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

15 records for providers who work at Eastgate Family Care, Riverside Orthopedics and Stonebridge. Clear all filters

Caleb Foster
Payer enrollment: Harborline Health
Current
Current. Start the renewal by Dec 9, 2026.No. HARB-ENR-DEMO-4100Ends Apr 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
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. 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. Julian Moore
Payer enrollment: Larkspur Health Plan
Current
Current. Start the renewal by Aug 17, 2028.No. LARK-ENR-DEMO-4118Ends Dec 15, 2028
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
Dr. Julian Moore
Payer enrollment: Medicare
Current
Current. Start the renewal by Dec 18, 2030.No. MCR-ENR-DEMO-4117Ends Apr 17, 2031