Cross-source identity
National Provider Identifier 1104210582 as it appears in every federal dataset Fonteum holds. Each row is a distinct public source; the chip carries the source and the snapshot date behind that field — the record-level form of the source-provenanced graph.
| Federal source | Key | What it provides | Provenance |
|---|---|---|---|
| CMS Open Payments |
| NPI 1104210582 |
| 10 industry-payment records, 2024 |
| Source:CMS Open PaymentsSnapshot PY2024 |
| CMS Medicare Part D | NPI 1104210582 | 20 drugs prescribed, 2024 | Source:CMS Part DSnapshot DY2024 |
| Fonteum entity graph | entity 87f6f74a… | Canonical resolved node · 2 identifier(s) · 0 edge(s) | Source:Entity graphSnapshot 2026-06-11 |
Industry payments
Payments and transfers of value this clinician received from drug and device manufacturers, disclosed under the Physician Payments Sunshine Act. A payment is a disclosure, not a judgment.
| Nature of payment | Amount | Records |
|---|---|---|
| Food and Beverage | $685 | 10 |
| Manufacturer | Amount | Records |
|---|---|---|
| Amgen Inc. | $384 | 3 |
| Vertex Pharmaceuticals Incorporated | $140 | 1 |
| Abbvie Inc. | $80 |
Prescribing
Prescriptions written under Medicare Part D, aggregated by drug across the program. Totals reflect claims paid, not patients treated.
| Drug | Claims | Drug cost |
|---|---|---|
| Ipratropium Bromide | 36 | $857 |
| Lantus(Insulin Glargine,Hum.Rec.Anlog) | 11 | $726 |
| Albuterol Sulfate Hfa(Albuterol Sulfate) | 18 | $431 |
| Amlodipine Besylate | 46 | $404 |
| Metoprolol Succinate | 20 | $393 |
Beneficiary counts below 11 are suppressed by CMS — the total shown is a lower bound.
Quality
CMS Quality Payment Program Merit-based Incentive Payment System (MIPS) final score, where this clinician participated. Absence of a score is not a quality signal — many clinicians report through a group or are exempt.
Enrollment & sanctions
Screening aid — re-confirm any match against the issuing list before acting. A clean result means no record was found in the federal OIG LEIE or the state Medicaid lists Fonteum currently holds (NY, OH, GA), not a guarantee that none exists elsewhere. Not a legal or credentialing certification.
Ownership & affiliations
One-hop relationships in the resolved entity graph — chain membership, ownership, and operation edges, each backed by a federal source row. Most individual clinicians carry none; edges populate for owners and organizations as the Lane D backfill runs.
| 2 |
| Novo Nordisk Inc | $57 | 3 |
| Hologic Sales And Service, Llc | $23 | 1 |