EXCLUDEDPROVIDER
Individual Revocation

Anthony H Kim

Manlius, NY 13104

Public HHS-OIG LEIE exclusion record

The HHS-OIG List of Excluded Individuals/Entities (LEIE) file imported by ExcludedProvider.com on October 4, 2026 contains a record for Anthony H Kim of Manlius, NY with exclusion type 1128b4, which HHS-OIG's list of exclusion authorities describes as “license revocation, suspension, or surrender”, and an exclusion date of May 20, 2014. This page is not an official HHS-OIG record, and a matching name alone does not show that the record refers to a particular person; confirm identity and current status with HHS-OIG.

The LEIE record lists NPI 1154363109.

Status
Listed in the LEIE file imported October 4, 2026
Record type
Individual
Location
Manlius, NY 13104
Exclusion date
May 20, 2014
Exclusion type
Revocation (1128b4)
NPI (as listed in LEIE)
1154363109

Record summary

Anthony H Kim appears in the HHS-OIG List of Excluded Individuals/Entities (LEIE) public dataset as an individual record associated with Manlius, New York. The exclusion date shown in the source record is May 20, 2014. The exclusion type is 1128b4, identified by HHS-OIG as license revocation, suspension, or surrender.

Source record

SourceHHS-OIG LEIE downloadable file (UPDATED.csv)
Record typeIndividual
Status in imported filesListed in the LEIE file imported October 4, 2026
Exclusion dateMay 20, 2014
Exclusion typeLicense revocation, suspension, or surrender (1128b4)
NPI (as listed in LEIE)1154363109
UPIN (as listed in LEIE)E74693
LEIE file importedOctober 4, 2026
File timestampSeptember 10, 2026 (Last-Modified header from the HHS-OIG download server; not an official release date)
HHS-OIG release dateNot independently verified

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 Manlius, NY 13104. The listed provider category is Physician (MD, DO). The listed specialty is General Practice.

NPI Registry context

The LEIE record lists NPI 1154363109. CMS NPPES public registry data lists this NPI as an individual record with primary taxonomy Psychiatry & Neurology, Psychiatry (2084P0800X). Registered practice location: Morrisonville, NY. NPI enumeration date: Jun 12, 2006. NPPES status: Active. The NPI Registry lists credential: MD.

NPI Registry data is administrative provider-identification data from CMS. The NPI above is the one written in the LEIE record; this page does not confirm that the registry entry and the LEIE record refer to the same provider, and registry data does not verify or explain the exclusion. Verify identity and exclusion status directly with HHS-OIG.

Other excluded providers in Manlius, NY

Other individuals and entities in the latest imported HHS-OIG LEIE file with a Manlius, NY address.

Melissa Evelyn Scott Individual Revocation
Manlius, NY · License revocation, suspension, or surrender · Exclusion date Mar 20, 2019
James W Hodgson Individual Revocation
Manlius, NY · License revocation, suspension, or surrender · Exclusion date Jan 20, 2015
Angelo M Emmi Individual Revocation
Manlius, NY · License revocation, suspension, or surrender · Exclusion date Dec 20, 1999
Johanna Cavender Individual Revocation
Manlius, NY · License revocation, suspension, or surrender · Exclusion date Jul 28, 1997

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.

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