EXCLUDEDPROVIDER
Individual Revocation

Thomas Jacob Shaknovsky

Destin, FL 32541

Public HHS-OIG LEIE exclusion record

Thomas Jacob Shaknovsky of Destin, FL is registered in the CMS NPI Registry under National Provider Identifier (NPI) 1568690014 with a primary specialty of Surgery. According to the HHS-OIG List of Excluded Individuals/Entities (LEIE), Thomas Jacob Shaknovsky is currently excluded from participation in federally funded health care programs due to license revocation, suspension, or surrender, as of January 20, 2025.

Status
Currently listed by HHS-OIG
Record type
Individual
Location
Destin, FL 32541
Exclusion date
January 20, 2025
Exclusion type
Revocation (1128b4)
NPI
1568690014

Record summary

Thomas Jacob Shaknovsky appears in the HHS-OIG List of Excluded Individuals/Entities (LEIE) public dataset as an individual record associated with Destin, Florida. 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, 2025, 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 dateJanuary 20, 2025
Exclusion typeLicense revocation, suspension, or surrender (1128b4)
NPI1568690014
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 Destin, FL 32541. The listed provider category is Physician (MD, DO). The listed specialty is General Practice.

NPI Registry context

The LEIE record lists NPI 1568690014. CMS NPPES public registry data lists this NPI as an individual record with primary taxonomy Surgery (208600000X). Registered practice location: Crestview, FL. NPI enumeration date: Jun 23, 2009. NPPES status: Active. The NPI Registry lists credential: DO.

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 Destin, FL

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

Susan Shelton Individual Revocation
Destin, FL · License revocation, suspension, or surrender · Excluded Mar 2024
Bridget Mccune Individual Program Crime
Destin, FL · Conviction of program-related crimes · Excluded Jan 2024
Toni Delanoy Individual Program Crime
Destin, FL · Conviction of program-related crimes · Excluded Mar 2023
Walter David Robinson Individual Program Crime
Destin, FL · Conviction of program-related crimes · Excluded Sep 2018
Tania Briglevich Individual Revocation
Destin, FL · License revocation, suspension, or surrender · Excluded Feb 2018
Holly N Lovett Individual Revocation
Destin, FL · License revocation, suspension, or surrender · Excluded Apr 2006
Stephen Joseph Schenthal Individual Revocation
Destin, FL · License revocation, suspension, or surrender · Excluded Apr 2002
Scott J Streetman Individual Revocation
Destin, FL · License revocation, suspension, or surrender · Excluded Dec 2000

See all 10 excluded providers in Destin →

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 this record with the official HHS-OIG source Save or print this record Monitor this provider/entity Need to screen a list? Join the bulk screening beta

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Related

More Excluded Individuals in Florida More Records in Destin More Revocation Records