Thomas Keane Stetler, PA-C – Physician Assistant

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

Section 1128a(2) exclusion effective Jun 20, 2013.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPI: 1164531794
Entity type: Individual (NPI type 1)
Primary specialty: Physician Assistant 363A00000X
License: 5601003799 (MI)
Practice address: 4713 Pine St SW
S Boardman, MI 49680-9761
Phone: (231) 518-0189
Fax: (231) 518-0188
NPI assigned: Aug 29, 2006
Sex: Male
Sole proprietor: Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Boardman Health and Wellness, PLLC Physician Assistant · S Boardman, MI · NPI 1063453363

NPD (past) Authorized official PHYSICIAN ASSISTANT

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
HHS exclusion list flag: The National Provider Directory flags this NPI as appearing on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials: Physician Assistant

Practice roles

Organization	Specialty	Status	New patients
Boardman Health and Wellness, PLLC	Physician Assistant	Past since Jan 1, 2006	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physician Assistant	363A00000X	5601003799	MI	Yes

Addresses

Primary practice location

4713 Pine St SW
S Boardman, MI 49680-9761

Mailing address

4713 Pine St SW
S Boardman, MI 49680-9761
Phone (231) 518-0189

Other providers in S Boardman, MI

Boardman Health and Wellness, PLLC

All providers in S Boardman, MI · Physician Assistant in Michigan

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 21, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
OIG LEIE (HHS Office of Inspector General).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.