Credentials
Every credential on file and every requirement with nothing on file, in the order work has to happen.
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As of
Oct 8, 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 typesState medical licenseDEA registrationState controlled substance registrationBoard certificationMalpractice insuranceCAQH attestationPayer enrollmentHospital or surgery center privilegesCPR / BLS certificationOIG exclusion check
All sitesEast RegionWest RegionEastgate Family CareJefferson ParkMain CampusRiverbendRiverside OrthopedicsStonebridge
16 records for providers who work at Eastgate Family Care, Jefferson Park and Stonebridge. Clear all filters
- Dr. Hannah WeissPayer enrollment: Larkspur Health PlanPendingApplication sent Aug 29, 2026 (40 days ago) and not approved yet.No. LARK-ENR-DEMO-4088
- Dr. Ethan ColePayer enrollment: State MedicaidCurrentCurrent. Start the renewal by Nov 17, 2026.No. MCD-ENR-DEMO-4142Ends Mar 17, 2027
- Dr. Ethan ColePayer enrollment: MedicareCurrentCurrent. Start the renewal by Dec 1, 2026.No. MCR-ENR-DEMO-4141Ends Mar 31, 2027
- Dr. Hannah WeissPayer enrollment: Bluestem MutualCurrentCurrent. Start the renewal by Jan 8, 2027.No. BLUE-ENR-DEMO-4090Ends May 9, 2027
- Nadia BrooksPayer enrollment: Larkspur Health PlanCurrentCurrent. Start the renewal by Feb 1, 2027.No. LARK-ENR-DEMO-4045Ends Jun 1, 2027
- Dr. Priyanka RaoPayer enrollment: Bluestem MutualCurrentCurrent. Start the renewal by Apr 30, 2027.No. BLUE-ENR-DEMO-4110Ends Aug 29, 2027
- Dr. Ethan ColePayer enrollment: Larkspur Health PlanCurrentCurrent. Start the renewal by Jul 1, 2027.No. LARK-ENR-DEMO-4143Ends Oct 29, 2027
- Nadia BrooksPayer enrollment: State MedicaidCurrentCurrent. Start the renewal by Jul 29, 2027.No. MCD-ENR-DEMO-4044Ends Nov 26, 2027
- Nadia BrooksPayer enrollment: MedicareCurrentCurrent. Start the renewal by Aug 12, 2027.No. MCR-ENR-DEMO-4043Ends Dec 10, 2027
- Theo RamirezPayer enrollment: Larkspur Health PlanCurrentCurrent. Start the renewal by Sep 9, 2027.No. LARK-ENR-DEMO-4053Ends Jan 7, 2028
- Dr. Priyanka RaoPayer enrollment: Larkspur Health PlanCurrentCurrent. Start the renewal by Sep 30, 2027.No. LARK-ENR-DEMO-4109Ends Jan 28, 2028
- Dr. Hannah WeissPayer enrollment: Harborline HealthCurrentCurrent. Start the renewal by Sep 4, 2028.No. HARB-ENR-DEMO-4089Ends Jan 2, 2029
- Dr. Ethan ColePayer enrollment: Harborline HealthCurrentCurrent. Start the renewal by Sep 25, 2028.No. HARB-ENR-DEMO-4144Ends Jan 23, 2029
- Theo RamirezPayer enrollment: Harborline HealthCurrentCurrent. Start the renewal by Dec 4, 2028.No. HARB-ENR-DEMO-4054Ends Apr 3, 2029
- Dr. Priyanka RaoPayer enrollment: MedicareCurrentCurrent. Start the renewal by May 1, 2030.No. MCR-ENR-DEMO-4108Ends Aug 29, 2030
- Dr. Hannah WeissPayer enrollment: State MedicaidCurrentCurrent. Start the renewal by Apr 21, 2031.No. MCD-ENR-DEMO-4087Ends Aug 19, 2031