EXCLUDEDPROVIDER
Individual Program Crime

Warren Randolf Stack

Safford, AZ 85548

Public HHS-OIG LEIE exclusion record

Warren Randolf Stack of Safford, AZ is registered in the CMS NPI Registry under National Provider Identifier (NPI) 1013088814 with a primary specialty of Internal Medicine. According to the HHS-OIG List of Excluded Individuals/Entities (LEIE), Warren Randolf Stack is currently excluded from participation in federally funded health care programs due to conviction of program-related crimes, as of January 20, 2010.

Status
Currently listed by HHS-OIG
Record type
Individual
Location
Safford, AZ 85548
Exclusion date
January 20, 2010
Exclusion type
Program Crime (1128a1)
NPI
1013088814

Record summary

Warren Randolf Stack appears in the HHS-OIG List of Excluded Individuals/Entities (LEIE) public dataset as an individual record associated with Safford, Arizona. The latest imported LEIE dataset lists this record as currently excluded from participation in federally funded health care programs. The exclusion date shown in the source record is January 20, 2010, and the exclusion type is 1128a1, identified by HHS-OIG as conviction of program-related crimes.

Source record

SourceHHS-OIG LEIE (public dataset)
Record typeIndividual
Current statusCurrently listed by HHS-OIG
Exclusion dateJanuary 20, 2010
Exclusion typeConviction of program-related crimes (1128a1)
NPI1013088814
UPIND07511
Source dataset dateMay 2026

What this exclusion type means

HHS-OIG identifies exclusion type 1128a1 as “Conviction of program-related crimes.” Conviction of a criminal offense related to the delivery of an item or service under Medicare or a State health care program (mandatory exclusion, minimum 5 years).

This exclusion type is a statutory category used by HHS-OIG in the LEIE dataset. The category describes the legal authority associated with the exclusion record, not a separate investigation or additional reporting by Excluded Provider.

Location and provider classification

This LEIE record is associated with Safford, AZ 85548. The listed provider category is Medical Practice, MD. The listed specialty is Internal Medicine.

NPI Registry context

The LEIE record lists NPI 1013088814. CMS NPPES public registry data lists this NPI as an individual record with primary taxonomy Internal Medicine (207R00000X). Registered practice location: West Valley City, UT. NPI enumeration date: Nov 13, 2006. NPPES status: Active. The NPI Registry lists credential: MD.

NPI Registry data is administrative provider-identification data from CMS. It does not independently verify or explain the HHS-OIG exclusion record above. Verify exclusion status directly with HHS-OIG.

Other excluded providers in Safford, AZ

Other individuals and entities currently listed in the HHS-OIG LEIE public dataset with a Safford, AZ address.

Carl Stephen Galeos Yebes Individual Revocation
Safford, AZ · License revocation, suspension, or surrender · Excluded Aug 2024
Alexander Kiev Martinez Individual Felony Fraud
Safford, AZ · Felony conviction relating to health care fraud · Excluded May 2021
Maxim R Jr Sverdlov Individual Program Crime
Safford, AZ · Conviction of program-related crimes · Excluded Nov 2020
Sandra Kay Long Individual Revocation
Safford, AZ · License revocation, suspension, or surrender · Excluded Nov 2017
Edward Jack Sayegh Individual Program Crime
Safford, AZ · Conviction of program-related crimes · Excluded Oct 2016
Linda M Herbert Individual Revocation
Safford, AZ · License revocation, suspension, or surrender · Excluded Oct 2016
Pezhman Ebrahimzadeh Individual Program Crime
Safford, AZ · Conviction of program-related crimes · Excluded Dec 2013
Deanna Renee Garcia Individual Controlled Substance
Safford, AZ · Felony conviction relating to controlled substance · Excluded May 2010

See all 18 excluded providers in Safford →

How to verify this record

This page is a public-record summary and should be treated as a possible LEIE match, not final identity verification. To verify the record, use the official HHS-OIG LEIE search and compare available identifying information through the official process. Name, location, provider category, specialty, exclusion date, and NPI should be treated as matching clues rather than final proof of identity.

What this page does not include

This page summarizes the HHS-OIG LEIE public dataset only. It does not search state Medicaid exclusion lists, state licensing-board actions, court records, malpractice records, employment history, civil lawsuits, or non-public investigations.

Verify with HHS-OIG Remove / correct this record

Related

More Excluded Individuals in Arizona More Records in Safford More Program Crime Records