Domenick Braccia
Debarred entityBorn 7 Jan 1962 (64 years old),United States. Named in 5 sanctions listings.
Summary
License number: PROMIS# 001237131 Lic# OS006737L
Sanctions and listings5
- Effective
- 20 Oct 2020
Official designation
OIG/Pennsylvania Department of Human servicesUS Delaware Medicaid Sanctioned ProvidersUnited States
Terminate Provider Agreement-Active- Reporting Only Managed Care
- Effective
- 20 Oct 2020
Official designation
Department of Human ServicesUS Pennsylvania Medicheck listUnited StatesPrecluded
- Effective
- 20 Oct 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
1128a3
Programme US-HHS-OIGoig.hhs.govoig.hhs.gov
- Listed
- 8 Dec 2020
- Effective
- 30 Nov 2020
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.
- Listed
- 23 Oct 2020
- Effective
- 20 Oct 2020
Positions held1
Period not retained
FAMILY PRACTICE (PHYSICIAN (MD, DO))
Identifiers2
| Identifier | Number |
|---|---|
| ID number | OS006737L |
| NPI number | 1821178005 |
Addresses4
JOINT BASE MDL, NJ 08640
P O BOX 2000, #77212-066, JOINT BASE MDL, NJ 8640
(NJ), (NJ)
NJ, NJ
United States
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