ANATOL SIDAMONIDZE
CIN: KR02974N
Date of Birth: April 18, 1949
Gender: Male
Created: Aug. 9, 2026
Address:
1571 42ND STREET 3D
, BROOKLYN, NY 11219
Last Updated: Aug. 9, 2026 3:56 PM
Latest Eligibility Snapshot
Date of Service: Aug. 12, 2026
Medicaid Eligible:
Yes
Coverage: Aug. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: ELDERSERVE HEALTH INC MLTCP
Recertification:
Yes — Dec. 31, 2026
Code 60:
No
S1:
No
Eligibility History
| Date of Service | Status | Recert | Code 60 | S1 | Import | 271 |
|---|---|---|---|---|---|---|
| Aug. 12, 2026 | Eligible | ✓ | — | — | Just care Census ( Prem) - Just_Care_Census_CIN.csv | View |
| Aug. 6, 2026 | Eligible | ✓ | — | — | Just care Census ( Prem) - Just_Care_Census_CIN.csv | View |
| Aug. 6, 2026 | Eligible | ✓ | — | — | Just care Census ( Prem) - Just_Care_Census_CIN.csv | View |