BLANCA ESTELA CARDENAS, FNP, MSN, PHN, RN

NPI 1003133984, individual, San Diego, CA, Nurse Practitioner, Family

Evidence tier

documented action, then payment

Listed on the Medicare revocation list since March 11, 2024.
Medicaid still paid claims in 1 later month, $103 in total.

score 92 of 100, rank 442, $103 at stake

Public list actions

Medicare revocation effective March 11, 2024, barred from re-enrolling until March 11, 2034

424.535(a)(9) failure to report and 424.535(a)(3) felonies, Practitioner - Nurse Practitioner, CA

Paid after the action

Months in which Medicaid paid claims for this provider after a public action that should have triggered a screening check. This is a record of payments, not a determination that they were improper.

list	identity check	action date	window closed	months paid after	first	last	paid after	12 months before
Medicare revocation list 424.535(a)(9) failure to report and 424.535(a)(3) felonies	Exact NPI, name verified	Mar 11, 2024	Mar 11, 2034	1	May 2024	May 2024	$103	$3K

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	BLANCA ESTELA CARDENAS, FNP, MSN, PHN, RN
Type	Individual
Status	Active
NPI issued	April 30, 2010, last updated March 30, 2023
Practice location	2801 CAMINO DEL RIO S STE 204-1, San Diego, CA 92108-3800, 619-426-9731
Specialties	Nurse Practitioner, Family (363LF0000X, primary, license 19101 CA)

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
99349	Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes	$2K	61%	$22	$30 (top 5% from $115)	too few months to rank
99335	Domiciliary/rest home visit established level 2 (retired 2023)	$803	20%	$20	$19 (top 5% from $69)	too few months to rank
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	$744	19%	$24	$0.51 (top 5% from $73)	too few months to rank

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
Q4191	Restorigin, per square centimeter	7,260	50	$8.7M	$2K	$2K	1.3x	1.0x (90th percentile 1.3x)
Q4217	Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter	2,500	24	$1.5M	$2K	$769	2.0x
Q4271	Complete ft, per square centimeter	1,060	13	$1.4M	$2K	$2K	1.2x	1.1x (90th percentile 1.3x)
15271	Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less	292	53	$31K	$212	$141	1.5x	2.5x (90th percentile 5.3x)
99349	Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes	178	68	$15K	$177	$111	1.6x	2.0x (90th percentile 3.4x)
15275	Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less	83	20	$10K	$216	$145	1.5x	2.9x (90th percentile 6.9x)
99350	Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes	67	48	$8K	$268	$162	1.7x	1.9x (90th percentile 3.3x)
11042	Removal of skin and tissue, 20.0 sq cm or less	91	29	$5K	$185	$68	2.7x	2.9x (90th percentile 6.5x)

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

141 providers in San Diego County, CA carry an indicator in the public record, with $221.8M at stake between them. The most common is more hours than a day holds, on 83 of them, followed by part of a provider network on 43. 11 are tier 1: documented action, then payment.

tier	provider	at stake	why
1	BRENTON WYNN National City, CA, ranked 19	$52K	Listed on the CA Medicaid exclusion list and the Medicare revocation list since May 23, 2022. Medicaid still paid claims in 6 later months, $51,770 in total. and 1 more
1	MICHAEL I KELLER M.D. INC San Diego, CA, ranked 124	$141K	Listed on the CA Medicaid exclusion list since December 10, 2020. Medicaid still paid claims in 18 later months, $141,240 in total.
1	BRENTON D. WYNN, MD INC National City, CA, ranked 135	$125K	Listed on the CA Medicaid exclusion list since May 23, 2022. Medicaid still paid claims in 27 later months, $125,367 in total.
1	BRUCE BAKER Poway, CA, ranked 144	$107K	Listed on the CA Medicaid exclusion list since July 13, 2020. Medicaid still paid claims in 3 later months, $106,617 in total.
1	KYUNG BOEN San Marcos, CA, ranked 191	$50K	Listed on the WA Medicaid exclusion list since April 7, 2017. Medicaid still paid claims in 16 later months, $50,384 in total.
1	ROOZBEH BADII San Diego, CA, ranked 199	$45K	Listed on the OIG exclusion list and the NY Medicaid exclusion list and the CA Medicaid exclusion list since February 15, 2018. Medicaid still paid claims in 15 later months, $44,839 in total.
1	CHIVANO CHHIENG San Diego, CA, ranked 231	$24K	Listed on the CA Medicaid exclusion list since July 14, 2020. Medicaid still paid claims in 12 later months, $23,669 in total.
1	JOHN QIAN San Diego, CA, ranked 232	$23K	Listed on the CA Medicaid exclusion list since February 11, 2022. Medicaid still paid claims in 5 later months, $23,392 in total. and 3 more

All 141 in CA

Recent enforcement in CA

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJPleaded guiltyAug 27, 2026

Anaheim Woman Pleads Guilty to Submitting More Than $2.2 Million in Fraudulent Hospice Care Claims to Medicare

Galbraith submitted approximately $2,266,694 in claims to Medicare for hospice services for beneficiaries who did not have a terminal illness with a life expectancy of six months or less, and Medicare paid her company approximately $2,140,606.

DOJCivil settlementAug 26, 2026

DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests

DermTech Inc. submitted claims to Medicare for skin cancer tests conducted with an unvalidated positive control range and for tests lacking sufficient patient RNA, and did not retract results or adequately refund Medicare.

DOJCivil settlementAug 26, 2026

DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests

DermTech Inc. billed Medicare for skin cancer tests conducted using an unvalidated positive control range and for tests with insufficient patient RNA, and did not retract the results or adequately refund Medicare.

DOJCivil settlementAug 24, 2026

Medicare Advantage Provider Monogram Health Agrees to Pay $2.4 Million to Settle False Claims Act Lawsuit

Monogram knowingly submitted diagnosis codes in four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to Medicare Advantage Organizations.

DOJCivil settlementAug 24, 2026

Medicare Advantage Provider Monogram Health Agrees to Pay $2.4M to Settle False Claims Act Suit

Monogram Health knowingly submitted diagnosis codes within four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to MAOs.

Referral packet

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