Credentials

Every credential on file and every requirement with nothing on file, in the order work has to happen.

As of

Oct 7, 2026

Pick as many as you like in each row. A record shows if it matches any pick in a row, and every row.

All statuses Needs action Lapsed Missing Expiring Pending Action due Current Not verified at source

All types State medical license DEA registration State controlled substance registration Board certification Malpractice insurance CAQH attestation Payer enrollment Hospital or surgery center privileges CPR / BLS certification OIG exclusion check

All sites East Region West Region Eastgate Family Care Jefferson Park Main Campus Riverbend Riverside Orthopedics Stonebridge

32 records for providers who work at West Region and Jefferson Park. Clear all filters

Dr. Rosa Delgado
Payer enrollment: State Medicaid
Lapsed
Lapsed 20 days ago. No renewal has been recorded.No. MCD-ENR-DEMO-4156Ends Sep 17, 2026
Dr. Hannah Weiss
Payer enrollment: Larkspur Health Plan
Pending
Application sent Aug 28, 2026 (40 days ago) and not approved yet.No. LARK-ENR-DEMO-4088
Dr. Rosa Delgado
Payer enrollment: Medicare
Current
Current. Start the renewal by Nov 6, 2026.No. MCR-ENR-DEMO-4155Ends Mar 6, 2027
Dr. Ethan Cole
Payer enrollment: State Medicaid
Current
Current. Start the renewal by Nov 16, 2026.No. MCD-ENR-DEMO-4142Ends Mar 16, 2027
Dr. Ethan Cole
Payer enrollment: Medicare
Current
Current. Start the renewal by Nov 30, 2026.No. MCR-ENR-DEMO-4141Ends Mar 30, 2027
Caleb Foster
Payer enrollment: Harborline Health
Current
Current. Start the renewal by Dec 9, 2026.No. HARB-ENR-DEMO-4100Ends Apr 8, 2027
Dr. Hannah Weiss
Payer enrollment: Bluestem Mutual
Current
Current. Start the renewal by Jan 8, 2027.No. BLUE-ENR-DEMO-4090Ends May 8, 2027
Nadia Brooks
Payer enrollment: Larkspur Health Plan
Current
Current. Start the renewal by Jan 29, 2027.No. LARK-ENR-DEMO-4045Ends May 31, 2027
Dr. Julian Moore
Payer enrollment: Harborline Health
Current
Current. Start the renewal by Mar 31, 2027.No. HARB-ENR-DEMO-4119Ends Jul 29, 2027
Dr. Priyanka Rao
Payer enrollment: Bluestem Mutual
Current
Current. Start the renewal by Apr 30, 2027.No. BLUE-ENR-DEMO-4110Ends Aug 28, 2027
Dr. Ethan Cole
Payer enrollment: Larkspur Health Plan
Current
Current. Start the renewal by Jun 30, 2027.No. LARK-ENR-DEMO-4143Ends Oct 28, 2027
Nadia Brooks
Payer enrollment: State Medicaid
Current
Current. Start the renewal by Jul 28, 2027.No. MCD-ENR-DEMO-4044Ends Nov 25, 2027
Nadia Brooks
Payer enrollment: Medicare
Current
Current. Start the renewal by Aug 11, 2027.No. MCR-ENR-DEMO-4043Ends Dec 9, 2027
Theo Ramirez
Payer enrollment: Larkspur Health Plan
Current
Current. Start the renewal by Sep 8, 2027.No. LARK-ENR-DEMO-4053Ends Jan 6, 2028
Dr. Priyanka Rao
Payer enrollment: Larkspur Health Plan
Current
Current. Start the renewal by Sep 29, 2027.No. LARK-ENR-DEMO-4109Ends Jan 27, 2028
Dr. Aisha Grant
Payer enrollment: State Medicaid
Current
Current. Start the renewal by Feb 21, 2028.No. MCD-ENR-DEMO-4065Ends Jun 20, 2028
Dr. Aisha Grant
Payer enrollment: Bluestem Mutual
Current
Current. Start the renewal by Feb 25, 2028.No. BLUE-ENR-DEMO-4067Ends Jun 25, 2028
Dr. Julian Moore
Payer enrollment: Bluestem Mutual
Current
Current. Start the renewal by Mar 17, 2028.No. BLUE-ENR-DEMO-4120Ends Jul 16, 2028
Caleb Foster
Payer enrollment: Larkspur Health Plan
Current
Current. Start the renewal by Apr 27, 2028.No. LARK-ENR-DEMO-4099Ends Aug 25, 2028
Dr. Rosa Delgado
Payer enrollment: Larkspur Health Plan
Current
Current. Start the renewal by May 18, 2028.No. LARK-ENR-DEMO-4157Ends Sep 15, 2028
Dr. Aisha Grant
Payer enrollment: Larkspur Health Plan
Current
Current. Start the renewal by Jul 27, 2028.No. LARK-ENR-DEMO-4066Ends Nov 24, 2028
Dr. Julian Moore
Payer enrollment: Larkspur Health Plan
Current
Current. Start the renewal by Aug 17, 2028.No. LARK-ENR-DEMO-4118Ends Dec 15, 2028
Dr. Hannah Weiss
Payer enrollment: Harborline Health
Current
Current. Start the renewal by Sep 1, 2028.No. HARB-ENR-DEMO-4089Ends Jan 1, 2029
Dr. Ethan Cole
Payer enrollment: Harborline Health
Current
Current. Start the renewal by Sep 22, 2028.No. HARB-ENR-DEMO-4144Ends Jan 22, 2029
Grace Liu
Payer enrollment: Bluestem Mutual
Current
Current. Start the renewal by Oct 24, 2028.No. BLUE-ENR-DEMO-4133Ends Feb 21, 2029
Theo Ramirez
Payer enrollment: Harborline Health
Current
Current. Start the renewal by Dec 1, 2028.No. HARB-ENR-DEMO-4054Ends Apr 2, 2029
Caleb Foster
Payer enrollment: Medicare
Current
Current. Start the renewal by May 18, 2029.No. MCR-ENR-DEMO-4098Ends Sep 17, 2029
Dr. Priyanka Rao
Payer enrollment: Medicare
Current
Current. Start the renewal by Apr 30, 2030.No. MCR-ENR-DEMO-4108Ends Aug 28, 2030
Grace Liu
Payer enrollment: State Medicaid
Current
Current. Start the renewal by Nov 8, 2030.No. MCD-ENR-DEMO-4132Ends Mar 10, 2031
Grace Liu
Payer enrollment: Medicare
Current
Current. Start the renewal by Nov 22, 2030.No. MCR-ENR-DEMO-4131Ends Mar 24, 2031
Dr. Julian Moore
Payer enrollment: Medicare
Current
Current. Start the renewal by Dec 18, 2030.No. MCR-ENR-DEMO-4117Ends Apr 17, 2031
Dr. Hannah Weiss
Payer enrollment: State Medicaid
Current
Current. Start the renewal by Apr 18, 2031.No. MCD-ENR-DEMO-4087Ends Aug 18, 2031