← Readiness queue
PRV-4002
ReadySynthetic provider file · no real PII / no PHIHospitalist · Internal medicine · TRH Main — Medicine
Weighted readiness
100
6/6 checks verified
Deadline
118d
Recredential due 2026-11-07
Flags
exclusion clear
Primary-source verification checklist
| Dimension | Status | Detail | Primary source | Weight |
|---|---|---|---|---|
| State medical license | Verified | Active | TMB primary source (batch PSV) | 25% |
| DEA registration | Verified | Active through 2027 | DEA CSA registry (batch) | 15% |
| Board certification | Verified | ABIM current | ABMS (batch) | 15% |
| Payer enrollment (BCBSTX) | Verified | Active, PAR | BCBSTX enrollment export | 20% |
| OIG-LEIE / SAM exclusion | Verified | No match on last batch screen | OIG-LEIE + SAM.gov (batch) | 15% |
| Malpractice coverage | Verified | Current | COI on file | 10% |
Evidence provenance
- Owner
- L. Nguyen
- Evidence
- Credentialing packet PRV-4002 · PSV batch 06-30
- Linked agreement
- Statewide Blue Plan Participation Agreement
Readiness workflow
Demo action — resets on reload · not persistedChronology & session activity
- seed2026-06-30 — PRV-4002 surfaced by VERIFY readiness rule from the Credentialing + PSV batch extract · FY2026 Q3.
- seed2026-06-30 — Primary-source verification results reconciled against agreement scope and payer enrollment.