PAUL JOHN HANNAN SR
Debarred entityBorn 20 Jun 1965 (61 years old),United States. Named in 6 sanctions listings.
Summary
License number: CSR No. DR-0008693
UPIN: H64470
Sanctions and listings6
- Effective
- 28 Mar 2018
Official designation
Delaware Secretary of StateUS Delaware Medicaid Sanctioned ProvidersUnited States
207L00000X- terminated or Disclosure not recvd 2080N0001X-is Managed Care “Reporting Only” is active.
- Effective
- 15 Jan 2021
Official designation
New Jersey Office of the State ComptrollerUS New Jersey Ineligible Medicaid ProvidersUnited States
DISQUALIFICATION
- Listed
- 22 Dec 2020
- Effective
- 20 Dec 2020
- Effective
- 2 Jun 2020
Official designation
New York State Office of the Medicaid Inspector GeneralUS New York State Medicaid ExclusionsUnited States
- Effective
- 20 Dec 2020
List of Excluded Individuals/Entities (LEIE)
Department of Health and Human Services Office of Inspector GeneralUS Health and Human Services Inspector General ExclusionsUnited States
1128b4
Programme US-HHS-OIGoig.hhs.govoig.hhs.gov
- Listed
- 1 Mar 2021
- Effective
- 27 Jan 2021
Reciprocal
OPMUS SAM Procurement ExclusionsUnited StatesActive
Prohibition/Restriction
Debarment or Suspension by the U.S. Office of Personnel Management under the authority of 5 U.S.C. 8902a and implementing regulations at 5 CFR Part 890, Subpart J, excludes health care providers from participation in the Federal Employees Health Benefits Program (FEHBP). Debarred or suspended health care providers are prohibited from receiving payment, directly or indirectly, from FEHBP funds for items or services furnished to an employee, annuitant, family member, or former spouse covered by a federal health benefits plan.
Positions held1
Period not retained
PAIN MANAGEMENT (PHYSICIAN (MD, DO))
Identifiers2
| Identifier | Number |
|---|---|
| ID number | 00250782 |
| NPI number | 1639166572 |
Other names4
Also known as4
Addresses3
6619 WALLASTON COURT, BROOKLYN, NY 11204
BROOKLYN, NY 11204
6619 WALLASTON CT, BROOKLYN, NY 11204
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