Lolita V Palmer, MD

Offices

1 location · Skilled Facility Health Care Solutions Inc · 60 clinicians in this group

Looking this up.

Plan participation

Not verified

We could not verify current plan participation for this doctor. This does not mean they are out of network. Call Dr. Palmer’s office at (408) 295-2665 to ask if they take your plan before you enroll.

California Medical Board record

Licence A112491 · Current

Licensed to practise in California · since 2010 · expires 2027-09-30 · University of Arkansas College of Medicine. Board flags: Limitations on Practice.

Public record actions

Sort by

Actions the Medical Board of California publishes for this licence

2021-08-20	Board disciplineDiscipline	Five years probation with various terms and conditions. restrictions: prohibited from performing laparoscopic surgery; and prohibited from supervising physician assistants and advanced practice nurses. · 8002017032704

Original Medicare doctor bills

$1,050,016

Medicare paid this office $1,050,016 for 583 people.

This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.

Sort by

Largest Original Medicare bills

Removal of bone, 20.0 sq cm or less	124	$282,634	$278
Subsequent nursing facility care with moderate level of medical decision making, per day at least 30 minutes	353	$191,119	$94
Removal of muscle and/or tissue, 20.0 sq cm or less	157	$160,575	$181
Removal of skin and tissue, 20.0 sq cm or less	249	$101,031	$102
Subsequent nursing facility care with high level of medical decision making, per day at least 45 minutes	112	$76,154	$136

See all 15 services

Sort by

Every Original Medicare service billed

Removal of bone, 20.0 sq cm or less	124	$282,634	$278
Subsequent nursing facility care with moderate level of medical decision making, per day at least 30 minutes	353	$191,119	$94
Removal of muscle and/or tissue, 20.0 sq cm or less	157	$160,575	$181
Removal of skin and tissue, 20.0 sq cm or less	249	$101,031	$102
Subsequent nursing facility care with high level of medical decision making, per day at least 45 minutes	112	$76,154	$136
Subsequent nursing facility care with straightforward level of medical decision making, per day 20 minutes or more	356	$73,197	$65
Initial nursing facility care with high level of medical decision making, per day 50 minutes or more	305	$48,082	$158
Removal of bone, each additional 20.0 sq cm or less	49	$43,368	$106
Removal of muscle and/or tissue, each additional 20.0 sq cm or less	40	$27,141	$64
Application of chemical to stop tissue regrowth in wound	69	$14,775	$60
Removal of skin and tissue, each additional 20.0 sq cm or less	36	$9,748	$36
Initial nursing facility care with moderate level of medical decision making, per day at least 35 minutes	70	$8,263	$118
Aspiration of abscess, blood, or cyst	37	$4,872	$96
Complicated or multiple drainage of skin abscess	18	$3,403	$189
Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast	12	$772	$51

Procedures Medicare counted

Sort by

Procedure volume Medicare published

Removal of skin lesions	158	More than 78% of doctors who do this
Removal of tissue	2221	More than 99% of doctors who do this
Removal or shaving of skin growth	12	More than 66% of doctors who do this
Skin biopsy	11	More than 59% of doctors who do this

Who their Medicare patients are

583 Original Medicare patients in 2024. Average age 76 · Under 65 12% · 85 and older 24% · Women 51% · Also on Medicaid 72% · Health risk score 2.94. Sicker patients than 9 in 10 peers; the typical general surgery clinician is at 1.69.

Conditions among them: High blood pressure 75% · Diabetes 55% · Depression 52% · Heart failure 48% · Chronic kidney disease 47% · Dementia 47% · Coronary heart disease 39% · COPD 38% · Atrial fibrillation 38% · Stroke 21% · Cancer 12%.

The office billed $1,639,552, Medicare allowed $1,307,877 and paid $1,050,016; for 8,472 services of 20 kinds.

Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.

Year by year

Sort by

Original Medicare by year

2024	583	8,472	76	2.94	$1,639,552	$1,050,016
2023	575	7,785	75	2.90	$1,417,802	$894,772
2022	599	6,732	75	2.85	$1,172,970	$725,457
2021	519	4,729	76	2.79	$884,533	$548,355
2020	530	6,029	76	2.77	$1,139,445	$704,701
2019	604	5,815	75	3.05	$965,158	$570,812
2018	549	5,054	74	2.95	$672,573	$393,467
2017	225	1,032	73	2.38	$232,307	$83,799
2016	150	303	69	1.35	$272,263	$58,896
2015	166	374	69	1.24	$380,856	$77,133
2014	93	184	71	1.21	$162,154	$32,603
2013	158	366	68	1.33	$360,915	$76,178

Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.

See the services billed each year

2023: 15 services

Sort by

Original Medicare services billed in 2023

Removal of bone, 20.0 sq cm or less	116	$229,649	$263
Subsequent nursing facility care with moderate level of medical decision making, per day at least 30 minutes	357	$211,518	$89
Removal of muscle and/or tissue, 20.0 sq cm or less	162	$152,325	$175
Removal of skin and tissue, 20.0 sq cm or less	258	$82,658	$98
Subsequent nursing facility care with straightforward level of medical decision making, per day 20 minutes or more	357	$75,772	$61
Initial nursing facility care with high level of medical decision making, per day 50 minutes or more	356	$53,766	$151
Removal of bone, each additional 20.0 sq cm or less	36	$29,997	$100
Removal of muscle and/or tissue, each additional 20.0 sq cm or less	46	$23,936	$61
Application of chemical to stop tissue regrowth in wound	61	$11,307	$66
Removal of skin and tissue, each additional 20.0 sq cm or less	36	$6,136	$34
Subsequent nursing facility care with high level of medical decision making, per day at least 45 minutes	31	$5,148	$129
Complicated or multiple drainage of skin abscess	25	$4,748	$164
Aspiration of abscess, blood, or cyst	33	$3,352	$82
Subsequent nursing facility care with moderate level of medical decision making, per day at least 30 minutes	11	$1,167	$90
Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast	11	$726	$52

2022: 15 services

Sort by

Original Medicare services billed in 2022

Removal of bone, 20.0 sq cm or less	111	$177,007	$262
Removal of muscle and/or tissue, 20.0 sq cm or less	196	$142,484	$183
Subsequent nursing facility care with moderate level of medical decision making, per day at least 30 minutes	335	$136,222	$75
Subsequent nursing facility care with straightforward level of medical decision making, per day 20 minutes or more	368	$79,874	$56
Removal of skin and tissue, 20.0 sq cm or less	231	$59,750	$97
Initial nursing facility care with high level of medical decision making, per day 50 minutes or more	292	$39,309	$134
Subsequent nursing facility care with high level of medical decision making, per day at least 45 minutes	95	$23,690	$109
Removal of bone, each additional 20.0 sq cm or less	30	$20,401	$100
Application of chemical to stop tissue regrowth in wound	65	$11,967	$66
Removal of muscle and/or tissue, each additional 20.0 sq cm or less	42	$10,214	$62
Initial nursing facility care with moderate level of medical decision making, per day at least 35 minutes	77	$7,717	$99
Removal of skin and tissue, each additional 20.0 sq cm or less	37	$5,640	$35
Aspiration of abscess, blood, or cyst	31	$4,607	$94
Complicated or multiple drainage of skin abscess	15	$2,667	$178
Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast	11	$561	$51

2021: 15 services

Sort by

Original Medicare services billed in 2021

Subsequent nursing facility care with high level of medical decision making, per day at least 45 minutes	219	$117,760	$111
Removal of bone, 20.0 sq cm or less	81	$115,205	$262
Removal of muscle and/or tissue, 20.0 sq cm or less	140	$93,397	$180
Subsequent nursing facility care with moderate level of medical decision making, per day at least 30 minutes	264	$75,536	$74
Removal of skin and tissue, 20.0 sq cm or less	179	$49,146	$98
Subsequent nursing facility care with straightforward level of medical decision making, per day 20 minutes or more	190	$24,160	$57
Initial nursing facility care with high level of medical decision making, per day 50 minutes or more	173	$23,220	$134
Initial nursing facility care with moderate level of medical decision making, per day at least 35 minutes	165	$17,175	$104
Removal of bone, each additional 20.0 sq cm or less	24	$10,410	$101
Application of chemical to stop tissue regrowth in wound	32	$5,582	$63
Removal of muscle and/or tissue, each additional 20.0 sq cm or less	19	$4,729	$61
Complicated or multiple drainage of skin abscess	23	$4,061	$169
Removal of skin and tissue, each additional 20.0 sq cm or less	24	$2,076	$35
Biopsy of related skin growth, first growth	18	$1,806	$90
Aspiration of abscess, blood, or cyst	12	$1,225	$102

2020: 17 services

Sort by

Original Medicare services billed in 2020

Removal of bone, 20.0 sq cm or less	80	$171,312	$262
Subsequent nursing facility care with high level of medical decision making, per day at least 45 minutes	217	$154,770	$113
Removal of muscle and/or tissue, 20.0 sq cm or less	139	$132,779	$178
Subsequent nursing facility care with moderate level of medical decision making, per day at least 30 minutes	269	$76,983	$76
Removal of skin and tissue, 20.0 sq cm or less	211	$69,673	$97
Initial nursing facility care with high level of medical decision making, per day 50 minutes or more	127	$17,279	$136
Subsequent nursing facility care with straightforward level of medical decision making, per day at least 10 minutes	153	$15,905	$34
Initial nursing facility care with moderate level of medical decision making, per day at least 35 minutes	140	$14,513	$104
Removal of bone, each additional 20.0 sq cm or less	26	$13,029	$100
Subsequent nursing facility care with straightforward level of medical decision making, per day 20 minutes or more	107	$12,306	$57
Removal of muscle and/or tissue, each additional 20.0 sq cm or less	21	$4,946	$62
Removal of skin and tissue, each additional 20.0 sq cm or less	39	$4,230	$35
Application of chemical to stop tissue regrowth in wound	30	$3,812	$58
Initial nursing facility care with straightforward or low level of medical decision making, per day at least 25 minutes	57	$3,636	$64
Complicated or multiple drainage of skin abscess	19	$3,313	$158
Simple separation of fingernail or toenail from nail bed, first nail	16	$1,742	$79
Biopsy of related skin growth, first growth	15	$1,250	$78

2019: 17 services

Sort by

Original Medicare services billed in 2019

Removal of bone, 20.0 sq cm or less	91	$165,762	$259
Removal of muscle and/or tissue, 20.0 sq cm or less	151	$124,893	$168
Removal of skin and tissue, 20.0 sq cm or less	254	$76,533	$90
Subsequent nursing facility care with straightforward level of medical decision making, per day at least 10 minutes	388	$49,944	$35
Subsequent nursing facility care with moderate level of medical decision making, per day at least 30 minutes	105	$33,735	$75
Subsequent nursing facility care with straightforward level of medical decision making, per day 20 minutes or more	185	$26,656	$56
Removal of bone, each additional 20.0 sq cm or less	22	$15,578	$101
Initial nursing facility care with straightforward or low level of medical decision making, per day at least 25 minutes	207	$15,106	$73
Initial nursing facility care with high level of medical decision making, per day 50 minutes or more	93	$12,500	$134
Initial nursing facility care with moderate level of medical decision making, per day at least 35 minutes	109	$11,514	$106
Removal of muscle and/or tissue, each additional 20.0 sq cm or less	33	$11,435	$60
Application of chemical to stop tissue regrowth in wound	52	$9,343	$58
Removal of skin and tissue, each additional 20.0 sq cm or less	46	$7,754	$34
Complicated or multiple drainage of skin abscess	26	$4,304	$148
Simple separation of fingernail or toenail from nail bed, first nail	21	$1,752	$67
Biopsy of related skin growth, first growth	18	$1,635	$82
Aspiration of abscess, blood, or cyst	12	$1,167	$97

2018: 15 services

Sort by

Original Medicare services billed in 2018

Removal of bone, 20.0 sq cm or less	58	$92,254	$252
Subsequent nursing facility care with straightforward level of medical decision making, per day at least 10 minutes	406	$70,663	$35
Removal of muscle and/or tissue, 20.0 sq cm or less	108	$69,961	$162
Removal of skin and tissue, 20.0 sq cm or less	168	$36,372	$87
Subsequent nursing facility care with straightforward level of medical decision making, per day 20 minutes or more	137	$24,906	$55
Subsequent nursing facility care with moderate level of medical decision making, per day at least 30 minutes	71	$20,230	$73
Initial nursing facility care with straightforward or low level of medical decision making, per day at least 25 minutes	283	$20,027	$71
Application of chemical to stop tissue regrowth in wound	42	$11,137	$62
Removal of bone, each additional 20.0 sq cm or less	22	$10,911	$98
Initial nursing facility care with moderate level of medical decision making, per day at least 35 minutes	97	$9,780	$100
Initial nursing facility care with high level of medical decision making, per day 50 minutes or more	60	$7,898	$132
Removal of skin and tissue, each additional 20.0 sq cm or less	30	$7,050	$33
Complicated or multiple drainage of skin abscess	25	$4,351	$155
Removal of muscle and/or tissue, each additional 20.0 sq cm or less	20	$3,035	$58
Simple separation of fingernail or toenail from nail bed, first nail	11	$1,225	$82

2017: 11 services

Sort by

Original Medicare services billed in 2017

Subsequent nursing facility care with straightforward level of medical decision making, per day at least 10 minutes	118	$13,198	$35
Removal of skin and tissue, 20.0 sq cm or less	47	$8,872	$89
Subsequent nursing facility care with straightforward level of medical decision making, per day 20 minutes or more	44	$5,530	$54
Initial nursing facility care with straightforward or low level of medical decision making, per day at least 25 minutes	77	$5,411	$70
Removal of muscle and/or tissue, 20.0 sq cm or less	17	$5,316	$166
Application of chemical to stop tissue regrowth in wound	12	$2,173	$59
Subsequent nursing facility care with moderate level of medical decision making, per day at least 30 minutes	16	$2,146	$72
New patient visit (30+ min)	28	$1,962	$70
Initial nursing facility care with moderate level of medical decision making, per day at least 35 minutes	20	$1,931	$97
New patient visit (45+ min)	17	$1,720	$101
Removal of skin and tissue, each additional 20.0 sq cm or less	11	$1,127	$32

2016: 7 services

Sort by

Original Medicare services billed in 2016

Removal of gallbladder using an endoscope	16	$8,067	$504
New patient visit (45+ min)	58	$7,393	$127
Repair of groin hernia using an endoscope	16	$6,018	$376
New patient visit (30+ min)	59	$4,920	$83
Return visit (30+ min)	17	$1,517	$84
Short return visit (20+ min)	11	$689	$57
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report	29	$409	$14

2015: 7 services

Sort by

Original Medicare services billed in 2015

Repair of groin hernia using an endoscope	27	$10,547	$391
New patient visit (45+ min)	76	$9,519	$125
Removal of gallbladder using an endoscope	17	$7,880	$464
Repair of incisional or abdominal hernia	13	$7,736	$553
New patient visit (30+ min)	56	$4,719	$84
Placement of mesh to repair incisional or abdominal hernia	15	$3,044	$203
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report	39	$550	$14

2014: 3 services

Sort by

Original Medicare services billed in 2014

New patient visit (45+ min)	30	$3,628	$121
New patient visit (30+ min)	34	$2,932	$86
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report	17	$234	$14

2013: 7 services

Sort by

Original Medicare services billed in 2013

New patient visit (45+ min)	64	$8,275	$129
Removal of gallbladder using an endoscope	14	$7,287	$520
Repair of groin hernia using an endoscope	14	$4,937	$353
New patient visit (30+ min)	52	$4,495	$86
Return visit (30+ min)	22	$1,980	$82
Short return visit (20+ min)	15	$842	$56
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report	40	$592	$15

Medicaid work

$102,489 in 2024

Medicaid paid $102,489 for 3,857 billed services this clinician did in 2024, up to 57 people in a month for one service.

Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.

Sort by

Largest Medicaid services in 2024

Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less	657	$31,267
Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less	464	$21,791
SBSQ NURSING FACILITY CARE MOD MDM 30 MINUTES	946	$16,001
Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less	413	$9,659
SBSQ NURSING FACILITY CARE HIGH MDM 45 MINUTES	433	$9,478
SBSQ NURSING FACILITY CARE LOW MDM 20 MINUTES	598	$7,363
INITIAL NURSING FACILITY CARE HI MDM 50 MINUTES	112	$2,854
Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion	136	$2,396
Chemical cauterization of granulation tissue (ie, proud flesh)	98	$1,680

Sort by

Medicaid work by year

2024	3,857	9	57	$102,489
2023	1,820	7	41	$63,187
2022	378	5	21	$7,734
2021	64	3	17	$1,273
2020	89	2	22	$825
2019	528	4	22	$7,638
2018	396	3	30	$5,168

See the largest Medicaid services in earlier years

2023

Sort by

Largest Medicaid services in 2023

SBSQ NURSING FACILITY CARE MOD MDM 30 MINUTES	751	$19,280
Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less	144	$14,394
Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less	137	$10,499
Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less	238	$9,626
SBSQ NURSING FACILITY CARE LOW MDM 20 MINUTES	322	$4,976
INITIAL NURSING FACILITY CARE HI MDM 50 MINUTES	83	$2,717
Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion	145	$1,695

2022

Sort by

Largest Medicaid services in 2022

SBSQ NURSING FACILITY CARE MOD MDM 30 MINUTES	237	$4,589
SBSQ NURSING FACILITY CARE LOW MDM 20 MINUTES	72	$1,228
SBSQ NURSING FACILITY CARE HIGH MDM 45 MINUTES	27	$876
Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less	23	$836
Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion	19	$205

2021

Sort by

Largest Medicaid services in 2021

SBSQ NURSING FACILITY CARE HIGH MDM 45 MINUTES	19	$590
SBSQ NURSING FACILITY CARE LOW MDM 20 MINUTES	21	$355
SBSQ NURSING FACILITY CARE MOD MDM 30 MINUTES	24	$328

2020

Sort by

Largest Medicaid services in 2020

SBSQ NURSING FACILITY CARE SF MDM 10 MINUTES	66	$482
SBSQ NURSING FACILITY CARE HIGH MDM 45 MINUTES	23	$343

2019

Sort by

Largest Medicaid services in 2019

Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less	212	$4,647
SBSQ NURSING FACILITY CARE LOW MDM 20 MINUTES	148	$1,775
SBSQ NURSING FACILITY CARE SF MDM 10 MINUTES	147	$807
SBSQ NURSING FACILITY CARE MOD MDM 30 MINUTES	21	$408

2018

Sort by

Largest Medicaid services in 2018

SBSQ NURSING FACILITY CARE SF MDM 10 MINUTES	256	$2,203
Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less	48	$1,506
SBSQ NURSING FACILITY CARE LOW MDM 20 MINUTES	92	$1,459

Drugs they prescribed that Part D paid

$4,773

Pharmacies billed $4,773 in 2024.

This is pharmacy cost, not the office bill, and not what patients paid.

Opioids were 0% of their Part D prescriptions (0 of 88) in 2024. At or below the middle of the specialty; the typical general surgery clinician is at 34%.

82 generic and fewer than 11 brand-name prescriptions · $4,773 in drug cost.

Part D prescriptions only. The opioid rate is opioid prescriptions as a share of all this clinician's Part D prescriptions; surgeons and pain specialists run higher than others, so it is shown against the same specialty.

Sort by

Largest Part D drug costs

Baclofen	12	$372	$31

Year by year

Sort by

Part D prescribing by year

2024	88	24	0% (0)	None	$4,773
2023	102	34	0% (0)	20%	$6,646
2022	72	15	0% (0)	40%	$2,025
2021	55	21	0% (0)	27%	$1,236
2020	154	34	0% (0)	27%	$4,008
2019	98	23	0% (0)	26%	$5,478
2017	101	36	25% (25)	None	$1,105
2016	197	74	35% (68)	None	$4,032
2015	210	79	32% (67)	None	$3,191
2014	85	39	53% (45)	None	$1,462
2013	163	87	63% (103)	None	$2,370

Part D prescriptions only. A drug prescribed to fewer than 11 people in a year is hidden.

See the drugs prescribed each year

2023: 2 drugs

Sort by

Part D drugs prescribed in 2023

Permethrin	12	$875	$73
Levothyroxine	12	$127	$11

2022: 2 drugs

Sort by

Part D drugs prescribed in 2022

Silver Sulfadiazine	28	$400	$14
Hydrocortisone	11	$100	$9

2021: 1 drug

Sort by

Part D drugs prescribed in 2021

Silver Sulfadiazine	12	$189	$16

2020: 5 drugs

Sort by

Part D drugs prescribed in 2020

Nyamyc	35	$680	$19
Silver Sulfadiazine	39	$655	$17
Ketoconazole	15	$441	$29
Mupirocin	28	$408	$15
Triamcinolone Acetonide	12	$129	$11

2019: 5 drugs

Sort by

Part D drugs prescribed in 2019

Santyl	14	$3,569	$255
Ketoconazole	12	$666	$56
Nyamyc	19	$282	$15
Silver Sulfadiazine	11	$169	$15
Triamcinolone Acetonide	21	$165	$8

2017: 3 drugs

Sort by

Part D drugs prescribed in 2017

Polyethylene Glycol 3350	20	$171	$9
Hydrocodone-Acetaminophen	19	$169	$9
Tamsulosin	13	$158	$12

2016: 6 drugs

Sort by

Part D drugs prescribed in 2016

Hydrocodone-Acetaminophen	41	$807	$20
Oxycodone-Acetaminophen	12	$436	$36
Ibuprofen	33	$333	$10
Polyethylene Glycol 3350	35	$287	$8
Ondansetron	16	$158	$10
Ondansetron Odt	16	$158	$10

2015: 4 drugs

Sort by

Part D drugs prescribed in 2015

Hydrocodone-Acetaminophen	58	$931	$16
Ondansetron	35	$460	$13
Polyethylene Glycol 3350	36	$356	$10
Ibuprofen	40	$320	$8

2014: 1 drug

Sort by

Part D drugs prescribed in 2014

Hydrocodone-Acetaminophen	33	$347	$11

2013: 1 drug

Sort by

Part D drugs prescribed in 2013

Hydrocodone-Acetaminophen	88	$748	$8

Checkups this office reported

Medicare did not publish checkup rates for this clinician.

Medicare’s overall office score: 100.0 / 100; Scores the office’s reporting and systems. It is not a grade for how the doctor treats you.

Professional record

NPI: 1295939874
Licence: CA A112491California A112491: Current · expires 2027-09-30
Trained: University of Arkansas College of Medicine, 2004
Group: Skilled Facility Health Care Solutions Inc
Gender: Female

More record details

Sole proprietor: No
Taxonomy: Surgery (208600000X)
Mailing address: 10470 Old Placerville Rd, Suite 100, Sacramento, CA, 95827
NPI first listed: 2007-06-14
NPI last updated: 2015-07-22

This is when the NPI record was last certified, not a medical board exam.