena MD 25096

D 25096

Corner Michael F. P.A. HHS 11/29/1989 305 Saybrooke View Dr Gaithersburg MD

C 00651

Cornfeld Edward M.D. LB 5/23/2005 20428 Boland Farm Road Germantown MD

D 01872

Cosca (Corp.) Ruben M.D. F 10/30/1989 6601 Sweetwater Dr Derwood MD 20855

D 04421

Costanzo Anthony DPM HHS 11/20/2001 11100 Luttrell Lane Silver Spring, MD

Monday, October 18, 2010 Page 14 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 15: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Costley Betty Aide HHS 11/21/2002 6967 Eden Mill Road Woodbine MD 21797

Cothran Dorothy M.D. LB 8/9/1996 1715 D Street, SE Washington DC

D 20918

Coulter Steven T. M.D. LB 5/28/2003 11140 Rockville Pike; #348 Rockville MD 20852

D 39934

Council Michael Delroy Aide HHS 6/16/2003 5143 Nelson Avenue Baltimore MD

CPM Corporation Corporation F 3/13/2003 5550 Baltimore Nat'l Pikek Baltimore MD 21228

Crawford Gene O. M.D. LB 10/28/1992 401 Rexburg Ave Ft Washingto

D 22772

Crisp Ronald M.D. HHS 6/24/1992 8288 Waterside Court Frederick MD 21701

Crowder Veronica PCP HD 2/16/2010 6670 Palmers Mill Road Hurlock MD 21643

Crumitie Audrey Aide HHS 9/25/1995 1616 North Bethel Baltimore Md 21213

Crutchley Valerie Nurse HHS 10/20/2005 20161 Sunnyside Drive Melfa VA 23410

R 162449; LP 29727 ; T 20031191 MD;

Cudlipp Frederick P.T. HHS 4/20/2006 6865 Snowberry Court Frederick MD 21703

15319

Cummins David D.D.S. HHS 7/8/1993 42 W. Deerpark Road; #101 Gaithersburg MD

Cunningham Dean S. M.D. LB 10/22/2003 Morgantown FCI; POBox 1000

Morgantown WV

D 42521

Curtis Derek D.D.S. HHS 12/18/2008 P.O. Box 1000 Lewisburg PA 17837

5564

D & J Personal Care Services

Corporation HHS 11/19/2009 1011 Reverdy Road Baltimore MD 21212

Dabney Lillie PCP HD 4/25/2008 112 S. Symington Avenue Catonsville MD 21228

Monday, October 18, 2010 Page 15 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 16: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Dabney's Elder Care Corporation HD 4/25/2008 112 S. Symington Avenue Catonsville MD 21228

03AL0729

Daduk Steven O.D. LB 6/14/1982 36 South Market St. Frederick MD 21701

Dalrymple Anne M. M.D. HHS 6/27/1991 207 N. Manor Circle Takoma Park MD

Dang Dien Hieu D.D.S. F 4/12/1985 Suite 3 Silver Spring

Daniel George M.D. HHS 4/23/1990 11610 Milbern Drive Potomac MD 16280

D31839

Danquah Gloria E. M.D. F 3/3/1987 6705 Surreywood Lane Bethesda MD 20817

D 27379

DaShiell Hilda T. PCP HD 10/29/2003 POBox 1148 Hurlock MD 21643

Davis Jane PCP HD 2/15/1994 1508 Rawlings Well Road Baltimore MD 21228

Davis Mark M.D. HHS 11/2/1990 PO Box 830 Belair MD 21014

D 23760

Davis Patricia PCP HD 10/16/1992 1527 W. Baltimore Street Baltimore MD 21223

Davis Sigmond E. Aide HHS 5/20/1998 3205 Howard Park Ave Baltimore MD 21207

Dawson Robert Citizen HHS 7/20/1999 1422 Fernhill Court Forestville MD 20747

de la Cruz Maureen D.D.S. HHS 2/7/1997 5807 Lindar Lane Bethesda MD 20817

Dee Rosita H. M.D. LB 8/14/2006 8830 Cameron Street; #206 Silvler Spring

D 21691

Delcid Ever A. Citizen MFCU-A 8/15/2006 2142 Collingwood Lane Frederick MD 21702

Demonte Rose Aide HD 12/16/2008 114 Linwood Avenue Bel Air MD 21014

Monday, October 18, 2010 Page 16 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 17: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Deonarine Nelinee Citizen F 10/20/2006 1643 Agens Avenue, S.E. Palm Bay FL 32909

Deptula Richard Citizen HHS 8/20/2003 1290 Folly Quarter Road Ellicott City MD 21042

DeWitt Patrice Nurse HHS 6/20/2007 8247 N. Boundary Road Baltimore, MD 21222

LP24855

Dewitt Nancy Wanbui Kimani Aide MFCU-A 9/12/2006 1308 Highland Drive Baltimore MD 21239

Dialysis with Heart Corporation F 6/28/2002 1 Nashua Court; Suite E Baltimore MD 21221

Dickerson Ronald G. Citizen HHS 5/20/2008 6728 Vermont Court Landover MD 20785

Diggins Carolyn L. PCP HD 7/13/2005 3547 Milford Mill Road Baltimore MD 21244

Diggins Carolyn PCP HD 4/27/2006 3547 Millford Mill Road Baltimore MD 21207

Dishon Lori Ann Citizen F 9/22/1999 3208 Fait Avenue Baltimore MD 21224

Diwani Selwa M.D. LB 6/10/2009 4900 Silver Hill Road Suitlant MD 20746

D 39713

Dolly Judy PCP HD 10/16/1995 719 Sylvan Avenue Cumberland MD

Donovan James Citizen HHS 11/15/1995 3906 Woodbine Avenue Baltimore MD 21207

Dorsey Cornell PCP HD 4/14/1993 2105 N. Charles Street Baltimore MD 21218

Dorsey Juanita L. PCP HD 1/10/1995 P. O. Box 42 Bryantown MD

Doswell Ronald J. LCSW F 7/12/1997 3311 The Alameda Baltimore MD 21218

06799

Downes Tabitha Beatrice Aide HD 1/15/2002 1039 Cosby Avenue Cambridge MD 21613

Monday, October 18, 2010 Page 17 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 18: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Dressel Tammy A. Nurse HHS 1/28/2003 9222 Orbitan Road Baltimore MD

Dubin Samuel M.D. LB 6/30/1988 17904 Georgia Ave Olney MD 20832

D 02307

Dubroff Seymour J. M.D. LB 12/31/1994 8905 Fairview Rd Silver Spring

D 02344

Dudley-Richardson Lynnette PCP HD 12/7/2004 5806 Prince George Street Baltimore MD 21207

Duke Mary Ann M.D. LB 11/30/2004 10220 Democracy Blvd Potomac MD 20854

D 38796

Duke Ellis J. Citizen F 9/14/1984 10231 Carroll Place Kensington MD 20895

Dunham George Corporation HHS 6/23/1989 Route 3, Box 144 Hagerstown MD

Dunn James M.D. LB 6/25/2009 419 West Redwood Baltimore MD 21201

D 56049

Dunsworth Joseph Aide MFCU-A 9/2/2010 218 E. Franklin Street Hagerstown MD

A00001268

Duong Linh H. D.D.S. HHS 6/28/1999 8003 Hastings Hunt Court Severn MD 21144

10972

Edwards Arthur Citizen F 3/17/1992 17725 New Hampshire Avenue

Ashton MD 20861

Edwards Angela Eliane PCP HD 9/17/1998 2231 Aiken Street Baltimore MD 21218

Eisenband Nancy W. Nurse HHS 9/19/2002 100 Harbor View Drive Baltimore MD 21230

Eldridge Marguerite L. PCP HD 5/12/1993 7115 Faulkner Road Hanover MD 21076

Ellin Morton M.D. LB 3/14/2007 5310 Old Court Road #201 Randallstown MD

D 03078

Elliott Erin R.N. HHS 8/20/2007 926 Hammonds Lane Baltimore MD 21225

R49332

Monday, October 18, 2010 Page 18 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 19: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Ellis Julia PCP HD 8/14/1995 4701 Hamilton Avenue Baltimore MD 21206

Ellis-Bales Theresa Nurse HHS 3/20/2003 1430 Dundalk Avenue Baltimore MD 21222

Ellison Raeford Acupuncture

HHS 4/18/2002 8 N. Sacramento Avenue; Apt. A

Ventnor City NJ

Emamali Ronald Citizen F 5/20/1993 14117 Peartree Lane; #33 Silver Spring

Emerson Thomas Nurse HHS 9/20/2007 1911 Thayer Terrace Baltimore MD 21207

R 163950

Ennals Dominique Aide MFCU-A

Ervin Christopher M.D. LB 3/22/2006 500 Upper Chesapeake Drive

Bel Air MD 21014

D 52310

Ervin Emma Jean PCP HD 7/15/1992 665 Queenstown Road Severn MD 21144

Etheredge Personal Care Corporation HD 9/27/2005 550 Glenn Court Glen Burnie

Evangelista Gracia Nurse HHS 12/18/2008 Route 37 Danbury CT 06811

R121367

Evans John Mark Nurse LB 10/28/2002 9000 Franklin Square Drive Baltimore MD 21237

Ezeocha Obioma Aide MFCU-A 1/7/2008 2119 Townhill Road, Apt. F Parkville MD 21234

Ezrine Edwin D.D.S. LB 12/31/1998 1811 A S. Crain Hwy Glen Burnie

04604

Facey Sharon Citizen F 2/12/1997 8244 Church Lane Randallstown MD

Fafinski Carol Ann Knabb Nurse HHS 9/20/2001 8210 Woodyard Road Clinton MD

Fakuade Phyllis Demetrice Citizen MFCU-A 12/19/2005 6611 Parr Avenue Baltimore MD 21215

Monday, October 18, 2010 Page 19 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 20: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Family & Children Enrichment Services, Inc.

Corporation F 8/29/2008 1777 Reisterstown Road, Ste 204

Pikesville MD 21208

Family Home Center Corporation F 3/7/2003 5501 Oakland Mills Road Columbia MD 21045

Farzanfar Mohammad R. M.D. LB 7/27/1994 930 N. Charles St Baltimore MD 21201

D 04295

Fatemi Mohammad Ali T. D.D.S. F 5/5/2004 1730 S. Plantation Drive Dunkirk MD 20754

11720

Fauter Harald H. M.D. LB 10/26/1994 8314 Liberty Rd Baltimore MD 21244

D 01943

Federroll Susan W. LCSW LB 2/10/2006 8028 Ritchie Highway; Suite 313

Pasadena MD 21122

02585

Feldman Martin J. M.D. LB 12/22/1987 205 E. Joppa Rd; Ste 2001 Towson MD 21204

D 01083

Felsenberg Stanley M.D. LB 7/24/1996 6310 Greenspring Ave Baltimore MD 21209

D 01085

Ferguson Sandra Aide HHS 8/27/1995 9805 Langs Road; Apt. L Baltimore MD 21220

Ferrer Romeo M.D. LB 9/8/2010 300 Hospital Drive #128 Glen Burnie

D 09255

Fiddermon Maryln Aide HHS 2/20/2000 10555 Campus Way, South Upper Marlboro

Fiedler Kurt M.D. F 10/23/1992 325 Hospital Drive; #109 Glen Burnie

D 01409

Fielding Gregory Edward PCP HD 9/14/1994 1503 Adams Street, NE Washington DC

Fingal John Joseph Citizen HHS 9/20/2001 10803 Kencrest Drive Mitchellville MD

Finucan, Jr. Thomas E. M.D. LB 1/24/2001 3 Maudlin Ave North East MD

D 32395

Flegel Eric M.D. LB 6/22/2007 4994 Beaverbrook Road Columbia MD 21044

H 59852

Monday, October 18, 2010 Page 20 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 21: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Fletcher Jean Virgie PCP HD 5/29/2004 710 Leonards Lane Cambridge MD 21613

Fletcher's Assisted Living Corporation HD 5/5/2006 11754 Mansion Street Princess Anne MD

Floyd Beverly PCP HD 2/23/1995 2583 Edmondson Avenue Baltimore MD 21223

Folashade Charles M.D. LB 5/15/2009 108 Pine Bluff Road Salisbury MD 21801

D 50759

Forde Richard M.D. LB 11/26/1980 Pincrest Btc-Salisbury Center New York NY 13454

D 08483

Foster Robert N. M.R.T. HHS 10/19/2000 4701 Everlea Court Preston MD 21655

R 04392

Foster, Jr. Grady D.D.S. HHS 6/20/2000 c/o 8730 Georgia Avenue; 404

Silver Spring

Franks Denis M.D. LB 7/19/1997 1900 E. Northern Pkwy Baltimore MD 21239

D 17419

Franz Charles P. D.D.S. LB 2/18/2004 2201 Hammons Ferry Road Baltimore MD 21227

7882

Frederick Spinal Care Center Corporation HHS 4/20/1999 101 Baughmans Lane Frederick MD 21702

Freedenberg Gerald Citizen F 6/29/1992 7036 Vangough Plano TX 75093

Freeman Debra M.D. LB 2/14/2008 2401 W. Belvedere Avenue Baltimore MD 21215

D 40730

French David W. Citizen F 6/24/1999 51 Murphy Avenue Annapolis MD 21401

Fringer Susan D. PCP HD 9/30/1993 1322 Deer Park Lane Westminster MD

Frontera Miguel M.D. LB 11/6/2009 515 Fairmount Avenue Towson MD 21286

D 37559

Frost Rosalyn Citizen HHS 12/20/1995 8200 Autumn Lake Court Severn MD 21144

Monday, October 18, 2010 Page 21 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 22: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Fuentes Michael M.D. HHS 5/20/2010 32 Lake Drive Darien CT 06820

D 30922, MD035920E, 28388,

Fulton Cynthia D. Aide HHS 6/27/1991 739 N. Kenwood Avenue Baltimore MD 21205

Fuster David E. D.D.S. HHS 6/20/2005 8305 Old Germantown Road

Bethesda MD 20814

# 8287

Futterman Steven D.D.S.. HHS 5/20/1999 8901 Shady Grove Court Gaithersburg MD

Gambill Colin Aide MFCU-A 1/25/2010 10338 Old Liberty Road Frederick MD 21701

Gammill Joan Nurse HHS 11/20/2006 53 Lafayette Avenue Annapolis MD 21401

R 067585

Ganz Joel M.D. LB 6/7/2010 11420 Strand Drive, Ste. 206

Rockville MD 20852

D 01544

Gardner Patrina Y. Aide HHS 3/20/2002 203 Parier Drive; Apt. H Elkton MD 21923

Gardner Elmer M.D. HHS 9/10/1996 Box 137 Brookerville MD

D 13039

Garner Wilma J. Aide HHS 6/20/2000 1618 Four Georges Court; #A-3

Baltimore MD 21222

Geist, Jr. William C. Citizen F 4/30/2004 1684 Nickerson Way Arnold MD 21012

Gentry Samantha Citizen F 4/28/2006 3530 Aldina Road Churchville MD 21029

Gershoni Daniel Citizen HHS 6/20/2002 19636 Club House Road; Suite 120

Gaithersburg MD

Gill William M.D. LB 9/8/2010 26423 Burton Avenue Crisfield MD 21817

D 15715

Ginn David H. M.D. LB 7/28/2004 10006 Hillgreen Circle; Apt. K

Cockeysville MD

D 32043

Glenn Linnell PCP HD 8/26/1993 4119 Hayward Avenue Baltimore MD 21215

Monday, October 18, 2010 Page 22 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 23: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Godwin-Hult Sandra PCP HD 7/10/1991 3507 Bantry Way Olney MD 20832

Goldbaum Henry R. Citizen HHS 5/20/1998 108 Deerfield Place Frederick MD 21702

Goldberg Harold L. D.D.S LB 4/21/2000 7501 Liberty Road Baltimore MD 21207

02524

Goldberg Lise Adele M.D. HHS 5/20/1998 1539 Ivystone Court Silver Spring

D 29617

Golden Crown Construction

Corporation HD 3/18/2005 1007 Call Drive Upper Marlboro

Goldschmitt Neil Citizen F 6/3/2010 4417 Meanderwood Drive Burtonsville MD

Goldstein Robert B. M.D. LB 9/30/1998 1205 York Rd; Ste 34 Lutherville/Timonium

D 01275

Gonsalves Dia PCP HD 8/30/1995 7206 Oakhaven Circle Baltimore MD 21244

Gonzalez Ramon L. M.D. LB 5/16/1998 6207 Capella Ave Burke VA 22015

D 29566

Gopalani Hanif A. M.D. LB 6/12/2001 3004 Ohara Place Olney MD 20832

D 37448

Gordan Coral M.D. LB 10/1/1989 2122 Pot Spring Rd Timonium MD 21093

D 04375

Gordon Robert Chiropractor

HHS 4/27/1994 118 W. Market Street Snow Hill MD 21863

Grace Pharmacy Pharmacy LB 1/18/2002 8000-A Martin Luther King Hwy

Glenarden MD 20706

P 01877

Graham Marva C. M.D. HHS 11/19/1998 One Cooperfield Ct Phoenix MD 21131

D 45552

Graham-Melvin Associates Inc.

Corporation F 4/1/1997 7060 Oakland Mills Road; #1

Columbia MD 21046

Graning Harold LCSW LB 7/30/2010 6190 Georgetown Boulevard

Eldersburg MD 21784

10333

Monday, October 18, 2010 Page 23 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 24: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Grant-Grayton Miranda LCSW HD 8/10/2008 2412 Minnesota Avenue, Ste 201

Washington DC

12509, LC303653

Grant-Grayton Urban Supports, Inc.

Corporation HD 7/18/2008 3611 Branch Avenue; Ste 201

Temple Hills MD

Gray Darrell M. M.D. LB 3/5/2000 810 Painted Post Ct Baltimore MD 21208

D 21711

Gray Rowena Citizen HD 9/28/2009 2021 Kennicott Road Baltimore MD 21244

Grayton James Citizen HD 7/18/2008 9006 Dangerfield Place Clinton MD 20735

Greco William M.D. HHS 12/4/1984 7229 Hanover Pkwy, Ste. B Greenbelt MD 20770

D01485

Green Jacquetta Aide HHS 4/20/2005 4303 Wakefield Road; Apt. 6

Baltimore MD 21216

Green Lynaya Nurse HHS 11/20/2000 14159 Castle Blvd; #301 Silver Spring

Green Donald D.P.M. HHS 1/20/2004 1460 Burbridge Road, SE, FCI

Cumberland MD

SC 001474L

Green Matthew R.Ph. HHS 6/20/2007 6216 Duntley Place Springfield VA 22152

13770

Greenberg Alan S. M.D. HHS 8/20/2001 1537 Jarrettsville Road Jarrettsville MD 21084

D 04728

Greenberg Eric M.D. LB 4/16/2009 11125 Rockville Pike # 103 Rockville MD 20852

D50275

Greene Rose M. Citizen F 1/9/1998 2501 W. Fairmount Avenue Baltimore MD 21223

Greenway Diane L. PCP HD 9/17/1998 1119 Riggs Avenue Baltimore MD 21217

Greer Douglas Ophthalmologist

HHS 3/20/2008 P.O. Box 1000 Cumberland MD

Grillo Aderonke A. Aide HHS 5/13/1998 5 Virunga Court; Apt. J Baltimore MD 21244

Monday, October 18, 2010 Page 24 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 25: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Grimes James M. P.A. HHS 5/18/2000 4620 Magnolia Ave Baltimore MD 21227

C 01204

Grooms Shelie W. Aide MFCU-A 10/12/2006 1811 Ruxton Avenue Baltimore MD 21216

Gross Rhonda Aide HHS 4/10/1995 1809 E. Chase Street Baltimore MD 21213

Grossblatt Norton R.Ph F 10/17/2008 3410 Garrison Farms Road Pikesville MD 21208

Guerzon Rosario M.D. LB 7/10/1996 8821 Mayberry Ct Potomac MD 20854

D 02524

Gurley Theodore PCP HD 7/14/1995 4804 Hamilton Avenue Baltimore MD 21206

Hackney David M.D. HHS 9/18/2008 3011 Southern Avenue, Apt. 15

Temple Hills MD

Hailfmariam Mekuria M. PCP HD 6/10/1996 6159 64th Avenue Riverdale MD 20737

Hake Diane Nurse HHS 5/20/2007 815 W. 4th Street, Apt. 313 Williamsport PA

Hakim Arcadius H. M.D. LB 10/7/2002 8701 Oxon Hill Road Oxon Hill MD 20744

D 06460

Hall Sandra Y. Citizen HHS 2/14/1997 3804 Byfield Road Baltimore MD 21207

Hall Lucille PCP HD 9/17/1998 8 E. Adkins Avenue; Parkview

Willards MD 21874

Hallowitz Robert A. M.D. HHS 4/28/1993 Montgomery Village Ave Gaithersburg MD

D 16524

Hamilton John M. M.D. HHS 4/1/1997 5430 Lynx Lane; #125 Columbia MD 21044

D 04895

Hamm Mary Lou Citizen HD 7/27/2005 8431 Newark Road Newark MD 21841

Harden Gerald Anthony Citizen HHS 8/20/2001 16829 Cashell Road Olney MD 20832-

Monday, October 18, 2010 Page 25 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 26: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Harding James PCP HD 11/2/2009 P.O. Box 835, 421 S. Main Street, P.O. 835

Cambridge MD 21643

Hardy Michelle D. Nurse HHS 3/20/2003 2501 Roslyn Avenue Baltimore MD 21216

Harney John M.D. LB 7/29/2009 4000 Annapolis Road Baltimore MD 21227

D21716

Harper Michael M.D. LB 9/24/2008 5505 Hopkins Bayview Circle

Baltimore MD 21224

D 30673

Harris Sabaina PCP HD 1/8/2001 1722 Purdy Street; Apt. 4G Bronx NY 21203

Harris Leonard M.D. HHS 11/10/1992 PO Box 4654 Newark DE 19715

D 37915

Harris, Jr. Vernon Citizen HHS 8/20/1998 1244 Gittings Ave Baltimore MD 21239

Harris-Chin Cheryl M.D. LB 5/26/2006 1708 W. Rogers Avenue Baltimore MD 21209

D 53865

Hart Barbara Citizen HHS 9/20/1999 7606 Brightside Avenue Baltimore MD 21237

Hart Velda Belinda Aide HHS 5/20/1998 519 E. 41st Street Baltimore MD 21218

Hatch Judith Louise D.C. HHS 8/20/2001 1220 East West Highway; Apt. 1012

Silver Spring

GA 3106

Haw Dante Lee M.D. HHS 1/10/1991 6410 La Mirada Ave Hollywood CA 90038

D 22466

Hayford Sheila M. M.D. LB 7/27/2005 550 S. Dupont Hwy; Suite D Milford DE 19963

D 36731 04791

Haynes Carolyn Nurse HHS 11/14/2002 11247 Westport Drive Bowie MD 20720

Head Sue A. Citizen MFCU-A 7/18/2003 995 East New Road Orrtanna PA 17353

Health Mngmt Enterprises Corporation F 6/24/1999 211 Chinquapin Round Rd Annapolis MD 21401

Monday, October 18, 2010 Page 26 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 27: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Heath Kera Aide MFCU-A 10/22/2009 4149 Mountwood Road #4 Baltimore MD 21229

Hebeka George M.D. HHS 7/8/1993 7939 Wise Avenue Baltimore MD 21222

D 05053

Hedeman John L. M.D. LB 6/24/1998 1407 Forest Dr Annapolis MD 21403

D 05259

Henderson Joseph M. Optician F 12/1/1992 P.O. Box 48547 Washington DC

Henderson Freddie Citizen F 10/1/1992 2062 Harlequin Terrace Silver Spring

Hendler Nelson M.D. LB 2/6/2006 1718 Greenspring Valley Road

Stevenson MD 21153

D 15330

Henry Ricardo Citizen HHS 4/20/2009 P.O. Box 1000, #28577-016 Cumberland MD

Henry Victor E. D.P.M. LB 7/22/2001 1450 Mercantile Lane #151 Largo MD 20774

00309

Heritage House I & II Corporation HD 5/15/2005 1405 Crockett Lane Silver Spring

Herlich Steven Citizen F 5/2/1990 1920 Eastridge Road Timonium MD 21093

Herrera Alfredo M.D. F 6/20/2001 10300 A Balt Nat'l Pike Ellicott City MD 21042

D 17863

Hewitt John H. M.D. LB 1/17/2003 150 Baughman's Lane Frederick MD 21702

D 27908

Heyward Donna Maria PCP HD 7/28/1993 319 B Suter Road Baltimore MD 21228

Hickory Plaza Pharmacy Pharmacy LB 6/1/2005 10805 Hickory Ridge Road Columbia MD 21044

P 01791

Hicks Ernestine PCP HD 10/1/2008 814 North Brice Street Baltimore MD 21217

Hicks, Jr. Willie Howard Aide HHS 5/20/1999 516 W. 8th Street Laurel DE 19956

Monday, October 18, 2010 Page 27 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 28: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

High Ronald Citizen F 1/21/2000 2 Horseman Court Randallstown MD

Hill Ezell PCP HD 7/27/1994 3722 Ellerslie Avenue Baltimore MD 21228

Hill James M.D. HHS 4/14/1994 PO Box 1722; Country Club road

Cumberland MD

D 8081

Hill Leo M.D. HHS 2/10/1997 1815 61st Ave Cheverly MD 20785

C 01305

Hill Brunetta PCP HD 5/3/2001 2409 Jefferson Street Baltimore MD 21205

Hill Denise PCP HD 7/23/1992 161 Reedbird Avenue Baltimore MD 21225

Hillegas Sherry Nurse HHS 2/20/2001 18 S. collington Avenue Baltimore MD 21231

Hillgard Else M.B. M.D. LB 10/23/1991 8500 Tyspring St; #320 Vienna VA 22182

D 12713

Hilliard Silas Aide HHS 9/16/1992 522 W. Lanvale Street Baltimore MD 21217

Hinds Sandra Marcia Aide HHS 5/19/2005 920 Kenbrook Drive Wheaton MD 20902

D 45096

Hines Larry Citizen F 2/24/1994 735 Reservoir Street; 2nd Floor

Baltimore MD 21217

Hiotis Michael P. P.D. F 6/9/1993 1612 Gray Haven Court Baltimore MD 21222

Hisco Pharmacy Pharmacy F 12/7/2003 5613 Bel Air Road Baltimore MD 21206

Hitzig Pietr M.D. LB 2/4/1999 15 Charles Plaza Baltimore MD 21201

D 12795

Hodges Corvalis Gail Citizen HHS 9/20/2005 2136 Alice Avenue; Apt #302

Oxon Hill MD 20745

Hodjati Hassan H. M.D. LB 3/20/2002 6192 Oxon Hill Road; Ste 507

Oxon Hill MD 20745

D 23383

Monday, October 18, 2010 Page 28 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 29: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Holland Richard W. M.D. LB 6/20/1999 13700 Ivywood Lane Silver Spring

D 48276

Holland Dannielle PCP HD 5/4/2009 99 Greystone Road North East MD 21901

Holland Rosetta Francine PCP HD 5/28/1993 59 Mt. Harmony Lane; P.O. Box 400

Owings MD 20736

Holliday Mary PCP HD 3/31/2001 904 Central Avenue Cambridge MD 21613

Holman Antoinette Nurse HHS 1/20/2010 853 St. Nicholas Avenue, Apt. 302

New York, NY 10031

LP42184, NY228546

Holmes Teresa PCP HD 10/13/1994 901 Druid Lake Drive; Apt. 1-B

Baltimore MD 21217

Holum Nahid I. M.D. LB 6/2/1981 9605 Burgess Lane Silver Spring

D 14709

Home Feet Podiatric Home Care Inc.

Corporation HD 2/8/2007 448 Luzerne Avenue Baltimore MD 21224

Home Medical Equip Corporation HHS 8/11/1997 1800 Belair Road; Ste. 4 Benson MD 21018

Hope Senior Assisted Living

Corporation HD 5/23/2005 4825 Ellicott Woods Lane Ellicott City MD 21043

Hopkins Tracey PCP HD 9/24/2001 2536-B North Edgecombe Circle

Baltimore MD 21215

Hopson Jessica PCP HD 2/13/2008 30 E. Baltimore Street Taneytown MD 21787

Horn Thomas Citizen HHS 8/19/2010 1620 Brimfield Circle Sykesville MD 21784

Horton Robert T. M.D. LB 1/9/2002 6501 N. Charles Street Baltimore MD

D 54056

Horvath Edward DPM F 11/26/2009 8118 Clifford Court Laurel MD 20708

01207

Houck Donna PCP HD 11/13/2000 1498 W. 9 th Street Frederick MD 21702

Monday, October 18, 2010 Page 29 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 30: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Houck Romulus M.D. LB 6/1/1994 6500 Panorama Drive Sykesville MD 21784

D 05193

Hremt Pharmacy Pharmacy LB 5/14/2003 7701 Quaint Court Bowie MD 20720

P 02010

Hughes, Jr. Charles E. Chiropractor

HHS 9/8/1993 811 Woodington Road Baltimore MD 21229

Human Development Assoc t/a Adelphia

Corporation HD 3/1/2005 2700 Rambler Place Adelphi MD 20783

Humphries Sharon Nurse HHS 4/20/2004 P.O. Box 228 Chester MD 21619

R 086209

Hunt Michael Citizen F 3/17/1992 401 Christopher Avenue; Apt.

Gaithersburg MD

Hunter Thelma Citizen F 12/24/2003 335 S. Ballou Court Baltimore MD 21231

Hurey Jacqueline Citizen HHS 2/15/1997 6106 Carswell Terrace Suitland MD 20746

Husain Tasaduq Citizen HHS 7/6/1995 3126 Nestling Pine Court Ellicott City MD 21042

Hussain Yasin M. Citizen F 6/10/1996 11646 Sun Circle Way Columbia MD 21044

Huttinger Carol Ann Nurse HHS 5/20/1999 RD #3; Box 38A Hanover PA 17331

Hyde David Jefferson D.D.S. LB 7/12/2004 1009 University Blvd E Silver Spring

8105

Hyson Mary Citizen HHS 6/12/1997 1012 Shaffner Drive Bel Air MD

Hyson Bradford A. Citizen HHS 6/12/1997 3148 Sandy Hook Road Street MD 21154-

Hyson Rodney Citizen HHS 6/12/1997 2413 Haddenhurst Court Falston MD

Ibeh Cyriacus Chidi Nurse HHS 6/20/2006 13625 Avebury Drive; Apt. 24

Laurel MD 20708

Monday, October 18, 2010 Page 30 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 31: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Idowu Olusola A. Nutritionist F 11/19/2008 11047 Sani Lane Hagerstown MD

Ige Moses Citizen HHS 2/20/2007 9005 Tarpleys Circle Baltimore MD 21237

Igwacho Florence N. Citizen HHS 4/20/2000 9127 Edmonton Terrace; #304

Greenbelt MD 20770

Imperial Roland M.D. LB 12/10/1999 4977 Battery Lane Bethesda MD 20814

D 05276

Inocencio Narciso M.D. LB 4/14/2004 1400 Mercantile Ln; #180 Landover MD 20785

D 41106

Izat Sarah C. Aide HHS 7/27/1996 216 Maryland Avenue Cumberland MD

Izzo Jaime Nurse HHS 1/18/2007 3161 Freestone Court Abingdon, MD 21009

R171283

Jack Joseph M.D. LB 4/15/1994 620 Towne Center Drive Jopp, MD 21085

D 05538

Jackson Theresa Citizen MFCU-A 8/28/2005 2620 Greenmount Avenue Baltimore MD 21218

Jackson Lionel Aide HHS 2/23/1997 4728 Wakefield Road; Apt. 30

Baltimore MD 21215

Jackson Howlett M.D. LB 11/7/2007 611 South Union Avenue Havre de Grace MD

D 20993

Jacobs Davita Citizen MFCU-A 12/6/2006 8135 Scotts Level Road Pikesville MD 21208

Jacobs Joe L. Citizen HHS 3/7/1986 1422 Crain Hwy South Glen Burnie

Jacobs Virginia L. Chiropractor

HHS 7/4/1997 555 Thayer Avenue Silver Spring

Janati Abdorasool M.D. HHS 9/20/2005 FCI Cumberland; Federal Correctl Inst; PO Box 1000

Cumberland MD

0101-044684

Jefferson Gary Citizen F 9/13/1999 7202 Chippenham Place; #303

Baltimore MD 21244

Monday, October 18, 2010 Page 31 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 32: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Jenkins Sheretta PCP HD 7/29/2002 5615 Thompson Town Road

East New Market

Jiggetts Wayne R. Nurse F 1/9/1998 3010 Fallstaff Manor Court Baltimore MD 21209

Jobes Philip Aide MFCU-A 11/8/2004 2007 Frames Road Dundalk MD

Johnson Constance S. PCP HD 12/11/2001 810 North Maple Avenue Brunswick MD 21716

Johnson Craig L. Citizen HHS 11/24/1991 1604 E. Chase Street Baltimore MD 21213

Johnson Subrina Aide HHS 5/19/1992 4918 Pallmer Avenue Baltimore MD 21215

Johnson Frederick M. M.D. LB 11/21/2000 201 Howard St La Plata MD 20646

D 060704

Johnson Mark D.D.S. HHS 11/21/1993 c/o 6424 Elliot Place Hyattsville MD 20783

Johnson Darice PCP HD 5/14/1996 P. O. Box 35 St. Michaels

Johnson Constance PCP HD 2/1/1996 3703 Stoneybrook Road Randallstown MD

Johnson Andrea M. Nurse HHS 3/18/2004 1360 Running Deer Drive Keswick VA 22947

Johnson Heather A. PCP HD 2/13/2002 810 North Maple Avenue Brunswick MD 21716

Johnson Leslie Aide HHS 11/8/1994 123 Lewis Street Marks MS 38646

Johnston Randolph M.D. LB 4/24/2009 6501 N. Charles Street Baltimore MD 21285

D 57175

Jones Ronald PCP HD 8/3/2002 6227 Jones Village Road Hurlock MD 21643

Jones Diane I. Aide HHS 12/6/1992 3051 Ascension Street Baltimore MD 21225

Monday, October 18, 2010 Page 32 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 33: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Jones Estella Louise PCP HD 6/30/1998 417 Naylor Street Salisbury MD 21801

Jones Mary PCP HD 3/1/1994 P. O. Box 67453 Baltimore MD 21215

Jones Roderick L. Citizen HHS 3/25/1990 3739 Parkfield Road Baltimore MD 21208

Jones Tania PCP HD 3/12/1998 902 N. Durham Street Baltimore MD 21205

Jones Yvonne M.D. HHS 7/19/2001 146-A Barrington Road Upper Darby, PA

039111E

Joyce David M.D. LB 12/12/1997 2003 Medical Pkwy; Ste 210 Annapolis MD 21401

D 45028

Jung Ha Yong M.D. F 9/15/1993 8534 Harvest View Ct Ellicott City MD 21043

D 28993

Kahntroff Bridget C. M.D. LB 3/30/2005 2401 W. Belvedere Avenue Baltimore MD 21215

D 20788

Karlsberg Robert M.D. HHS 2/20/2008 14406 Coral Gables Way North Potomas

D 06842

Karmo Roosevelt Citizen HHS 11/15/1995 6655 Knottwood Court Baltimore MD 21214

Keefer Angela PCP HD 3/3/1997 736 W. Franklin Street; 2nd Fl

Hagerstown MD

Keenan Robert M. M.D. LB 3/9/2004 1400 Generals Highway Crownsville MD 21032

D 42002

Kelly Wanda PCP HD 4/11/1994 8134 Hog Neck Road Pasadena MD 21122

Kelly Sarah LCSW LB 9/12/2008 16 K Spindrift Circle Baltimore MD 21234

12677

Kelly Jo-Anne B. M.D. LB 6/25/2003 2401 Research Blvd; #330 Rockville MD 20850

D 21467

Kelly's Kids Corporation HD 9/11/2006 6955 Castle Court; Apt. 205 Frederick MD 21703

Monday, October 18, 2010 Page 33 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 34: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Kennedy Jeffrey D. Nurse HHS 6/20/2006 4025 Belvoir Pines Drive Chattanooga TN

Kenson Nursing Home Corporation F 5/12/1988 2922 Arunah Avenue Baltimore MD 21216

Kessler James P.D. F 7/25/2000 25 Tenby Court Timonium MD 21093

P 07800

Keyes Katherine H. Aide HHS 3/12/1992 6005-A Old Frederick Road Baltimore MD 21228

Khandangle (Sadanand) Eric Citizen HD 2/28/2006 101 Carlisle Drive Silver Spring

Kharod Prabhakar M.D. LB 9/17/1997 8031 Ritchie Hwy Pasadena MD 21122

D 22212

Khayat Marwan Citizen HHS 5/20/2010 1715 15th Street, N.W., Apt. 19

Washington, D.C.

21674

Kiarie Patrick Aide MFCU-A 9/27/2005 1407 Mcculloh Street Baltimore MD 21217

King Kentrina Citizen HHS 2/16/1997 7101 Burshire Drive Temple Hillsl MD

Kioko Gideon M.D. LB 11/1/2005 3311 Todeddo Terrace Hyattsville, MD 20782

D08283

Kirby Richard David Aide HHS 6/18/1998 116 W. University Pkwy, A3 Baltimore MD 21210

Kirkland Mattie Aide F 3/6/2002 1017 Vanderwood Road Catonsville MD 21228

Kirven Lisa M.D. LB 5/2/1998 4018 Seton Avenue Bronx, NY 10466

D 42070

Kittrell Pamela PCP HD 3/28/1997 504 Clinton Street Cambridge MD 21613

Klingenstein Keith G. R.Ph HHS 12/5/1994 9115 49th Place College Park MD

10201

Knight Jessie Mae Citizen MFCU-A 6/18/2004 5102 Oaklawn Road Baltimore MD 21207

Monday, October 18, 2010 Page 34 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 35: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Knott William Citizen HD 4/1/2010 1401 West Joppa Road Towson MD 21204

Kolander Trina Nurse HHS 5/20/2010 809 Tydings Road #RS Havre De Grace MD

R 161268

Kordon Melvin M.D. LB 5/26/2010 9501 Old Annapolis Road; Ste. 302

Ellicott City MD 21042

D 06588

Korman William M.D. F 11/28/1989 2 High Stepper Court; #201 Baltimore MD 21208

D 06172

Koroma Nyamakoro Nurse HHS 1/20/1998 PO Box 382 Bladensburg MD

Krall Joseph D.D.S. HHS 12/20/1995 1318 Broadview Blvd Glen Burnie ME

03418

Krektyshev Sergey PCP HD 4/1/2003 281 Norht Van Buren Street Rockville MD 20850

Krulevitz Keaciel Kenneth M.D. F 5/16/1988 3306 Clarin Road Baltimore MD 21215

D 05946

Kundratic Diahann PCP HD 11/18/2002 17 Purple Plum Court Perry Hall MD 21236

Kuszmar Thaddeus P.A. HHS 9/20/2004 40 Sunrise Drive Rising Sun MD 21911

C 02205

Labertson Heather N. PCP HD 9/20/2004 31177 Rehobeth Road Westover MD 21871

Laboratory Management Service

Corporation F 10/24/1988 1008 Roxleigh Road Towson MD 21204

Lagmay Manuel R. Nurse HHS 6/20/2006 604 Menteth Point Drive Millersville MD 21108

Lake Anna Marie PCP HD 10/19/1996 L4976 Pintail Court Frederick MD 21701

Lakner Geroge S. M.D. LB 8/29/2005 70185 Fort McNair Washington DC

D 25404

Lambertson Heather Nicole Aide HD 9/20/2004 31177 Rehobeth Road Westover MD 21871

Monday, October 18, 2010 Page 35 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 36: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Landesman Renee K M.D. HHS 9/20/1996 11073 Gaither Farm Rd Ellioctt City MD

D 13405

Lane Denise Washington Citizen F 10/11/1997 1025 Webb Court Baltimore MD 21202

Lane Angela P. Citizen HHS 2/16/1997 5933 Chinquapin Parkway Baltimore MD 21239

Lang Joel J. D.P.M. HHS 3/20/2001 6839 Riverdale Rd Riverdale MD 20737

00234

Lange Paul A. M.D. LB 6/26/1997 1706 S. St, NE; #1 Washington DC

D 14520

Lankford, Jr. James E. Citizen HHS 8/14/1995 15309 Old Hanover Road Upperco MD 21155

Laurel Park Pharmacy Pharmacy F 6/10/1996 11646 Sun Circle Way Columbia MD

Lebow Frank L. D.P.M. HHS 8/17/1989 6611 Edenvale Road Baltimore MD 21209

#165

Lebson Arthur M.D. F 6/24/1991 3640 Fords Lane Baltimore MD 21215

D 17042

Lee Yung M. M.D. LB 7/6/2000 4414 Langtry Dr Glen Arm MD

D 19817

Lee Nadine PCP HD 6/30/2006 310 Crusader Road Cambridge MD 21613

Lee Terri Sha-Nae Aide MFCU-A 2/2/2005 3201 Lawnview Avenue Baltimore MD 21213

Lee Michael Aide HHS 8/19/1999 512 Quincy Street, N.W. Washington DC

Lester Andrew Todd Citizen HHS 8/20/1998 12402 Lime Kiln Rd Fulton MD 20759

Levi Ellis D.D.S. HHS 3/22/1995 17 Millstone Road Randallstown MD

Levitsky Leon R. M.D. LB 1/15/2008 8100 Good Luck Road Lanham MD 20706

D 09187

Monday, October 18, 2010 Page 36 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 37: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Levitt Jeffrey M. M.D. LB 2/24/1993 11415 Orleans Way Kensington MD 20895

D 29875

Levitt Keith M.D. LB 12/1/2009 22 S. Greene Street Baltimore MD 21201

D 28247

Lewis Samuel R. M.D. F 5/12/1989 11102 Hudee Court Mitchellville MD

D 06599

Lightfoote, II William E. M.D. HHS 11/20/2000 1328 Southern Avenue, S. E. Washington DC

DC-4267

Lin Tsu-Chun M.D. LB 3/20/2002 377-B Gambrills Road Gambrills MD 21054

D 24756

Lindemann Keith Jan M.D. LB 8/30/2005 23140 Moakley St; Suite 2 Leonardtown MD

D 50458

Linden/Williams Joanie PCP HD 9/26/1997 3901 Greenmount Avenue; 2nd Floor

Baltimore

Lindsey Glenda L. D.D.S. HHS 6/1/1997 7819 Liberty Rd Baltimore MD 21244

D 01532

Lipnick Robert M.D. HHS 12/19/2002 6238 29th Street, NW Washington DC

DC 11982

Lipscomb Bernadette Aide HHS 8/10/1994 1837 Bolton Street; Apt. #3 Baltimore MD 21217

Little Albert G. M.D. LB 12/31/2008 9505 Reisterstown Road, Ste 25

Owings Mills MD

D 19592

Logsdon Katherine PCP HD 7/10/1997 310 N. Cannon Avenue Hagerstown MD

Londa Saleh Aide HHS 8/18/2005 4202 Kaywood Drive; Apt. 8 Mount Rainier

Loot-Gayoso Ofelia M.D. LB 7/22/2009 5411 Old Frederick Road Baltimore MD 21229

D16328

Loveman Joseph Citizen HHS 11/25/1983 333 Harlem Lane Baltimore MD 21228

Loya Florentino M.D. LB 12/29/2007 6400 Marlboro Pike District Heights

D 41296

Monday, October 18, 2010 Page 37 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 38: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Lucas Dorothy PCP HD 4/15/1998 908 E. Valley Street; #11 Baltimore MD 21202

Luciuk James Nurse LB 8/28/2007 8536 Storch Woods Drive Savage MD 20763

R107868

Luckey Willie PCP HD 9/1/2001 6709 Kincheloe Avenue Baltimore MD 21207

Lyles Delores PCP HD 12/1/2007 400 W. South Street Apt. B Frederick MD 21701

Lynch Ray A. M.D. HHS 4/22/1997 9559 Wandering Way Columbia MD 21045

Lynch Kevin P. R.Ph HHS 10/20/2003 14601 Burbridge Road, S.E. Cumberland MD

RP 03701 1T

Mack Belinda Ann PCP HD 11/26/2001 7812 South Hampton Drive; Apt. 1

Glen Burnie

Macrey Angela V. PCP HD 9/26/1996 6002 Moravia Park Drive; #C-2

Baltimore MD 21206

Madison Stanley M.D. F 2/28/1990 1529 E North Ave; PO Box 23231

Baltimore MD 21203

D 07094

Mahase Vidhyanand R.Ph HHS 12/20/2009 Fort Dix FCI, P.O. Box 2000 Fort Dix NJ 08640

17711

Major Godfrey W. M.D. LB 6/20/2007 7801 York Road Towson MD 21801

D 42197

Makker Ram S M.D. LB 10/14/2009 500 Upper Chesapeake Drive

Bel Air MD 21014

D48367

Malamud Yasmin Redon M.D. HHS 9/20/1998 110 Irving St, NW Washington DC

DC 19142

Malekzodeh Assadullah Citizen F 6/8/1993 12221 Park Lawn Drive; Ste. 170

Rockville MD 20850

Mallory, III Herman C. Citizen F 2/16/1997 615 N. Rose Street Baltimore MD 21205

Manasan Eloida M.D. LB 4/9/1997 9602 Shipwright Drive Burke VA 22015

D 19597

Monday, October 18, 2010 Page 38 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 39: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Manekin Steven F. M.D. LB 5/18/2005 1049 S. Charles St Baltimore MD 21230

D 13700

Marcalus Steven R.Ph LB 9/9/1987 12312 Savanna Court Bishopville MD 21813

A1-0001956-DE

Margolius Jane Citizen F 6/21/2001 17 Tivoli Lake Court Silver Spring

Marion Robert Aide MFCU-A 10/7/2004 2548 Loyola Northway Baltimore MD 21215

Marsh Arthur M.D. LB 7/16/2010 700 East Main Street Ste. 102

Salisbury MD 21804

D 64981

Marshall Tinnie PCP HD 10/1/1997 4121 Woodhaven Baltimore MD 21216

Marshall Peter Citizen F 11/3/1993 3114 S. E. 17th Place Cape Coral FL 33904

Marshall Ashley PCP HD 4/15/2002 207 Wakefield Road Hagerstown MD

Martin Janet S. M.D. LB 12/8/2005 6510 Kenilworth Avenue #2400

Riverdale MD 20737

D 35386

Martinez Christine PCP HD 6/30/2003 6604 Maple Avenue Baltimore MD 21215

Martinez-O'Hara Joseph J. M.D. LB 7/19/1997 1203 E. Ferguson Pharr TX 78577

D 24049

Mary Lou's Assisted Living

Corporation HD 7/27/2005 8431 Newark Road Newark MD 21841

Mason, III Samuel M. Citizen HHS 10/20/2003 20 BON Oak Court Reisterstown MD

Massey Dean D.D.S. HHS 8/24/1987 320 West Main Street Crisfield MD 21817

06959

Matthews Thomasina Citizen HHS 7/20/2005 8019 Mollye Road; Apt. F Pikesville MD 21208

Matthews Shandell Aide MFCU-A 1/21/2003 3822 Regency Parkway Suitland MD 20746

Monday, October 18, 2010 Page 39 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 40: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

McAllister Katrina Citizen F 12/20/1995 428 E. North Avenue; 3rd Floor

Baltimore MD 21202

McAnally Bryan M. Aide HHS 1/28/2003 139 Lassiter Circle Finksburg MD 21048

McBride Margo Shelia M.D. LB 4/12/2005 54 Regatta Bay Court Annapolis MD 21401

D 45096

McClain Vivian Regina PCP HD 4/28/1998 2227 W. Saratoga Street Baltimore MD 21223

McClary Rhonda Aide MFCU-A 2/14/2006 4803 Overton Court Baltimore MD 21229

McCrary Bernard Citizen HD 4/1/2010 1416 Clarkview Road Baltimore MD 21209

McCready Leah T. Citizen HD 7/12/2006 5651 Burnstville Road Marion MD 21838

McDonald Allan D. D.D.S. HHS 9/20/1998 109 Wright Street Frostburg MD 21532

McGregor Clinton Aide HHS 11/4/2000 7930 Brock Bridge Road Jessup MD 20794

McInnes Thomas K. O.D. HHS 2/20/2002 19739 Selby Avenue Poolesville MD 20837

TA 1284

McKenna Karen Nurse HHS 8/20/2007 843 Kellogg Road Lutherville MD 21093

McKenzie Deana Citizen HHS 9/20/1999 19 Marview Drive Berlin MD 21811

McLaren Martin M.D. HHS 12/20/2009 FCI Petersburg Low, P.O. Box 1000

Petersburg VA 23804

D16372

McLean Nakita S. Aide MFCU-A 8/8/2005 6612 Eberle Drive Baltimore MD

McNeil Robert D.D.S. LB 5/16/1998 6721 Ritchie Hwy Glen Burnie

D 11761

Medicine Shoppe Pharmacy

Pharmacy LB 7/14/2009 59

Monday, October 18, 2010 Page 40 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 41: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Mehlman Susan K. Ph.D. F 5/24/2007 12103 Ridge Valley Road Owings Mills MD

07150

Mehta Barry (Bahrat M.) Citizen F 3/13/2003 5501 Oakland Mills Road Columbia MD 21045

Meiller Morris M.D. LB 6/13/2005 9015 Woodyard Road; Suite 209

Clinton MD 20735

D 08540

Meldrom Carole J. Nurse HHS 10/20/2002 1145 Oakview Drive Crownsville MD 21032

Melvin-Hodge Fayanna Citizen F 9/24/1997 2907 Rosalind Avenue Baltimore MD 21215

Merendino, Sr. John J. M.D. HHS 6/12/1997 4701 Randolph Road Rockville MD 20852

D 08544

Merillat Suzanne Marie Nurse HHS 12/20/2004 105 Rockdale Drive Silver Spring

LP 27045-MD

Merriweather Sue Grace Aide F 10/28/1999 6405 Brays Street Lanham MD 20706

Mid-Atlantic Compassionate

Corporation HD 2/4/2005 7277 Wisconsin Ave; Ste 300

Bethesda MD 20814

Middleton Barbara PCP HD 8/19/1994 420 A. Captain Circle Annapolis MD 21401

Middleton William F. Citizen F 1/22/1993 21 Fenceline Drive Gaithersburg MD

Milan Jose Antonio Olivari M.D. HHS 4/18/2002 Villa Olimpia 2: #A-12 Yauco PR 00690

Miller Edwin R. Citizen HHS 8/20/2001 4601 E. Monument St Baltimore MD 21205

Miller Gerald A. M.D. HHS 2/1/1994 3455 Wilkens Ave Baltimore MD 21229

D 13275

Miller Carol D. P.D. F 4/19/2001 46 Cannon Drive Berlin MD 21811

10152

Miller Louis M.D. LB 12/10/2007 1838 Greene Tree Road, Suite 300

Pikesville, MD 21208

D 07421

Monday, October 18, 2010 Page 41 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 42: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Miller Jewel Lynne Aide HHS 6/27/1991 3026 Tennessee Avenue Baltimore MD 21227

Miller Keith B. Chiropractor

LB 11/30/2001 11618 Reisterstown Road Reisterstown MD

S01427

Miller Oram D.O. HHS 4/20/2004 P.O. Box 2223 Fairfield IOWA

02085(IA); H29971(MD)

Miller, Jr. Thomas Aide HHS 4/8/1997 1217 Randalia Road Chesapeake City, MD

Mills Ronald J. Citizen F 3/17/1992 17 Water Street; Apt. #6 Gaithersbur MD

Ming Bernell LMSW HHS 1/18/2007 294 Putnam Avenue Brooklyn NY 11216

G11284, 064132NY

Miranda-Solari Artemio M.D. LB 7/31/2000 889 W. Lombard St Baltimore MD 21201

D 23276

Mireille Noumi N. PCP HD 11/23/2003 6800 Highview Terrace; #301

Hyattsville MD 20782

Mistysyn Christine J. Aide HHS 6/20/2000 417 E. Mifflin Street Orwigsburg PA 17961

Mitchell Joshua M.D. LB 5/18/2010 2202 Garrison Blvd Baltimore MD 21216

D 08782

Mitchell Terita Aide HHS 7/7/1992 2756 Tivoly Avenue Baltimore MD 21218

Moaddab Mohammed B. D.D.S. LB 5/20/2003 5905 Ipswich Road Bethesda MD 20814

9427

Molina Gerardo Citizen HHS 9/19/2002 C-31 DuQuesa St; Montibello Development

Hormiguero PR

Molly's House of Hope Corporation HD 6/6/2006 12801 Meadowbrook Lane Waldorf MD 20601

Molmenti Luis A. M.D. HHS 2/20/2006 60 Bartlett Road Plymouth MA 02360

Momah Clement I. M.D. LB 12/20/2000 8301 Ashford Blvd Laurel MD 20707-

D 46933

Monday, October 18, 2010 Page 42 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 43: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Monroe Charles A. Citizen HHS 9/15/1992 1109 Ashburton St Baltimore MD 21216

Montgomery Jessica E. Aide HHS 7/20/2006 304 Crusader Road; Apt. 103

Cambridge MD 21613

Montgomery Co. Family Life Ctr. Corporation F 4/25/1991 7101 Wisconsin Avenue; #1404

Bethesda MD 20814

Montgomery County Taxi Corporation HHS 6/30/1994 806 S. Frederick Road Gaithersburg MD

Moore Lillie Ruth Citizen HHS 10/20/2002 353 S. Center St.; Apt. 19A Orange NJ 07050

Morgan Rosa E. PCP HD 7/19/1991 2732 Parkwood Avenue Baltimore MD 21217

Morris Janice PCP HD 3/4/1991 4106 W. Forest Park Avenue

Baltimore MD 21207

Morris Andrea PCP HD 7/15/1997 8978 Centerway Road; Court IV

Gaithersburg MD

Morrison Sharese I. Aide HHS 10/18/1993 802 Dartmouth Baltimore MD 21212

Morton Denise Bell Aide HHS 6/30/1994 1305 Kitmore Road Baltimore MD 21239

Morton Charles Nurse HHS 4/12/1993 9108 Abigail Drive Crisfield MD 21237

Moss Brian Leslie Citizen F 3/17/1992 19731Framingham Drive Gaithersburg MD

Motley Robin Aide HHS 8/20/2008 1549 Southview Dr Apt. 102

Oxon Hill MD 20745

Mueller Annemarie RDH HHS 10/20/2004 5260 Duke Street; Apt. 411 Alexnadra VA 22304

4304

Mullan Paul A. M.D. LB 8/23/2000 7401 Olser Dr Towson MD 21204

D 08462

Muller Alfred M.D. LB 2/27/2002 1396 Piccard Drive Rockville MD 20850

D 15017

Monday, October 18, 2010 Page 43 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 44: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Murphy Leslie A. PCP F 2/28/2009 143 Haverhill Road Joppa MD 21085

Musikabhumma Anchaleee M.D. LB 6/28/2006 2300 Garrison Boulevard Baltimore MD 21216

D 17081

Naranjo Ynocencio Corporation HHS 10/29/1990 14720 Homecrest Road Silver Spring MD

Nash Roderick PCP HD 12/20/1991 1536 Pentwood Road Baltimore MD 21239

Nathanson Barry M.D. LB 10/18/1993 2200 Defense Hwy; #103 Crofton MD 21114

D 23454

Nathenson Lucille D.D.S. LB 3/6/2002 6901 Security Boulevard Baltimore MD 21244

07998

National Cardio Labs, LLC Corporation HHS 4/20/2010 1601 Alton Parkway Irvine CA 92606

Newcare Home Health Services, Inc.

Pharmacy LB 1/5/2007 3027 E. Madison Street Baltimore MD 21205

PW0101

Ngang Ita Nurse F 8/28/2004 9482 Ridgeview Drive Columbia MD 21046

27475

Nguyen Tuoc Kim D.D.S. HHS 6/17/1999 8003 Hasitng Hunt Court Severn MD 21144

Nguyen James An M.D. F 8/28/2005 5601 Loch Raven Blvd; Ste 301

Baltimore MD 21239

D 39748

Nimley Lucia PCP HD 8/27/1996 350 Childress Terrace Burtonsville MD

Norris Diana Lynn Dee Aide HD 6/5/2005 1022 Grove Hill Road Halethorpe MD 21227

North Catherine M.D. LB 12/10/2007 1100 Copper Hill Road Baltimore MD 21209

D 36128

Nukks Shelley Lynn PCP HD 3/5/2001 1088 Wadsworth Way Baltimore MD 21239

Nurse Express, LLC Corporation HD 1/15/2005 10 East Lee St; Ste 2406 Baltimore MD 21202

Monday, October 18, 2010 Page 44 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 45: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Nwaehiri Callixtus P.D. LB 1/5/2007 1439 Huntfield Way Jarrettsville MD 21084

10899

Obeahon Alexander C. Aide HHS 6/22/1998 34 Chapel Town Circle Baltimore MD 21236

Obeng Esther Aide HHS 9/20/2006 6717 Tower Drive; Apt. 104 Alexandria VA 22306

1401-095243

O'Berry Christin Nurse HHS 3/20/2008 21 Bridgeview Court Baltimore MD 21236

R156998

Ogbonna Chinonso Ndidi Aide HHS 9/22/2003 36 Heraldry Court Baltimore MD 21244

Oglesbee Megan Aide MFCU-A 12/18/2005 204 Airport Street Keyser WV 26726

Ogundele Gbengo Benson Aide HHS 9/19/2002 800 Fairlawn Avenue; #2 Laurel MD 20707-

Ogundeyi Aboyomi Aide MFCU-A 9/9/2010 5221 Harford Road, #3 Baltimore MD 21214

Ohiokpehai Tajudeen M.D. LB 12/29/2006 2600 Liberty Heights Avenue

Baltimore MD 21215

D30115

Ojewoye Paul R.Ph HHS 6/20/2007 218 Karin Boulevard Townsend DE 19734

13396

Ojuko Absayo Citizen F 4/28/2007 16 Liberty Place Road, Apt. 8

Baltimore MD 21244

Okafor Ndubuisi M.D. HHS 3/19/2009 P.O. Box 759 Minersville PA 17954

D43460

Okafor Augustine Nurse HHS 4/20/2006 3420 Maryvale Road Baltimore MD 21244

Oke Oluwole Citizen HHS 3/20/2007 P.O. Box 31902 Capitol Heights

PRC899

Okine Katerina PCP HD 1/3/2007 47 Squanto Court Middle River MD

Okoye Godwin R.Ph HHS 8/20/2003 Montgomery FPC; Montgomery Air Force Base

Montgomery AL

RI 020809

Monday, October 18, 2010 Page 45 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 46: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Omer Tarig A. Citizen HHS 7/20/2005 6337 Kinsey Terrace Lanham MD 20706

Open Arms Assisted Living

Corporation HD 5/18/2005 104 Charles Street Sudlersville MD

Oppenheim Steven Citizen HHS 9/26/1990 6 Sour Cherry Court Darnestown MD

Optimum Care Medical Center

Medical Ctr. Corporation HHS 9/20/2001 444 N. Frederick Ave; #307 Gaithersburg MD

Orem Medical Corp Corporation HHS 6/12/1997 2413 Haddenhurst Court Fallston MD

Orneus Renald Aide MFCU-A 11/27/2008 765 Division Street Salisbury MD 21804

Orth Debra C. Aide HHS 10/18/2001 4300 Stanwood Avenue Baltimore MD 21206

Ortiz Armando L. Citizen HHS 2/20/2000 7082 MacBeth Way Sykesville MD 21784

Osborne Tamara PCP HD 11/7/2005 73 Swan Street Aberdeen MD 21001

O'Shaughnessy Timothy J. Citizen HHS 5/24/1999 6106 Pine Branch Rd Bethesd, MD 20816

O'Shea Frank M. M.D. LB 8/9/2000 3901 Fox Hill Dr Ellicott City MD

D 27961

Oshodi Eunice R.Ph HHS 7/20/2008 2730 Pennsylvania Avenue Baltimore MD 21217

14276

Osrud Vincent J. Nurse HHS 9/20/2000 R. R. 1; box 782 Hollywood MD 20636

Ostrovsky Roman M.D. F 8/16/2006 5018 Dorsey Hall Drive Ellicott City MD 21042

D 51563

Owens Eugene M.D. HHS 12/31/1993 1735 E. Federal St Baltimore MD

D 12607

Oyler George A. M.D. LB 11/18/2003 2924 Guilford Avenue Baltimore MD 21218

D 46921

Monday, October 18, 2010 Page 46 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 47: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Pagalunan Gertrude Corporation HD 5/15/2005 9515 Lawnsberry Terrace Silver Spring

Pagano Dwight M.D. HHS 5/19/2005 444 E. 20th Street; Apt. 3D New York NY 10009

D 26063

Page Bobbi Jo Aide HHS 1/20/2010 P.O. Box 105 Barnes City, IA

MT0048961, CNA224636,

Pak Jim Su P.D. LB 4/7/2005 Hickory Plaza Pharmacy; 10805 Hickory Ridge Road

Columbia MD 21044

Pal Bimal K. M.D. F 9/30/1995 3750 Chateau Ridge Dr Ellicott City MD 21042

D 12748

Palladeno Angela K. Aide HHS 2/27/1992 3-D BywaySouth Baltimore MD 21221

Panteleakis Peter Citizen F 10/24/1988 1008 Roxleigh Road Towson MD 21204

Park Do Sun M.D. HHS 4/10/1995 13805 Turnmore Rd Silver Spring

D 30102

Park Kyung S. M.D. LB 5/17/2000 1823 Duffield Lane Alexandria VA 22307

D 36375

Parker April R. Aide HHS 9/20/2000 3515 Madison Place Hyattsville MD 20782

Pasatiempo Abner M.D. LB 4/26/2006 115 Enfield Road Baltimore MD 21212

D 45431

Patel Ketankumar P.D. LB 7/14/2009 5951 Cecil Way Eldersburg MD 21784

10301

Pathak Arvind K. M.D. LB 7/18/2001 6930 Little River Turnpike Annandale VA 22003

D 12867

Paul Haendel Aide MFCU-A 2/27/2008 10553 Jason Lane Columbia, MD 21044

Paye Isiwatu Aide HHS 3/20/2007 3 Maidstone Court, Apt. M Rosedale MD 21237

Payne, Jr. Arnold R.Ph HHS 5/20/2001 3549 Greenmount Avenue; #2

Baltimore MD 21203

Monday, October 18, 2010 Page 47 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 48: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Pediatric Plus Corporation HD 1/15/2005 10 East Lee St; Ste 2406 Baltimore MD 21202

Perez Yolanda Aide HHS 12/18/2001 1752 Gorsuch Avenue Baltimore MD 21218

Perry Deborah Citizen HHS 2/11/1993 604 McCabe Ave Baltimore MD 21212

Persinger Virginia PCP HD 8/25/1993 Route 2; Box 179 Newberg MD 20664

Pertnooy Allen B. D.D.S. LB 10/23/2002 821 Eastern Boulevard Baltimore MD 21221

03749

Peters Colleen Nurse HHS 11/20/2007 288 Wye Knot Court Queenstown MD

R158619

Peterson Jocelyn M. Citizen F 11/3/2005 29581 Bright Spot Road Highland CA 92346

Peterson Patricia M. Citizen HHS 4/13/1994 1856 Beth Ridge Circle Forest Hill MD 21050

Peterson Ralph M. Citizen F 11/3/2005 29581 Bright Spot Road Highland CA 92346

Petway Dena Joan PCP HD 8/26/1996 6309 Elliott Street Baltimore MD 21224

Phalsaphie Mansour M.D. LB 3/25/1998 4003 Hidden Creek Henderson KY 42420

D 39182

Pharmacare, Inc. Cockeysville Pharmacy Pharmacy F 7/25/2000 10255 York Road Cockeysville MD

P 01589

Phattiyakul Pricha M.D. LB 9/19/2001 100 Hospital Road; Calvert Memorial

Prince Frederick

D 17730

Phillips Patricia A. Aide HHS 10/18/2001 2325 Barclay Street Baltimore MD 21218

Pierce William David M.D. LB 3/9/2004 11042 Nicholas Lane; Suite B

Berlin MD 21811

D 56681

Pittman Thomas A. M.D. HHS 7/17/1991 7498 Sea Change Columbia MD 21045

D 10875

Monday, October 18, 2010 Page 48 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 49: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Pitts Mark D.D.S. LB 2/10/2009 2100 Old Farm Drive Frederick MD 21702

11347

Pleas Barbara A Aide HHS 8/11/1997 3267 Queenstown Dr Mt Ranier MD 20712

Pointer Brenda Denise Aide HHS 9/19/2001 15 N. Calhoun St Baltimore MD 21223

Pollock Hamilton Citizen HHS 12/20/1995 211 E. Lombard Street Baltimore MD 21201

Pollock Natasha Nurse HHS 2/18/2010 17008 Downing Street Gaithersburg MD

AL 1-105020

Polsin Michael J. Nurse HHS 3/18/2004 34602 Blakistone Road Hollywood MD 20636

Poole Milton L. Citizen HHS 6/20/2006 3916 23rd Parkway; #22 Temple Hills MD

Pooya Manoochehr M.D. LB 11/7/2007 700 7th Street SW #2 Washington DC

DC4594, D 05507

Potash Michael M.D. LB 12/16/2009 2331 Old Court Road, Apt. 409

Baltimore MD 21208

D09463

Powell Velma E. L. M.D. HHS 1/23/1992 6201 Greenbelt Road College Park MD

D 25624

Powell Jack M.D. LB 1/26/2007 23704 Ocean Gateway Mardela Springs

D 36483

Powell Nicheia Aide HHS 9/19/2002 704 Winston Avenue Baltimoe MD 21212

Powell Richard M.D. LB 8/25/2004 6501 N. Charles Street Baltimore MD 21285

D 58515

Powell Toni Darnell PCP HD 9/18/1995 2519 Marbourne Avenue Baltimore MD 21230

Prager Harris J. D.P.M. HHS 10/27/1993 420 S. Crane Hgwy; #1 Glen Burnie

00961

Prescimone Doreen Nurse HHS 10/20/2003 4806 Berry Hill Circle; Apt. 103

Perry Hall MD 21128

R 116997

Monday, October 18, 2010 Page 49 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 50: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Press Zachary D.D.S. HHS 1/4/1995 4805 Garrison Blvd Baltimore MD 21215

09179

Pribadi Jean W. M.D. LB 6/13/2008 10632 Little Patuxent Parkway

Columbia MD 21044

D 30510

Progressive Care Ambulance Serv.

Corporation F 4/27/2000 c/o P.O. Box 536 Jessup MD 20794

Pullen Sonia A. Citizen HHS 2/15/1996 1308 N. Kenwood Avenue; 2nd Floor

Baltimore MD 21213

Pulliam's Contracting Corporation HD 10/20/2009 45464 Stoney Run Drive Great Mills MD 20634

Purdum Pharmacy Pharmacy F 10/17/2008 6901 York Road Baltimore MD 21212

Purnell Elmer A. M.D. LB 12/11/1992 652 W. Main Street Salisbury MD 21801

D 09429

Qaiyumi Waheeda M.D. LB 2/5/2004 9650 Santiago Road; #110 Columbia MD 21045

D 24705

QRSS Corporation HHS 6/12/1997 4701 Randolph Road Rockville MD

Queen Jennifer PCP HD 5/16/2005 4527 Northwood Drive Baltimore MD 21239

Rabb Willie DPM LB 8/1/2006 420 S. Crain Highway; #2 Glen Burnie

01257

Radulski Joanne B. Citizen F 7/8/2010 2124 Oaklyn Drive Fallston MD 21047

Radvan-Ziem Stanley A. M.D. HHS 11/1/1990 9400 Old Georgetown Road

Bethesda MD 20814

D 10902

Raines Bannister L. M.D. LB 1/27/2005 660 Kenilworth Dr.; #206 Towson MD 21204

D 17735

Rakhunov Izabella PCP HD 12/17/2002 1 Russern Court; 2A Baltimore MD 21215

Rancocas Valley Anesthesia Assoc

Corporation HHS 11/14/2002 Sunset Road Willingboro NJ 08046

Monday, October 18, 2010 Page 50 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 51: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Rapkin Harvey R.Ph F 12/19/2008 2207 Shefflin Court Baltimore MD 21209

Ray Douglas M.D. HHS 4/6/1992 10208 Prince Place Largo MD

Reddy Vijayalakshmi M.D. LB 10/13/2010 821 N. Eutaw Street, Ste. 312

Baltimore MD 21201

D 47644

Regency Hlth Services, Inc.

Corporation HHS 5/6/2004 7420 Marlboro Pike Forestville MD 20028

Reid Jesse Aide HHS 9/20/1999 3806 Brighton Street Baltimore MD 21216

Reilly Elizabeth Citizen HD 9/15/2008 3100 North Ridge Road Ellicott City MD

Rermgosakul Adul M.D. F 9/30/1995 5632 Annapolis Rd-Suite 8 Bladensburg MD

D 18441

Resolutions Unlimited, Inc.

Corporation F 3/2/2004 204 E. Joppa Road Towson MD 21286

Reynolds Angelo PhD F 7/14/2007 1027 Savvanna Drive LaPlata, MD 20646

Reynolds (Mullins) Debbye Lynn Nurse HHS 11/20/2006 P.O. Box 7612 Hyattsville MD 20787

LP 30845

Rhee Aphonso Y. M.D. LB 12/4/1998 1224 Brook Hollow Road Towso, MD

D 13631

Ricci Renzo M.D. LB 1/26/2007 3125 Baltimore Blvd, Box 500

Finksburg MD 21048

D 25804

Richardson Cheryl E. M.D. HHS 9/19/1999 84 Willis Street Westminster MD

D 37919

Richardson Gravney A. M.D. HHS 8/10/1994 40 Joyceton Way Upper Marlboro

19756

Richardson Carolyn E. Citizen HHS 2/15/1996 2601 Greenmount Avenue; 1st Floor

Baltimore MD 21218

Richardson Joseph M. D.D.S. HHS 1/6/1995 1407 Dilston Road Silver Spring

Monday, October 18, 2010 Page 51 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 52: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Ritch Sherry Aide HHS 1/10/2002 5504 Windsor Mill Road Baltimore MD 21207

Rivera Rose M. Nurse HHS 6/17/2004 500 Wick Lane Blue Bell PA 19422

RN-332695-L

Riverview Nursing Ctr, Inc.

Corporation HHS 10/18/2001 1 Eastern Boulevard Baltimore MD 21221

Roane Donald M.D. LB 5/21/2010 1616 Forest Drive Annapolis MD 21403

D 10698

Roark David Nurse HHS 4/20/2010 277 Geremma Drive, Apt. B Ballwin MO 63011

R 129614

Roberts Isaac Aide MFCU-A 1/18/2007 8500 Goshen View Drive Gaithersburg MD

Roberts, Jr. Leroy Citizen HHS 3/7/1991 6 Papago Court Randallstown MD

Robinson Lawrence PCP HD 5/3/1996 8806 Lanier Drive; #101 Silver Spring

Roby Neil O. Citizen HHS 5/20/1998 13190 Linden Station Clarksville MD 21209

Rodkey Jeffrey Lee Pharmacy HHS 8/18/2005 23621 Cemetery Road Chance MD 21821

10073

Rodrigues Cheryl PCP HD 5/25/2005 23249 Colton Point Road Avenue MD 20609

Rodwell Dino Corporation HHS 6/20/2002 8314 Glenmar Road Ellicott city MD 21045

Roffman Benjamin Citizen HHS 8/17/1987 6314 Greenspring Ave; Apt. 6

Baltimore MD 21207

Rogers Tena Citizen F 5/8/2003 2905 Garrison Boulevard Baltimore MD 21216

Romero Yolanda O.T. HHS 1/20/2004 P.O. Box 2784 Baltimore MD

01559

Rorie Valerie R. PCP HD 6/9/2004 5506 Wayne Avenue Baltimore MD 21207

Monday, October 18, 2010 Page 52 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 53: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Rose Manor Assisted Living

Corporation HD 9/15/2008 3100 North Ridge Road Ellicott City MD

Rosen Nancy Citizen F 5/26/2001 8330 Greensboro Drive; #423

McLean VA 22102

Rosov Howard L. D.D.S. HHS 10/20/2004 1106 Spy Glass Drive Arnold MD 21012

5349

Ross Bradford A. M.D. LB 4/27/1998 200 Milton Avenue Fallston MD 21047

D 26689

Rothelder David D.D.S. HHS 5/18/1979 620 Aisquith Street Baltimore MD 21202

Rothman Leonard M.D. LB 4/24/1996 PO Box 5716 Incline Village

D 15256

Rothstein Binyamin D.O. LB 5/25/2005 Greenspring Shopping Ctr; 2835 Smith Ave; Ste 209

Baltimore MD 21209

H 30277

Roundtree Silverrene P M.D. HHS 6/28/1999 200 Oak St Mt. Pocono PA 18344

D 19789

Rowlette Bertha PCP HD 7/22/1998 8618 Bramble Lane Randallstown MD

Rowley Bethany Aide MFCU-A 6/8/2008 P.O. Box 632, 203 Clarence Street

Hyndman PA 15545

Royal Jeffrey L. Radiologist HHS 9/20/2000 4309 Glenrose Street Kensington MD 20895

R 03369

Rubin Seymour H. M.D. HHS 7/22/1991 7111 Park Heights Avenue Baltimore MD 21208

D 10187

Rucyamuzi Kenny Aide HHS 4/20/2006 11700 Old Coumbia Pike #1905

Silver Spring MD

1401105926 (VA)

Ruddock Thaddeus Citizen HHS 2/19/2009 7901 Bon Air Road Baltimore MD 21234

L01705

Rudman Michael M.D. HHS 8/22/2007 J Elmer Harp Medical Ctr Middletown MD 21769

D17106

Rudo Howard F. D.D.S. LB 8/24/2000 420 S. Crain Hwy; Ste 6 Glen Burnie

03816

Monday, October 18, 2010 Page 53 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 54: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Sadanand Home, Inc. Corporation HD 2/28/2006 101 Carlisle Drive Silver Spring

Sadri Manouchehr M.D. F 11/30/1996 2 Piney Meetinghouse Ct Potomac MD

D 30549

Samie Abdul Citizen HD 5/19/2006 4918 Grindon Avenue Baltimore MD 21214

Sampson Michelle PCP HD 4/3/1996 1015 Washington Street Cambridge MD 21613

Samuels Thomasina R. Aide HHS 3/10/1997 4301 23rd Parkway; Apt 10 Temple Hills MD

Sanborn Michele R. Nurse HHS 2/20/2001 772 Fairview Avenue; Apt. C

Annapolis MD 21403

Sanchuk Daniel Paul Citizen F 7/12/2000 9487 Canary Drive Bel Alton MD 20611

Sanders Kendall Aide HHS 2/15/2002 726 N. Carey Street Baltimore MD 21217

Sang Evadne M.D. LB 12/24/1991 Martin Luther King Ave Washington DC

D 24228

Sanghera Anil M.D. LB 11/28/2007 6919 Harford Road Baltimore MD 21234

D 24722

Santana Maria Citizen HD 5/24/2006 8511 Allenswood Road Randallstown MD

Santiago Feliciana PCP HD 3/1/2001 10920 Connecticut Avenue Kensington MD 20895

Santos Rene M.D. LB 1/15/2009 2835 Churchville Road Churchville MD 21028

D14036

Sarabia Erlinda S. Citizen F 8/12/2006 8316 Elvation Road Millersville MD 21108

Satogkit Supoj M.D. LB 12/11/1990 101 Medical Blvd Stockbridge GA 30281

D 19665

Scandaltato Frank PCP HD 2/10/1998 102 Palmetto Drive Edgewood MD 21040

Monday, October 18, 2010 Page 54 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 55: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Schade John Chiropractor

HHS 10/20/1998 103 Baughmans Lane; #204 Frederick MD 21702

Schauber Michael M.D. LB 4/25/2007 505 Dutchmans Lane, Suite B

Easton MD 21601

D 56373

Scheibe Melissa Lynn Aide HHS 6/20/2000 1111 St. Paul Place Baltimore MD 21221

Schlesinger Richard S. M.D. LB 6/2/2005 50 L Painters Mill Road Owings Mills MD

D 23329

Schott Alan J. D.D.S. HHS 2/4/1997 8016 Nighwind Court Baltimore MD

Schwartz Lyndell K. D.D.S. LB 11/15/2006 795 Aquahart Road Glen Burnie

03818

Schwartzberg Allan M.D. LB 8/11/2010 9021 Shady Grove Court Gaithersburg MD

D 10705

Scott Delores Elaine Nurse F 7/13/2006 11 Rebecca Lane Owings Mills MD

Scott Bernita E. Aide HHS 12/15/1993 602 Gibson Road Baltimore MD 21229

Searcey Vicky C. Nurse HHS 9/19/2002 3146 Middlesex Drive Toledo OH 43606

Senior Connections d/b/a SK Adult Daycare

Corporation HD 4/1/2010 1401 West Joppa Road Towson, MD 21204

Sera Carlos C. M.D. LB 9/30/1998 12000 Longridge Lane Bowie MD 20715

D 11001

Setaro John L. Psychologist

HHS 3/10/1997 19 Melanie Court Baltimore MD 21234

02364

Setlen Williams Citizen HHS 4/19/1985 4527 Tapscott Road Pikesville MD 21208

Settles Diane Aide HHS 9/29/1996 11919 L Tarragon Road Reisterstown MD

D 24228

Shade David M.D. F 6/20/1984 14 Warfield Avenue La Vale MD 21502

04758

Monday, October 18, 2010 Page 55 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 56: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Shah Dinesh M.D. LB 9/23/2010 2327 Pulaski Highway, Ste. 101A

North East, MD

D 23334

Shamaeizadeh Ali M.D. LB 3/3/2004 710 Lisbon Center Dr; Ste H Woodbine MD 21797

D 28857

Shandler Melvin LCSW HHS 4/20/2009 P.O. Box 1000 Cumberland MD

00934

Shelton Pam PCP HD 4/26/1995 183 Fairfield Drive Frederick MD 21702

Shepherd Family Services, Inc.

Corporation HD 2/6/2007 3450 Laurel Fort Meade Road

Laurel MD 20724

Sheppard Millard C. Citizen F 4/27/2000 c/o P.O. Box 536 Jessup MD 20794

Sheridan Todd M.D. LB 9/28/2009 600 N. Wolfe Street Baltimore MD 21287

D 64256

Sherwood Shannon Dental Tech.

HHS 12/20/2009 855 Aurora Road Ernul NC 28527

13266

Shiraldi Teresa Nurse HHS 6/20/2005 3700 Misty Valley Court Abingdon MD 21009

R 070048

Shirazi Mahmaud M.D. LB 6/18/2007 5671 Royal Mile Blvd Salisbury MD 21801

D 46962

Showell Cora Louise Aide MFCU-A 12/6/2004 509 Bay Street Berlin MD 21811

Shpigelman Mikhail PCP HD 5/13/2002 2 Ameeht Court; 1C Baltimore MD 21215

Shraga Inessa PCP HD 5/30/2003 5 Wind Blown Court; Apt. 102

Baltimore MD 21209

Sic-Cua Karen Lynn Nurse HHS 11/18/2004 3139 Northway Drive Baltimore MD 21234

R 112181

Sichinava Inga PCP HD 3/7/2005 2001 Allanwood Court Silver Springs

Siegel Irving Optometrist HHS 9/10/1996 4251 Wilson Blvd Arlington VA 22203

0601-000279

Monday, October 18, 2010 Page 56 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 57: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Sierra Myrna Luz Vigo M.D. HHS 4/18/2002 67 Toledo Street Bel Monte, Mayaguez,

Sierra Mountain Enterprises

Ltd. Corporation F 4/30/2004 Nevada

Silverman David M.D. HHS 2/18/2010 17164 Braxton Street Granada Hills CA

G35319

Simmons Stephanie Citizen HHS 3/20/2001 2712-A Gatehouse Drive Baltimore MD 21207

Simmons Kevin Citizen F 5/27/2006 10356 Kentsdale Drive Waldorf MD 20603

Simms Rena C. PCP HD 5/12/1993 3705 W. Forest Park Ave Baltimore MD 21215

Simon Jock M.D. LB 11/5/2008 30686 Satterfield Court Salisbury MD 21804

D 28257

Simons Evelyn Nurse HHS 12/20/1998 13631 Colgate Way Silver Spring

Simpson Cleveland Cole PCP HD 2/20/1998 3019 Garrison Blvd Baltimore MD 21216

Singh Bhupinder M.D. LB 6/27/2008 200 Hospital Drive, Suite 500

Glen Burnie

D 23341

Singh Mahindra Nurse HHS 6/19/2008 2 Pissaro Court North Potomac

R050514

Singletary Mitchell Aide HHS 9/1/1992 6646 Collinsdale Road Baltimore MD 21234

Singleton Faith R. Citizen HHS 6/11/1990 4408 Old Frederick Road Baltimore MD 21229

Singleton Celestyne Aide HHS 9/2/1992 17 Orenco Court Baltimore MD 21220

Skinner Hubert G. M.D. LB 5/8/2006 11085 Little Patuxent Pkwy; Suite 205

Columbia MD 21044

D 10586

Skipworth Robert D. M.D. LB 10/31/1999 P O BOX 6 Laurel MD 20707

D 28906

Monday, October 18, 2010 Page 57 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 58: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Skrinskaya Natailya PCP F 10/1/2002 3720 Bel Pre Road; Apt. 9 Silver Spring

Slavin Carl J. M.D. LB 7/26/2006 3231 Superior Lane; #A2 Bowie MD

D 33271

Sliger Traci PCP HD 11/28/2000 8505 George Washington Hwy

Oakland MD 21550

Sloan Nina Citizen HHS 12/20/2009 11 Foxmoor Court Owings Mills MD

SMCHD Assignee of A. Abell

PCP HD 3/29/2006 19862 Preference Way Callaway MD 20620

Smith Elizabeth Ann Citizen MFCU-A 11/8/2003 6102 Alta Avenue Baltimore MD 21206

Smith Joyce Nurse HHS 6/17/1999 26 Dowling Circle Baltimore MD 21234

Smith Dale A. Aide HHS 2/19/1998 6010 Valley Court Lexington Park

Smith Carla Y. PCP HD 5/19/2006 9 Greenbrush Court Baltimore MD

Smith Lance C. Citizen F 10/1/1992 18800 Walkers Choice Road Gaithersburg MD

Smith Anthony Citizen F 8/29/2008 4228 Huntshire Road Foxridge MD 21133

Smith Donny W. LCSW F 8/28/2005 3745 Maple Crest Drive Knoxville MD 21758

08197

Smith Tammara Aide HHS 6/17/1999 6466 Roots Drive Glen Burnie

Smith Dorothy Julia Aide HHS 9/13/1997 912 Thompson Blvd Baltimore MD 21221

Smith Kevin P. Citizen HD 5/19/2006 9 Greenbrush Court Baltimore MD 21244

Smith Joseph H. M.D. HHS 5/16/1993 4705 Locust Hill Court Bethesda MD 20014

Monday, October 18, 2010 Page 58 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 59: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Smith Tammy LCSW F 8/29/2008 4228 Huntshire Road Foxridge MD 21133

09997

Smoot Melanie PCP HD 8/25/1993 Route 3; Box 120 Oak Avenue

La Plata MD 20646

Snead Paul Nurse HHS 2/20/2001 2108 Callow Avenue; Apt. #1

Baltimore MD 21217

Snell Sherman Leon Citizen HHS 7/22/1991 P.O. Box 549 Jessup MD 20794

Sodipo Steven P.D. LB 1/5/2007 2403 Nora Court Forest Hill MD 21050

11532

Solomon Larry Citizen F 10/24/1988 613 19th Street, N.E. Washington DC

Solomon Neil M.D. HHS 6/30/1994 901 Dulaney Valley Rd; Ste 602

Towson MD 21204

D 12963

Somaiya Mamta D. M.D. LB 11/16/2005 1 Trillium Circle; Apt. 1702 Dothan AL 36301

D 57457

Sood Rajan M.D. LB 2/13/2009 3060 Mitchellville Road Bowie MD 20716

D29097

Soriano Asuncion M.D. LB 5/23/2007 119 Capitol Hgts Boulevard Capitol Heights

D 17128

Soriano, Jr. Cesar M.D. LB 7/3/2004 119 Capitol Heights Blvd Capitol Heights

D 14468

Soudah Truman F. M.D. LB 6/1/2010 8813 Waltham Woods Road, Ste. 101

Baltimore MD 21234

D 18966

Spencer Deborah PCP HD 2/27/2007 429 Merryman Road Annapolis MD 21401

Srinivasan Sridhar Citizen HD 4/1/2010 720 Ft. Washington Avenue New York, NY 10040

SSS Nutrition & Dietetic Srvcs, Inc.

Corporation F 11/19/2008 235 Mill Street, Ste. 3 Hagerstown MD

Stalling Reginal W. M.D. LB 11/17/1999 9211 S. Normal Street Chicago IL 60620

D 22887

Monday, October 18, 2010 Page 59 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 60: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Starling Greg Citizen HHS 2/20/2008 3918 Elite Street Bowie MD 20716

Staton Kimberly V. Citizen HHS 6/11/1990 10 Duke of Windsor Ct; T4 Baltimore MD 21207

Steckler Scott D.D.S. F 2/15/2004 4002 Thistlebridge Way Rockville MD 20853

11778

Stepney Glenda PCP HD 8/18/1991 P.O. Box 535; Hunting Creek Road

Huntingtown MD

Stevens April Citizen MFCU-A 1/8/2008 1723 Crimson Tree Way, Apt D

Edgewood MD 21040

Stevenson Lawrence PCP HD 3/18/1996 6063 Marquette Road Baltimore MD 21206

Stewart Kevin R. Aide HHS 4/27/1992 5211 Goodnow Road; Apt. D

Baltimore MD 21206

Stocks Gregory Nurse LB 3/23/2004 140 E. Centre Street Baltimore MD 21202

103773

Stone Nancy Nurse MFCU-A 2/17/2006 502 Francis Nicholson Way Annapolis MD 21401

RO46901

Stoner Alfred Citizen F 3/17/1992 511 S. Frederick Avenue; #10

Gaithersburg MD

Storck Frederick D.D.S. HHS 11/25/1983 5220 Ten Oaks Road Clarksville MD 21029

Stratton Judith Z. Nurse HHS 4/20/2003 12308 Featherwood Drive; Apt. 13

Silver Spring

225977 NY

Stubbs Darryl Aide HHS 2/10/2002 4311 23rd Avenue; Apt. 1006

Temple Hills MD

Stumpfel Ernest Ronald PCP HD 12/7/1993 8411 Morven Road; Apt. I Baltimore MD 21234

Sumler Robert A. Aide HHS 11/12/1990 500 E. Madison Street Baltimore MD 21202

Summers Holly R. D.D.S. LB 3/1/2005 19221 Montgomery Village Professional

Gaithersburg MD

09207

Monday, October 18, 2010 Page 60 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 61: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Sungenis Albert M.D. LB 6/15/2006 5179 Harpers Farm Road Columbia MD 21044

D 37324

Supreme Health Systems, Inc.

Corporation HD 3/30/2008 4801 York Road Baltimore MD 21212

Sutton Veronica PCP HD 12/11/2009 1215 Etting Street Baltimore MD 21217

Sviriduk Ella PCP F 3/4/2007 18923 Lark Song Terrace Germantown MD

Swartz Linda PCP HD 8/17/1995 116 Columbia Street Cumberland MD

Tall Deborah A.Day D.D.S. HHS 2/7/1997 340 Tumbleweed Place Waldorf MD 20601

Tanna Peter M.D. F 12/31/1995 12708 Serpentine Way; #307

Silver Spring

D 24861

Tasher Jacob M.D. LB 5/26/2004 26 Erie Drive Slingerlands NY 12159

D 34871

Tasker Nelda L. Aide HD 6/10/2005 P.O. Box 1 Oakland MD 21550

Tauraso Nicola M.D. LB 8/12/2010 7051 Poole Jones Road Frederick MD 21702

D0011324

Taylor Esterlynn Aide HHS 9/20/2006 3119 Lunar Court Laurel MD 20724

A00044352 (MD)

Taylor Lafenus Donnell Aide MFCU-A 4/13/2004 3002 Spaulding Avenue Baltimore MD 21215

Taylor Hester Ann PCP HD 5/2/1996 104 S. Somerset Avenue Crisfield MD 21817

Temkin Diane PCP HD 12/15/2004 12005 Tarragon Road; Apt. G

Reisterstown MD

Temple Marion B. LCSW F 7/5/1989 14512 Sandy Ridge Road Silver Spring

Teves-Upshur Maria Citizen HHS 2/20/2008 P.O. Box 44714 Fort Washingto

Monday, October 18, 2010 Page 61 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 62: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Than-Riddle Khin Cho Cho M.D. LB 7/28/2004 1520 Crownsvile Road Crownsville MD 21032

D 52233

Thaung Phone Citizen F 3/17/1992 12636 Falconbridge Drive Darnestown MD

The Dixon Home Corporation HD 9/28/2009 409 North Lakewood Avenue

Baltimore MD 21224

30AL2547

The Medicine Shoppe Corporation LB 11/15/2006 Frostburg Village Shopping Center

Frostburg MD 21532

P 01901

The Medicine Shoppe Corporation HD 8/15/2008 8035 A Liberty Road Baltimore MD 21244

P01709

The Medicine Shoppe Corporation HD 11/15/2006 Frostburg Village Shopping Center

Frostburg MD 21532

The Medicine Shoppe Corporation HD 8/15/2008 8035 A Liberty Road Baltimore MD 21244

The Medicine Shoppe Corporation HD 8/15/2008 5900 Reisterstown Road Baltimore MD 21215

P01909

The Medicine Shoppe Corporation LB 7/14/2009 11813 1/2 Reisterstown Road

Reisterstown MD

P01686

The Smith House Corporation HD 1/1/2007 7117 Campfield Road Baltimore MD 21207

Thomas Henry Maurice Aide HHS 9/20/1999 3426 Edmondson Avenue Baltimore MD 21229

Thomas Patricia F. Aide HHS 9/19/1999 M.D. Correctional Inst-Women; P.O. Box 535

Jessup MD 20794

Thomas Lindwall D.D.S. HHS 6/5/1995 10912 Lockwood Drive Silver Spring

Thomas Tamara PCP HD 12/8/1997 90 Waverly Drive; #JJ102 Frederick MD 21702

Thomas Dwight N. PCP HD 9/17/1998 7049 Caldwell Road Pasadena MD 21122

Thomas Barbara Citizen HHS 12/5/1994 2135 Freemantle Court Waldorf MD 20601

Monday, October 18, 2010 Page 62 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 63: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Thomas Liston Citizen HHS 10/20/1998 14601 Burnside Southwest Cumberland MD

Thompson Colleen Nurse MFCU-A 5/17/2005 312 Boardwood Drive Rockville MD 20850

Thompson Carl N. PCP HD 7/24/1992 7412 Beech Avenue Baltimore MD 21206

Thompson Stephanie Aide HHS 2/18/2010 3008 Gallery Place, Apt. 33 Waldorf MD 20602

702685

Thompson Regina PCP HD 5/7/2003 524 Cedar Street Cambridge MD 21613

Thompson Yvonne PCP HD 3/27/1996 914 E. Biddle Street Baltimore MD 21202

Thornton Keisha PCP HD 3/12/2002 307 Barclay Street Salisbury MD 21853

Thornton Martha PCP HD 6/16/1993 402 Cedar Street Pocomoke MD 21851

Tibold Kinga M.D. LB 6/24/2010 11355 Pembrooke Square. Ste. 107

Waldorf MD 20603

D53753

Tilghman Anitra Citizen HHS 12/20/1995 3 Valley Arbor Court Essex MD 21221

Tinnin Louis Watson M.D. HHS 3/27/2006 RR 1; Box 215 Brucetonw Mill WV

D 12494MD; 11975WV; 13815KY;

Tolliver John M.D. HHS 8/20/1998 8629 Cross Chase Court Fairfax Station

D36868, 17373

Tom Victoria PCP HD 12/10/2004 201 Poplar Springs Road; Apt. I

Rockville MD 20850

Tomboyeke Idrisa Aide MFCU-A 7/25/2005 408 Torrington Place Silver Spring

Tompkins Lauren Nurse HHS 10/20/2005 601 N. Eutaw Street Baltimore MD 21201

R 093760

Torain Doris Citizen HHS 5/6/1988 2359 Sundew Terrace Baltimore MD 21209

Monday, October 18, 2010 Page 63 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 64: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Towers, Jr. Earl Madison P.D. LB 10/15/1990 214335 E C I; Route 1, Box 500

Westover MD 21871

Towns Charles D.D.S. HHS 11/25/1983 6400 Rossville Blvd Baltimore MD 21237

Treece Thaddeus R. PCP HD 3/15/1994 2628 E. Madison Street Baltimore MD 21205

Truby Derrick P.D. HHS 10/20/2010 7018 Hamlet Avenue Parkville MD 21234

12736

Tuason Rhonda Nurse HHS 9/19/2002 25 Halfpenny Lane Baltimore MD 21228

Tullner William W. M.D. LB 1/27/2006 9901 Medical Center Drive Rockville MD 20850

D 25136

Tunstall Daphne Citizen F 3/19/1996 400 Battery Drive Harve de Grace MD

Turner Joseph Citizen F 9/16/1993 807 Benninghouse Road Baltimore MD

Twenty Four Seven Home Health Care

Corporation HD 7/28/2005 905 W. Seventh Street; PMB 302

Frederick MD 21702

Tyco Clinical Lab. T. Husain Citizen F 3/1/1995 405 Frederick Road; #158 Catonsville MD 21228

Tymiuk Wasyl P.D. LB 7/21/1993 2405 Mayfield Avenue Baltimore MD 21213

Uche Hyacinth R.Ph F 12/7/2003 1413 King William Drive Baltimore MD 21228

11960

Udebiuwa Oparaugo M.D. F 11/30/2006 450 West Central Avenue Davidsonville MD

D 44603

United Medical, Inc. Corporation HHS 1/7/1998 639 Riverside Drive Annapolis MD 21403

Valentine Eugene Citizen HHS 10/20/2002 P. O. Box 867 Arnold MD 21012

Valerie's Assisted Living Corporation HD 3/24/2004 5506 Wayne Avenue Baltimore MD 21207

Monday, October 18, 2010 Page 64 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 65: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Valove Paul M.D. LB 1/24/2007 11085 Little Patuxent Pkwy. Columbia MD 21044

D 17463

Van Horn Eugean C. Corporation HHS 9/15/1989 8163 Murry Hill Drive Fort Washingto

Vandi Solomon Daniel Aide HHS 1/20/2006 9340 Edmonston road; Apt. 201

Greenbelt MD 20770

Varga Pal M.D. HHS 12/31/1991 213 Philadelphia Avenue Salisbury MD 20801

Vassallo Anthony Michael PCP HD 11/1/2006 455 N. Centre Street Cumberland MD

Vaters Willa J. Corporation HHS 5/2/1989 Route 3, Box 144 Hagerstown MD

Vaughn Hope L. Aide HHS 10/18/1993 1940 W. North Avenue Baltimore MD 21217

Vegetarian Institute Corporation F 11/3/2005 7185 Columbia-Gateway Drive

Columbia MD 21046

Villars Maureen PCP HD 5/10/1996 11308 Gilsan Street Silver Spring

Villaruz Rogelio M.D. F 6/28/1988 576 Stocketts Run Road Davidsonville MD

D 20839

Wagner Keith Citizen F 6/5/1991 9304 Warren Street Silver Spring

Waison Marion Smith M.D. LB 9/16/2005 Woman to Woman Comp Care; Hickory Ridge Road

Columbia MD 21044

D 28668

Waites Regina Marie Nurse F 8/2/2002 16425 Calla Hill Road NW Mount Savage

R 071263

Walker Tonya Aide HHS 3/13/1999 3416 Brinkley Road; #402 Temple Hills MD

Wallace Michelle PCP HD 12/27/2002 9409 Jolean Road Randallstown MD

Wallach Daniel E. M.D. F 12/21/1992 90-B Painters Mill Road Owings Mills MD

D 24863

Monday, October 18, 2010 Page 65 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 66: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Ward David C. M.D. HHS 2/19/1999 3317 Mondawmin Avenue Baltimore MD 21216

Warren Vinita Citizen HHS 12/20/1995 2003 Georgian Wood Place Wheaton MD 20902

Watkins Mildred PCP HD 8/7/2008 412 South Cedar Street, Apt #2

Cumberland MD

Watkins Rose PCP HD 9/30/2008 1027 Cosby Avenue Cambridge MD 21613

Wattay Ellen G. P.T. LB 1/17/2006 408 Parkwood Drive Salisbury MD 21804

13600

Watts Sherrie Citizen F 10/28/1987 1907 Forest Park Apt; 53 Baltimore MD 21207

Waxler Richard M. Citizen HHS 6/19/2003 6015 Middewater Court Columbia MD 21044

Weaver Brian M.D. LB 4/29/2010 1124 N. Main Street Sikeston MO 63801

D 42017

Weaver Darlynn PCP HD 8/6/1997 1503 East 29th Street Baltimore MD 21218

Webster Dewitt D.D.S. LB 8/1/1990 6409 Ager Road Hyattsville MD 20782

4123

Weems George M.D. LB 7/1/1994 BOX 262-C Prince Frederick

D 12969

Wehren Lois M.D. LB 3/13/1997 4098 Fragile Sail Way Ellicott City MD 21042

D 21325

Weiss Sam Arthur Aide HD 6/11/2004 3506 Glen Avenue Baltimore MD 21215

Weissfuss Meaghan N. Citizen MFCU-A 12/7/2005 11934 North Street; Apt. 5-3 Libertown MD 21762

Weitzman Warren Citizen HHS 10/20/2002 7107 Thomas Branch Drive Bethesda MD 20817

Welch Barbara Jean Nurse HHS 6/20/2006 1628 E. Southern Avenue; Bldg 9 PMB 139

Tempe AZ 85282

Monday, October 18, 2010 Page 66 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 67: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Wells Luititia D. PCP HD 7/1/2002 P.O. Box 205 Newburg MD 20664

Weneck Bruce M.D. F 8/27/1986 303 Memorial Blvd Hagerstown MD

D 22698

Werner Stephanie A. Nurse HHS 4/20/2004 423 Lincoln Avenue Glen Burnie

R 097064

Weston Danly P. D.D.S. HHS 4/22/1997 12821 Old Fort Road Fort Washingto

Wheeler, Jr. Rudolph D. Citizen F 2/14/1997 2007 Mayfield MD Baltimore MD 21213

White Sandra E. Aide HHS 4/12/1993 4604 Bromley Ave Suitland MD 20746

White Puanani J. Citizen HHS 10/20/2004 405 Parsonage Lane Saint Michaels

White, Jr. Charles Edward P.A. HHS 9/26/1990 2921 Pulaski Highway Baltimore MD 21224

Whitehead Jessica PCP HD 5/16/1996 6713 Newport Road Hyattsville MD 20784

Wiesman Albert M.D. HHS 4/12/1993 12605 Orchard Brook Terrace

Rockville MD 20854

Wilborne Victor G. Citizen HHS 9/2/1992 5606 McClean Blvd; Apt. C Baltimore MD 21212

Wilder Craig R. M.D. HHS 7/20/2010 2510 Moores Plans Boulevard

Upper Marlboro

D 66430, A77700, MD034904

Wilkes Darryl Ivan Citizen HD 9/21/2005 12428 Gable Lane Ft. Washingto

Wilkinson Morris A. M.D. HHS 4/13/1993 7815 Old Reciever Rd Frederick MD 21702

D 20279

Wilks Deborah Citizen HHS 11/15/1995 2023 Woodlawn Drive; Apt. B

Baltimore MD 21207

Williams Fortune J. M.D. HHS 9/20/2005 5010 York Road Baltimore MD 21212

D 30591

Monday, October 18, 2010 Page 67 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 68: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Williams Daniella Citizen F 4/23/2003 1523 Ellamont Avenue Baltimore MD 21206

Williams Sharon PCP HD 10/7/1996 P. O. Box 316; Peabody Street

Leonardtown MD

Williams Carter M.D. F 4/14/1993 3104 Woodholme Ave Baltimore MD 21234

D 27537

Williams Arnita L. PCP HD 2/18/1998 1025 Webb Court Baltimore MD 21202

Williams Deborah PCP HD 9/17/1998 5409 Schley Avenue Baltimore MD 21213

Williams Olivette PCP HD 1/6/1998 6237 Maxwell Drive Camp Springs

Williams Lillian Nurse HHS 4/20/2003 8925 Footed Ridge Columbia MD 21045

Williams Joanie Linden PCP HD 9/26/1997 3901 Greenmount Avenue; 2nd Floor

Baltimore MD 21218

Williams Barbara L. Aide HHS 11/10/1992 6934 Walker Rd; #B-1 Capitol Heights

Williams Thomas C. Aide MFCU-A 3/2/2004 1113 Bonaparte Avenue Baltimore MD 21218

Williams Cleveland M.D. LB 8/20/1991 1111 Spring St; Ste 103 Silver Spring

D 26740

Williams, III Robert X. M.D. HHS 10/19/2006 3913 Fleetwood Avenue Baltimore MD 21206

D 62991

Willis Vida Marie Aide HHS 5/21/1997 3816 Towanda Ave; 1st Floor

Baltimore MD 21215

Wilson Rose PCP HD 5/15/1998 2926 Miles Avenue Balitmore MD 21211

Wilson Tamela PCP HD 9/27/1995 751 Woods Road Cambridge MD 21613

Wilson Donisha Aide MFCU-A 6/16/2006 11031 Kristin Way Worten MD 21678

Monday, October 18, 2010 Page 68 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 69: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Wilson Stuart K. M.D. LB 12/20/2000 717 Oyster Cove Dr Grasonville MD 21638

D 35598

Winder Tyrone Citizen HHS 12/20/1995 4608 Marble Hall Road Baltimore MD 21239

Windsor Respite Corporation HD 9/20/2005 7407 Castlemoore Road Windsor Mill MD

Wingate Shonelle PCP HD 11/27/2009 8601 Greens Lane Baltimore MD 21224

Wischer Noreen Ann PCP HD 3/19/2005 311 S. Robinson St. Baltimore MD 21224

Witriol Sol M.D. LB 9/26/2001 8679 Ft. Smallwood Road Pasadena MD 21122

D 29137

Wongus Rosalie Citizen F 11/27/1999 530 N. Curley Street Baltimore MD 21205

Woodard Dale Avery Aide MFCU-A 12/30/2003 206 Slitting Mill Place Baltimore MD 21228

Woods Joyce V. Ph.D. HHS 5/8/1991 17525 Sir Galahad Way Ashton MD 20861

Wooldridge Judith Nurse HHS 9/19/2003 1306 Willow Oak Drive Frederick MD 21701

R 043792

Wright Cynthia McGinnis Nurse HHS 10/19/2006 42825 Shaler Street Chantilly VA 20152

0001-092200(VA); R078532(MD)

Wright Stephanie Aide HHS 2/27/2000 P. O. Box 11949 Baltimore MD

Yarborough Pamela PCP HD 3/22/2004 137 Faywood Court; Apt. 5 Glen Burnie MD

Yazdani Farshad M.D. LB 4/4/1999 339 E. Antietam St Hagerstown MD

D 37046

Yoshabell's House, I,II, III Corporation HD 5/24/2006 8511 Allenswood Road, etc. Randallstown MD

Youmatz Henry F. D.D.S. F 12/11/1981 1503 West Lombard Street Baltimore MD 21223

Monday, October 18, 2010 Page 69 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments

Page 70: Sanctioned Providers and Entities Excluded From ...operationrescue.org/brigham/MD Aalai Sanction Medicaid Oct2010.pdf · Baumann Carol Nurse HHS 4/20/2004 3908 Eighth Street Brooklyn

LAST NAME FIRST NAME SPECIALTY SANCTION TYPE SANCTION DATE

ADDRESS CITY/STATE/ZIP

LICENSE #

Young Sara PCP HD 5/16/1995 381-D Willows Road Lexington Park MD

Young Henry A. M.D. HHS 2/13/1995 901 Eastern Avenue Baltimore MD 21221

D 33875

Young Leonard H. Citizen HHS 8/20/2009 7003 Targuin Avenue Temple Hills MD

Young Jennifer PCP HD 3/3/2005 26771 Johnson Creek Road Crisfield MD 21817

Yu Young H. M.D. LB 9/21/2001 1205 York Place; Ste. 30A Towson MD 21204

D 09075

Zakrzeski Paul Nurse F 6/28/2002 210 S. Sunset Drive Shrewsbury PA 17361

Zazo Loretta Nurse HHS 12/18/2008 P.O. Box 219, 4 Water St. Pier A, #133

Charlestown MD

Zedd Arnold J. M.D. LB 4/28/2004 2621 Jamestown Lane Apt. 203

Alexandria VA 22314

D 53164

Monday, October 18, 2010 Page 70 of 70

Sanction Type:MFCU-A = Medicaid Fraud Control Unit Vulnerable Adult Abuse Conviction

HHS = Department of Health and Human Services - Medicare Exclusion

LB - Licensing Board

F = Individual or Entity Convicted of Medicaid Fraud

HD = Health Departments


Recommended