EXCLUDEDPROVIDER
Individual Revocation

Jeffrey Donald Nelson

San Quentin, CA 94974

Public HHS-OIG LEIE exclusion record

Jeffrey Donald Nelson of San Quentin, CA is registered in the CMS NPI Registry under National Provider Identifier (NPI) 1295720936 with a primary specialty of Family Medicine, Sports Medicine. According to the HHS-OIG List of Excluded Individuals/Entities (LEIE), Jeffrey Donald Nelson is currently excluded from participation in federally funded health care programs due to license revocation, suspension, or surrender, as of March 20, 2022.

Status
Currently listed by HHS-OIG
Record type
Individual
Location
San Quentin, CA 94974
Exclusion date
March 20, 2022
Exclusion type
Revocation (1128b4)
NPI
1295720936

Record summary

Jeffrey Donald Nelson appears in the HHS-OIG List of Excluded Individuals/Entities (LEIE) public dataset as an individual record associated with San Quentin, California. 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 March 20, 2022, and the exclusion type is 1128b4, identified by HHS-OIG as license revocation, suspension, or surrender.

Source record

SourceHHS-OIG LEIE (public dataset)
Record typeIndividual
Current statusCurrently listed by HHS-OIG
Exclusion dateMarch 20, 2022
Exclusion typeLicense revocation, suspension, or surrender (1128b4)
NPI1295720936
Source dataset dateMay 2026

What this exclusion type means

HHS-OIG identifies exclusion type 1128b4 as “License revocation, suspension, or surrender.” License revocation, suspension, or surrender (permissive exclusion).

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 San Quentin, CA 94974. The listed provider category is Physician (MD, DO). The listed specialty is Family Practice.

NPI Registry context

The LEIE record lists NPI 1295720936. CMS NPPES public registry data lists this NPI as an individual record with primary taxonomy Family Medicine, Sports Medicine (207QS0010X). Registered practice location: Berkeley, CA. NPI enumeration date: Sep 19, 2005. NPPES status: Active. The NPI Registry lists credential: M.D..

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 San Quentin, CA

Other individuals and entities currently listed in the HHS-OIG LEIE public dataset with a San Quentin, CA address.

Edgar Gustavo Villamarin Individual Patient Abuse
San Quentin, CA · Conviction relating to patient abuse or neglect · Excluded Jan 2022
Efrain Castanon Individual Patient Abuse
San Quentin, CA · Conviction relating to patient abuse or neglect · Excluded Aug 2019
Joseph Allen Ross Individual Patient Abuse
San Quentin, CA · Conviction relating to patient abuse or neglect · Excluded Jan 2007
Mario Puma Taina Individual Patient Abuse
San Quentin, CA · Conviction relating to patient abuse or neglect · Excluded Aug 2000
Dean Andre Freeman Individual Patient Abuse
San Quentin, CA · Conviction relating to patient abuse or neglect · Excluded May 2000

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 California More Records in San Quentin More Revocation Records