Providers
NICOLAS VERGARA, M.D
NPI 1003084625, individual, Houma, LA, Psychiatry & Neurology, Psychiatry
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 29 months, but with up to 767 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 90833 ($130 per patient-month) sit in the top 5% of every provider billing that code.
score 55 of 100, rank 7555, $3.1M at stake
Hours billed per day
Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.
| month | what was found | hours per day, lower bound | hours per day, at price | hours per day, conservative | per working day | patients | billing organizations | codes | paid |
|---|---|---|---|---|---|---|---|---|---|
| Jun 2020 | More hours than a day holds, even counting one unit per claim line | 31.0 | 44.5 | 29.7 | 40.5 | 480 | 1 | 90833 90836 99223 99233 99239 | $68K |
| Oct 2020 | More hours than a day holds, even counting one unit per claim line | 26.3 | 27.4 | 18.3 | 25.7 | 315 | 1 | 90833 90836 99223 99233 99239 | $43K |
| Nov 2020 | More hours than a day holds, even counting one unit per claim line | 30.5 | 28.5 | 19.0 | 27.1 | 420 | 1 | 90833 90836 99223 99233 99239 | $43K |
| May 2021 | More hours than a day holds, even counting one unit per claim line | 25.6 | 30.2 | 20.1 | 29.7 | 460 | 2 | 90792 90833 90836 99223 99233 99238 | $51K |
| Jun 2021 | More hours than a day holds, even counting one unit per claim line | 30.0 | 38.7 | 25.8 | 35.2 | 522 | 2 | 90792 90833 90836 99223 99233 99238 | $63K |
| Apr 2022 | More hours than a day holds, even counting one unit per claim line | 24.3 | 34.5 | 23.0 | 32.8 | 395 | 2 | 90792 90833 99223 99233 99238 | $57K |
| May 2022 | More hours than a day holds, even counting one unit per claim line | 30.7 | 39.6 | 26.4 | 37.2 | 529 | 2 | 90792 90833 99223 99233 99238 | $68K |
| Jun 2022 | More hours than a day holds, even counting one unit per claim line | 27.4 | 34.2 | 22.8 | 31.1 | 521 | 2 | 90792 90833 99223 99233 99238 | $57K |
| Jan 2023 | More hours than a day holds, even counting one unit per claim line | 44.9 | 23.7 | 15.8 | 22.3 | 471 | 1 | 90833 99222 99223 99232 99233 99238 | $42K |
| Feb 2023 | More hours than a day holds, even counting one unit per claim line | 29.3 | 29.1 | 19.4 | 27.1 | 490 | 1 | 90833 99223 99232 99233 99238 | $47K |
| May 2023 | More hours than a day holds, even counting one unit per claim line | 25.8 | 35.0 | 23.4 | 31.5 | 453 | 1 | 90833 99223 99232 99233 99238 | $62K |
| Jun 2023 | More hours than a day holds, even counting one unit per claim line | 38.8 | 53.6 | 35.7 | 48.7 | 628 | 1 | 90833 99223 99232 99233 99238 | $92K |
| Jul 2023 | More hours than a day holds, even counting one unit per claim line | 26.9 | 36.3 | 24.2 | 35.7 | 457 | 1 | 90833 99223 99232 99233 99238 | $64K |
| Aug 2023 | More hours than a day holds, even counting one unit per claim line | 33.3 | 43.6 | 29.1 | 39.2 | 550 | 1 | 90833 99223 99232 99233 99238 | $77K |
| Sep 2023 | More hours than a day holds, even counting one unit per claim line | 36.0 | 43.1 | 28.7 | 41.0 | 581 | 1 | 90833 99223 99232 99233 99238 | $74K |
| Oct 2023 | More hours than a day holds, even counting one unit per claim line | 36.2 | 38.1 | 25.4 | 35.8 | 523 | 1 | 90833 99223 99232 99233 99238 | $68K |
| Nov 2023 | More hours than a day holds, even counting one unit per claim line | 33.3 | 43.0 | 28.7 | 39.1 | 585 | 1 | 90833 99223 99232 99233 99238 | $74K |
| Dec 2023 | More hours than a day holds, even counting one unit per claim line | 29.7 | 38.7 | 25.8 | 38.1 | 605 | 1 | 90833 99223 99232 99233 99238 | $70K |
| Jan 2024 | More hours than a day holds, even counting one unit per claim line | 31.9 | 36.6 | 24.4 | 32.8 | 593 | 1 | 90833 99223 99232 99233 99238 | $75K |
| Feb 2024 | More hours than a day holds, even counting one unit per claim line | 32.6 | 36.1 | 24.1 | 33.2 | 556 | 1 | 90833 99223 99232 99233 99238 | $70K |
| Mar 2024 | More hours than a day holds, even counting one unit per claim line | 42.7 | 40.3 | 26.9 | 39.6 | 673 | 1 | 90833 99223 99232 99233 99238 | $83K |
| Apr 2024 | More hours than a day holds, even counting one unit per claim line | 40.5 | 44.4 | 29.6 | 40.4 | 626 | 1 | 90833 99223 99232 99233 99238 | $88K |
| May 2024 | More hours than a day holds, even counting one unit per claim line | 41.7 | 48.6 | 32.4 | 43.6 | 767 | 1 | 90833 99223 99232 99233 99238 | $100K |
| Jun 2024 | More hours than a day holds, even counting one unit per claim line | 42.0 | 46.1 | 30.7 | 46.1 | 682 | 1 | 90833 99223 99232 99233 99238 | $92K |
| Jul 2024 | More hours than a day holds, even counting one unit per claim line | 30.8 | 36.4 | 24.2 | 32.7 | 528 | 1 | 90833 99223 99232 99233 99238 | $75K |
| Aug 2024 | More hours than a day holds, even counting one unit per claim line | 28.9 | 35.5 | 23.7 | 33.4 | 549 | 1 | 90833 99223 99232 99233 99238 | $74K |
| Sep 2024 | More hours than a day holds, even counting one unit per claim line | 33.5 | 37.9 | 25.2 | 36.1 | 539 | 1 | 90833 99223 99232 99233 99238 | $76K |
| Oct 2024 | More hours than a day holds, even counting one unit per claim line | 27.4 | 32.6 | 21.7 | 29.3 | 531 | 1 | 90833 99223 99232 99233 99238 | $67K |
| Nov 2024 | More hours than a day holds, even counting one unit per claim line | 26.6 | 31.7 | 21.1 | 30.2 | 501 | 1 | 90833 99223 99232 99233 99238 | $63K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | NICOLAS VERGARA, M.D |
| Type | Individual |
| Status | Active |
| NPI issued | February 17, 2008, last updated October 4, 2012 |
| Practice location | 1990 INDUSTRIAL BLVD., Houma, LA 70363-7055, 985-868-9300 |
| Mailing address | 1440 CANAL STREET, TB-53, New Orleans, LA 70112-2272 |
| Specialties | Psychiatry & Neurology, Psychiatry (2084P0800X, primary, license MD.204964 LA) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $1.2M | 36% | $178 | $96 (top 5% from $249) | 86th percentile | |
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | $980K | 28% | $130 | $49 (top 5% from $109) | 97th percentile | |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $513K | 15% | $111 | $81 (top 5% from $170) | 75th percentile | |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $282K | 8% | $100 | $67 (top 5% from $174) | 77th percentile | |
| S9480 | Intensive outpatient psychiatric services per diem | $193K | 6% | $965 | $946 (top 5% from $4K) | 51st percentile | |
| 99238 | Hospital discharge day management, 30 minutes or less | $158K | 5% | $44 | $48 (top 5% from $80) | 44th percentile | |
| 99239 | Hospital discharge day management, more than 30 minutes | $39K | 1% | $64 | $49 (top 5% from $101) | 69th percentile | |
| 90836 | Psychotherapy with evaluation and management visit, 45 minutes | $37K | 1% | $46 | $72 (top 5% from $190) | 23rd percentile |
Medicare Part B 2024, largest codes
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 39 | 38 | $5K | $250 | $164 | 1.5x | 3.0x (90th percentile 5.6x) |
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | 42 | 20 | $2K | $80 | $62 | 1.3x | 2.1x (90th percentile 3.5x) |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 21 | 13 | $2K | $200 | $112 | 1.8x | 2.6x (90th percentile 4.7x) |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 25 | 11 | $1K | $175 | $74 | 2.4x | 2.6x (90th percentile 4.3x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
4 providers in Terrebonne Parish County, LA carry an indicator in the public record, with $333K at stake between them. The most common is part of a provider network, on 2 of them, followed by more hours than a day holds on 1.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | BAYOU HOME CARE L.L.C. Houma, LA, ranked 1934 | $0 |
|
| 3 | HOPE HEALTHCARE AND HOSPICE BC, LLC Houma, LA, ranked 4767 | $0 |
|
| 4 | PATRICK WALKER Houma, LA, ranked 9332 | $327K |
|
| 5 | PHYSICIANS MEDICAL CENTER, LLC Houma, LA, ranked 11953 | $6K |
Recent enforcement in LA
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJOtherJul 30, 2026
Louisiana U.S. Attorneys Highlight Nine Recent Fraud Prosecutions Across the State
A nurse practitioner was sentenced for a health care fraud scheme involving over $12 million in fraudulent Medicare claims for medically unnecessary cancer genetic tests and receipt of kickbacks, and a New Orleans physician was charged with health care fraud for allegedly submitting $5.9 million in fraudulent claims to Medicare, Medicaid, and Humana for care not provided, in-person care for patients outside the state, and claims using other providers' identities.
DOJChargedJun 23, 2026
National Health Care Fraud Takedown Results in 455 Defendants Charged in Fraud Scheme Totaling Over $6.5 Billion
Defendants were charged in connection with schemes to submit claims for medically unnecessary respiratory pathogen panel testing, claims for care a physician did not provide, and false Medicaid claims for personal care services not rendered.
DOJSentencedJun 17, 2026
Nurse Practitioner Sentenced to 87 Months in Prison for $12M Medicare Fraud
A nurse practitioner received kickbacks for signing hundreds of orders for medically unnecessary cancer genetic tests after brief phone calls with patients without examining them, causing over $12.1 million in false and fraudulent claims to Medicare.
DOJSentencedApr 10, 2026
Slidell Doctor Sentenced For $6.6 Million In Health Care Fraud
Tassin, working through purported telemedicine companies, signed doctors' orders for cancer genetic tests for Medicare beneficiaries he never saw, spoke to, or treated, falsely certifying medical necessity in exchange for a set fee of typically $30 per order.
DOJSentencedJan 28, 2026
Slidell Chiropractor Sentenced For Health Care Fraud
Peyroux conspired with others to purchase Medicare beneficiary information and fabricated recordings and billed Medicare through his chiropractic clinic for over-the-counter COVID-19 test kits that were not requested or were otherwise ineligible for reimbursement, falsely listing a former nurse practitioner as the referring provider.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.