Sanctioned Providers from Participation in Maryland

[Pages:79]Sanctioned Providers from Participation in Maryland

LAST NAME

FIRST NAME

SPECIALTY

SANCTION TYPE

TERMINATION DATE ADDRESS

1ST RESPONSE MEDICAL TRANSPORT CORP

A & A Medical Supply Company

A&E Home Care I, II

HHS

Business Entity

HD

Business Entity

HD

11/8/2016 1530 Caton Center Drive 10/29/2015 146 Chartley Drive Ste 100

5/26/2005 1234 Cathedral Drive

Aalai Abate

Mehrdad

M.D.

F

Shastine

MD

LB

8/15/1994 10524 Democracy Blvd 12/31/2019 7004 Security Blvd, 101

Abbas Abell

Abundant Life Acree

Acri Action Healthcare Services Adam Adams

Adams

Adams

Muhmoud F Amanda Center, Inc. Virginia V. Joseph

Hakki B. Gloria Charlotte Alice

M.D. Personal Care Provider Business Entity Nurse

MD

F HD HHS HHS HHS

M.D.

F

Personal Care

HD

Provider

Personal Care

HD

Provider

MD

LB

6/10/1992 5411 Old Frederick Road 3/29/2006 19862 Preference Way

7/5/1989 30 South Broadway 12/20/2009 FPC Alderson, Glen Ray Road,

Box A 12/22/2017 147 Gettys Street

9/27/2017

8/24/1983 6172 Oxon Hill Road 3/16/2014 100 Maryland Avenue

10/24/1994 5313 Barbara Avenue

3/13/2018 4333 Old Branch

Adams

Jerry

MD

LB

9/30/2016 957 National Highway

CITY/STATE/ZIP

Halethorpe, MD, 21227

Reisterstown MD 21136 Glen Burnie MD 21061 Potomac MD 20854 Windsor Mill, MD 21209 Baltimore MD 21229 Callaway MD 20620

Baltimore MD 21231 Alderson WV 24910

Gettysburg, VA 17325

Oxon Hill MD 20715 Hurlock MD 21643

Baltimore MD 21206

Temple Hills, MD 20748 La Vale, MD 21502

Sanction Type: MFCU A = Medicaid Fraud Control Unit Adult Abuse LB = Licensing Board HD = Health Department HHS = Department of Health and Human Services Medicaid Medicare Services F = Individual or Entity Convicted of Medicaid Fraud

Friday, January 31, 2020

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LAST NAME

Addison

Addison Addison Addison-Scott Adedapo Adefolaju Adelanwa

Aderibigbe Adewale

Adeyemi

Adeyemi

Adeyemo Adger

Adiegwu Adler Advanced Clinical Associates Inc. Advanced Walk in Urgent Care Agroh

Aguzie

FIRST NAME Denise Raven Tyrea Ronetta Gloria Abosede Adebowale Gabriel W. Victoria O. Soloman Nancy Mukaila Adeleke Rossanna Nnamdi Jane M.

Musa Happiness

SPECIALTY

Personal Care Provider Aide Aide Individual Aide Nurse LCPC

Individual P.D.

Individual

Individual

M.D. Personal Care Provider Aide M.D. Business Entity

Aide

SANCTION TYPE HD F MCFU-A HHS HHS HHS F HHS HHS HHS F LB HD MFCU-A HHS F HHS MFCU-A MFCU

TERMINATION DATE ADDRESS

CITY/STATE/ZIP

9/9/1998 P.O. Box 6014

Baltimore MD 21231

5/28/2019 5/8/2019 2802 Kentucky Ave

7/20/2014 4120 Taylor Avenue Apt. 1 2/11/1999 1471 Hadwick Drive 7/20/2009 6405 Seta Drive 2/18/2007 7100 Chesapeake Road

5/22/1998 11380 Cherry Hill Road; #20 6/19/2008 4046 Warner Avenue, Apt. D1

8/20/2008 7758 Finns Lane, Apt. 2

2/28/1997 25 Strawhat Road; 1-C

3/26/2014 5267 AL Jones Drive 9/9/1998 2140 Boyd Street

Baltimore, MD 21213

Baltimore MD 21236

Baltimore MD 21221

Lanham MD 207060

Landover Hills MD 20784 Beltsville MD 20705

Landover Hills, MD 20784 New Carrollton MD 20781 Owings Mills MD 21117 Shady Side MD 20764

Baltimore MD 21223

11/8/2013 5002 Baltimore National Pike 9/20/2001 9812 Falls Road; Ste 114 10/2/1997 201 North Charles Street

Baltimore MD 21229 Potomac MD 20854 Baltimore MD 21201

7/28/2013 10801 Lockwood Drive, Suite 140 10/2/2012 4403 Silver Brook Lane Apt. A102 6/12/2018 1830 York Road, Suite F

Silver Spring, MD, 20901

Owings Mills MD 21117

Timonium, MD 21093

Sanction Type: MFCU A = Medicaid Fraud Control Unit Adult Abuse LB = Licensing Board HD = Health Department HHS = Department of Health and Human Services Medicaid Medicare Services F = Individual or Entity Convicted of Medicaid Fraud

Friday, January 31, 2020

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LAST NAME

Aiken Aikens-Afful Air Support Therapies

Ajimatanrareje, Jr. Ajong Ajouh Ajrawat Ajumobi Akande Akhigbe Akoda Aksoy Akthar Al-Attar Albers Albrecht Alemnji Alexander Alexander

FIRST NAME Stuart Nathaniel

Femi A. Eric Mekone Paramjit Chukwudi Dwanus Ehigiator Charles Yasar Waheed U. Ali Nancy Frank M. Cedonne Harold Daniel

SPECIALTY

D.P.M. M.D. Business Entity

Pharmacy Technician Aide Aide M.D. Individual Nurse M.D. MD M.D. M.D. M.D. Individual Counselor Aide

MD

SANCTION TYPE

HHS F HD

HHS HHS MFCU-A F HHS HHS HHS LB LB LB LB HHS HHS HHS HHS LB

TERMINATION DATE ADDRESS

CITY/STATE/ZIP

5/5/2006 16 Dartmoor Court 4/18/1983 3706 Collier Road 10/30/2015 P.O. Box 188 3/20/2014 9450 Whiskey Bottom Road

Olney MD 20832

Randallstown MD 21133

Upper Falls MD 21156

Laurel MD 20723

6/20/2011 13107 Serpentine Way 7/18/2014 2518 Molton Way

Silver Spring MD 20904

Baltimore MD 21224

10/17/2015 7327-A Hanover Parkway

Greenbelt MD 20770

8/19/2010 5404 85th Avenue, Apt. T3 1/20/2008 10849 N. Central Expressway

New Carrollton MD 20784

Dallas, TX 75231

10/20/2010 FCI Morgantown P.O. Box 1000 11/15/2016 7582 Annapolis RD

Morgantown WV 26507

Lanham, MD 20784

7/17/2001 1423 Cedarcroft Road

Baltimore MD 21239

9/9/2004 301 S. Theodore Green Blvd 4/22/2009 4900 Silver Hill Road

White Plains MD 20695

Suitland MD 20746

1/20/2008 750 Farnham Place

Bel Air MD 21014

8/20/2003 P.O.Box 877; 725 Elwood Ave

Easton MD 21601

4/20/2015 9338 Edmonston Road Apt 204

Greenbelt MD 20770

11/8/2016 7610 Pennsylvania Avenue

Forrestville, MD 20747

1/11/2017 7445 East Furnace Branch Road, Baltimore, MD, 21060 Glen Burnie, MD, 21

Sanction Type: MFCU A = Medicaid Fraud Control Unit Adult Abuse LB = Licensing Board HD = Health Department HHS = Department of Health and Human Services Medicaid Medicare Services F = Individual or Entity Convicted of Medicaid Fraud

Friday, January 31, 2020

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LAST NAME

FIRST NAME

Al-Khatib

Susan

Al-Khatib Allen Allotey

Sofian J Yvonne John B.K.

Ally Alperstein

Azad M. Arnold

Alpha Clinical Laboratories

Alpha Diagnostic Services, Inc.

Alpha Diagnostic Services, Inc.

Alpha Diagnostic Services, Inc.

American Diagnostic Laboratories

American Medical CoOp, LLC

Amirgholi

Mohammed H.

Amoss Anderson Anderson Anderson

Willard Susan Tasha M Morris

Anderson

Richard H.

SPECIALTY

Nurse M.D. Aide M.D. D.D.S. R.Ph Lab Business Entity Business Entity Business Entity Business Entity Business Entity M.D. M.D. Nurse PA-C Personal Care Provider M.D.

SANCTION TYPE HHS LB MFCU-A LB F HHS HHS F F F HD HD LB LB HHS LB HD LB

TERMINATION DATE ADDRESS

CITY/STATE/ZIP

2/20/2008 13014 Winchester Road, SW 10/7/2016 5501 Mariposa Street

Cumberland, MD 21502

Phoenix, AZ 85018

10/29/2014 2565 Francis Street

Baltimore MD 21217

11/14/2012 P.O. Box 925MP 7/21/2004 1643 Agnes Avenue, S.E.

Manprobi-Accra Ghana

Palm Bay FL 32909

1/20/2004 3202 Walnut Avenue

Owings Mills MD 21117

10/18/2016 9 Gwynn Mill CT, Suite F

Owings Mills, MD, 21117

7/30/2016 2700 MLK Jr. Ave. SE, Bld Ct Rm 3 Washington, DC 20032

7/30/2016 9-F Gwynns Mill Court

Owings Mills MD 21117

7/30/2016 9-F Gwynns Mill Court

Owings Mills MD 21117

10/28/2008 15749 Crabbs Branch Way

Rockville MD 20855

4/17/2016 330 Mallory Station Road, Ste. G26

3/23/1988 9401 Indian Head Hwy

6/20/2012 2303 Belair Road

Franklin TN 37067

Ft. Washington MD 20744 Fallston MD 21047

12/19/2002 11554 Buckskin Court

Lusby MD 20657

12/14/2017 1407 York Rd, Suite 310

Lutherville, MD 21093

7/21/1995 11 W. Baltimore; #1012 5/26/2001 13 Cedar Waxwing Road

Hagerstown MD 21740

Hilton Head Island SC 29928

Sanction Type: MFCU A = Medicaid Fraud Control Unit Adult Abuse LB = Licensing Board HD = Health Department HHS = Department of Health and Human Services Medicaid Medicare Services F = Individual or Entity Convicted of Medicaid Fraud

Friday, January 31, 2020

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LAST NAME

FIRST NAME

Andreadis Andrews Angel Square

Barbara L. Lorenzo

Angel's Paradise II Anifowose

Olufunke

Ankrah

Solomon

Ann's Loving Care

Appalachian Wellness Center Appel

Lawrence W.

Arbogast

Rebecca

ARG Associates, Inc.

Argos Vision & Eyecare Center Arian

Arrey

Arrington

Howard Pamela James

Arriva Medical LLC

Arroyo Arroyo

Jose C. Ruy Dan

SPECIALTY LCSW Nurse Business Entity Business Entity Aide Aide Business Entity

R.Ph Personal Care Provider Business Entity Business Entity MD P.D. Personal Care Provider

M.D. M.D.

SANCTION TYPE F HHS HD HD MFCU-A MFCU-A HD F HHS F HHS LB LB HD HD HHS HHS HHS

TERMINATION DATE ADDRESS

CITY/STATE/ZIP

5/20/2003 47 E. Main street 7/20/2004 8341 Canning Terrace 6/28/2005 2306 Breton Drive 12/1/2011 7808 Baltimore Annapolis Blvd. 9/20/2012 38 Trout Brook Circle 7/29/2013 3 Korado Court, Apt. 2B

9/5/2007 1536 Northgate Road 7/9/2018 507 Henderson Ave 12/20/2004 4 Coachman Ct; Apt. 202 1/6/2007 36856 Danny Lane

Hancock MD 21750

Greenbelt MD 20770

District Heights MD 20747 Glen Burnie 21060

Reisterstown MD 21236 Windsor Mill MD 21244 Baltimore MD 21218

Cumberland, MD 21502 Randallstown MD 21133 Chaptico MD 20621

5/20/2002 8314 Glenmar Road

9/20/2013 15920 Shady Grove Road

6/19/2017 500 Upper Chesapeake Drive 8/15/2008 13850 Kennard Drive 4/17/1996 4138 Woodhaven Avenue; Apt. 1

FL 11/4/2016 4252 NW 120th Avenue

6/18/1998 6400 Baltimore Nat'l Pike #512 9/20/1996 1215 Evesham Ave

Ellicott City MD 21045 Gaithersburg MD 20877 Belair, MD 21014

Glenelg MD 21737

Baltimore MD 21216

Coral Springs, FL, 33065 Baltimore MD 21228

Baltimore MD 21239

Sanction Type: MFCU A = Medicaid Fraud Control Unit Adult Abuse LB = Licensing Board HD = Health Department HHS = Department of Health and Human Services Medicaid Medicare Services F = Individual or Entity Convicted of Medicaid Fraud

Friday, January 31, 2020

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LAST NAME

FIRST NAME

SPECIALTY

SANCTION TYPE

TERMINATION DATE ADDRESS

CITY/STATE/ZIP

Arung

Elizabeth

Asemani

Ghafour B.

Ashimi Asinyang

Karen Raphael

Askins

Annie Delois

Askins Private Care Home

Aslam

Mohammad

Aslam

Zahid

Atlanta Institute of Med and Rehab

Atlantic Health Care, Inc.

Aurora Hlth Care Services, Inc.

Austin

Dan E.

Automated Billing Service

Awele Treatment and Rehab.Clinic

Ayers

George J.

Ayinwingong Aziz

Niba Ahmed

Azzato

Nicholas M.

Aide D.D.S. Aide Aide Personal Care Provider Business Entity M.D. MD

Business Entity Business Entity M.D. Business Entity Business Entity P.T. Individual D.D.S. M.D.

HHS HHS MFCU-A MFCU-A HD HD LB LB HHS HHS HD LB HHS HD HHS HHS LB HHS

4/20/2015 1817 Greenwich Wood Drive Apt. 24

7/18/2002 8667 Town & Country Blvd; F

5/24/2007 2424 Bridgehampton Drive, #J

Silver Spring MD 20903

Ellicott City MD 21043

Parkville MD 21234

12/7/2013 3546 Carriage Hill Circle, Apt. 303 5/4/2006 3301 Ripple Road

Randallstown MD 21133

Baltimore MD 21244

5/4/2006 3301 Ripple Road

Baltimore MD 21244

9/4/2014 501 S. Union Avenue 5/15/2018 300 East Pulaski Hwy 6/24/2013 2911 Piedmont Road, Ste E

Havre de Grace MD 21078 Elkton, MD 21901

Atlanta, GA, 30305

10/7/2007 7640 Fullerton Road 5/4/2005 14004 Silver Teal Way 4/4/1999 12164 Central Ave

6/12/1997 4701 Randolph Road 2/27/2007 2300 North Calvert Street

Springfield VA 22153

Upper Marlboro MD 20774 Mitchelleville MD 20721 Rockville MD 20852

Baltimore MD 21218

2/20/2006 75 Beatrice Street 6/18/2015 7941 Piedmont Avenue 11/26/2003 6117 Marlboro Pike 10/4/1989 333 University Blvd; West

Cumberland MD 21502

Greenbelt MD 20706

District Heights MD 20747

Kensington MD 20895

Sanction Type: MFCU A = Medicaid Fraud Control Unit Adult Abuse LB = Licensing Board HD = Health Department HHS = Department of Health and Human Services Medicaid Medicare Services F = Individual or Entity Convicted of Medicaid Fraud

Friday, January 31, 2020

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LAST NAME

Babaturk Babaturk Backmon Bagby Bagheri

Bagwell Bah Bailey

Bailey, Jr.

Bakare

Baker

Baker Ball Baltatzis Baltatzis Baltazar Banks Barahona Baral Barber

FIRST NAME

Hidir Hasan Marquil D. Victoria Farhad

Polla Darlene Haja Andrea

Purcell

Oluwatoyin

Betty

Cynthia Katherine Panaytiotis Panayiotis Rodney Evelyn Leonel Daniel Steven

SPECIALTY

M.D. M.D. Individual Individual D.D.S.

Aide Aide MD

M.D.

Personal Care Provider Personal Care Provider Nurse M.D. MD MD D.O. Individual M.D.

Individual

SANCTION TYPE

HHS LB HHS HHS LB

HHS HHS LB

LB

HHS

HD

HHS LB LB LB HHS F LB LB HHS

TERMINATION DATE ADDRESS

CITY/STATE/ZIP

9/30/1988 6578 Gulford Avenue

Clarksville MD 21029

2/25/2016 901 Eastern Boulevard, Ste 200 Baltimore MD 21221

2/15/1997 830 N. Kenwood Avenue

Baltimore MD 21205

10/20/2008 435 N. Curley Street

Baltimore MD 21224

8/15/2005 13529 Clopper Road 2/18/1999 3127 Artaban Place

Germantown MD 20874

Baltimore MD 21216

6/20/2005 3207 Toleda Place; Apt. 203

Hyattsville MD 20782

7/17/2017 3500 Old Washington Road, Suite 101

4/16/2015 2600 Liberty Heights Avenue Ste. 103

4/20/2015 8207 Consett Court

Waldorf, MD 20602 Baltimore MD 21215 Severn MD 21144

9/9/1998 524 W. Preston Street

Baltimore MD 21202

6/19/2008 5753 Hazelwood Circle, Apt. F 5/6/2016 30205 Ward Drive

9/29/2017 8113 Harford Road, Suite 100 10/4/2017 8113 Harford Road suite 100

2/6/2009 319 Maloney Road 10/28/1987 2140 Pine Avenue 11/19/2009 1101 Maiden Choice Lane

6/15/2018 7402 York Rd, Suite 100 2/20/2011 4305 Belfield Drive

Baltimore MD 21206 Trappe, MD, 21673 Baltimore, MD 21234 Baltimore, MD 21234 Elkton MD 21921 Baltimore MD 21207 Baltimore MD 21229 Towson, MD 21204 Greensboro NC 27407

Sanction Type: MFCU A = Medicaid Fraud Control Unit Adult Abuse LB = Licensing Board HD = Health Department HHS = Department of Health and Human Services Medicaid Medicare Services F = Individual or Entity Convicted of Medicaid Fraud

Friday, January 31, 2020

Page 7 of 79

LAST NAME

Barb's Mason Dixon Home Barnes Barnes

Barnes Barnette

Barr Barto Bass Bassett

Bates

Battaile

Battle

Baum

Baumann Baxter Beachley

Beauford Beaverbrook Corner Beck

FIRST NAME

Ronald Georgia Stephen Dawn Alvin Scott Johnnie Wilson Mitzi Lucille David W. Robert E. William G. Jesse Victor Carol Steven Carroll L. India

Jeffrey R.

SPECIALTY

Business Entity

Aide Personal Care Provider M.D. Personal Care Provider Nurse MD Nurse M.D.

Optician

M.D.

Individual

M.D.

Nurse Aide Aide

Aide Business Entity D.O.

SANCTION TYPE HD MFCU-A HD HD HD HHS LB HHS LB HHS LB HHS HD HHS HHS HHS HHS HD LB

TERMINATION DATE ADDRESS

CITY/STATE/ZIP

7/31/2006 29233-A West Line Road

Delmar MD 21875

6/18/2014 3501 Mayfair Road 4/14/2003 12 Garrisonridge Court

10/24/2015 600 N. Wolfe Street 4/1/1994 SR6; Box 277-13

Baltimore MD 21207

Owings Mills MD 21117 Baltimore MD 21287

LaPlata MD 20646

4/20/2004 8336 Evergreen Drive 2/28/2018 201 Delta Drive 7/18/2002 804 W. Nash Street 3/29/2006 CPC Health, Inc; 500 W.

Montgomery Avenue 7/7/1997 11511 Lockhardt Place

9/29/1996 Box 273

8/18/2011 6005 Tipton Drive

1/3/2016 919 Flordon Drive

4/20/2004 3908 Eighth Street 8/19/2010 1928 Rochell Avenue, Apt. 1213 5/13/1998 10420 Bailey Road

8/20/2014 1949 Ewald Avenue 2/1/2006 4994 Beaverbrook Road

7/13/2006 22 S. Greene Street

Lusby MD 20657

Johnstown, PA 15904

Terrell TX 75160

Rockville MD 20850

Silver Spring MD 20902 Gibson Island MD 21056 Temple Hills MD 20748 Charlottesville VA 22901 Brooklyn MD 21221

Forestville MD 20747

Hagerstown MD 21740 Dundalk MD 21222

Columbia MD 21044

Baltimore MD 21201

Sanction Type: MFCU A = Medicaid Fraud Control Unit Adult Abuse LB = Licensing Board HD = Health Department HHS = Department of Health and Human Services Medicaid Medicare Services F = Individual or Entity Convicted of Medicaid Fraud

Friday, January 31, 2020

Page 8 of 79

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