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 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 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
15 records for providers who work at Main Campus. Clear all filters
- Dr. Samuel OrtizPayer enrollment: Larkspur Health PlanCurrentCurrent. Start the renewal by Oct 30, 2026.No. LARK-ENR-DEMO-4076Ends Mar 1, 2027
- Dr. Rosa DelgadoPayer enrollment: MedicareCurrentCurrent. Start the renewal by Nov 6, 2026.No. MCR-ENR-DEMO-4155Ends Mar 6, 2027
- Dr. Lena OkaforPayer enrollment: State MedicaidCurrentCurrent. Start the renewal by Jan 1, 2027.No. MCD-ENR-DEMO-4019Ends May 1, 2027
- Dr. Owen HalePayer enrollment: MedicareCurrentCurrent. Start the renewal by Feb 8, 2027.No. MCR-ENR-DEMO-4008Ends Jun 8, 2027
- Dr. Owen HalePayer enrollment: Larkspur Health PlanCurrentCurrent. Start the renewal by Apr 30, 2027.No. LARK-ENR-DEMO-4009Ends Aug 30, 2027
- Dr. Lena OkaforPayer enrollment: Bluestem MutualCurrentCurrent. Start the renewal by Jul 9, 2027.No. BLUE-ENR-DEMO-4021Ends Nov 6, 2027
- Dr. Lena OkaforPayer enrollment: Larkspur Health PlanCurrentCurrent. Start the renewal by Dec 8, 2027.No. LARK-ENR-DEMO-4020Ends Apr 6, 2028
- Dr. Samuel OrtizPayer enrollment: Harborline HealthCurrentCurrent. Start the renewal by Jan 27, 2028.No. HARB-ENR-DEMO-4077Ends May 26, 2028
- Dr. Aisha GrantPayer enrollment: State MedicaidCurrentCurrent. Start the renewal by Feb 21, 2028.No. MCD-ENR-DEMO-4065Ends Jun 20, 2028
- Dr. Aisha GrantPayer enrollment: Bluestem MutualCurrentCurrent. Start the renewal by Feb 25, 2028.No. BLUE-ENR-DEMO-4067Ends Jun 25, 2028
- Dr. Rosa DelgadoPayer enrollment: Larkspur Health PlanCurrentCurrent. Start the renewal by May 18, 2028.No. LARK-ENR-DEMO-4157Ends Sep 15, 2028
- Dr. Owen HalePayer enrollment: Harborline HealthCurrentCurrent. Start the renewal by Jul 27, 2028.No. HARB-ENR-DEMO-4010Ends Nov 24, 2028
- Dr. Aisha GrantPayer enrollment: Larkspur Health PlanCurrentCurrent. Start the renewal by Jul 27, 2028.No. LARK-ENR-DEMO-4066Ends Nov 24, 2028
- Dr. Samuel OrtizPayer enrollment: MedicareCurrentCurrent. Start the renewal by Oct 24, 2028.No. MCR-ENR-DEMO-4075Ends Feb 21, 2029
- Dr. Samuel OrtizPayer enrollment: Bluestem MutualCurrentCurrent. Start the renewal by Jan 12, 2029.No. BLUE-ENR-DEMO-4078Ends May 14, 2029