RITESH KALRA, M.D.

NPI 1043436348, individual, Fair Lawn, NJ, Internal Medicine

Evidence tier

charged in a public enforcement record

Charged (charged, indicted) per a Department of Justice release dated July 17, 2025, not adjudicated.
Medicaid paid $376,280 in the last 12 observed months.

Public enforcement record: New Jersey Doctor Charged in 58-Count Indictment with Distributing Opioids in Exchange for Sexual Favors and Defrauding New Jersey Medicaid

score 66 of 100, rank 1198, $376K at stake

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	RITESH KALRA, M.D.
Type	Individual, sole proprietor
Status	Active
NPI issued	April 17, 2007, last updated July 21, 2022
Practice location	15-01 BROADWAY STE 8, Fair Lawn, NJ 07410-6018, 201-796-8060
Mailing address	38 CREEKSIDE CT, Secaucus, NJ 07094-3750
Specialties	Internal Medicine (207R00000X, license 243355 NY) Internal Medicine (207R00000X, primary, license 25MA08381300 NJ)

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
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	$1.1M	59%	$91	$60 (top 5% from $133)	80th percentile
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	$526K	30%	$68	$44 (top 5% from $110)	80th percentile
99401	Preventive counseling individual 15 min	$82K	5%	$26	$16 (top 5% from $46)	71st percentile
99204	New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	$34K	2%	$134	$95 (top 5% from $171)	81st percentile
99406	Smoking and tobacco use intensive counseling, 4-10 minutes	$30K	2%	$11	$7.24 (top 5% from $18)	75th percentile
99203	New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	$27K	2%	$71	$67 (top 5% from $121)	56th percentile
G0447	Face-to-face behavioral counseling for obesity, 15 minutes	$14K	1%	$20	$0.14 (top 5% from $22)	92nd percentile
G0108	Diabetes outpatient self-management training services, individual, per 30 minutes	$8K	0%	$50	$42 (top 5% from $112)	61st 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
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	126	22	$12K	$260	$140	1.9x	2.3x (90th percentile 3.8x)
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	55	15	$3K	$189	$100	1.9x	2.2x (90th percentile 3.8x)

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

15 providers in Bergen County, NJ carry an indicator in the public record, with $11.5M at stake between them. The most common is more hours than a day holds, on 10 of them, followed by paid after a public list action on 2. 2 are tier 1: documented action, then payment.

tier	provider	at stake	why
1	INFINITY DIAGNOSTICS LABORATORY, INC Teterboro, NJ, ranked 3	$1.0M	Listed on the Medicare revocation list and the NY Medicaid exclusion list since October 31, 2022. Medicaid still paid claims in 7 later months, $1,043,387 in total. and 1 more
1	BERGEN ALLIANCE COUNSELING SERVICE Waldwick, NJ, ranked 616	$0	Adjudicated (pleaded guilty) per a Department of Justice release dated March 19, 2024. No Medicaid payments in the last 12 observed months.
3	EMERSON CONVALESCENT CENTER INC Emerson, NJ, ranked 3143	$0	Part of provider network D1-00107, ranked 107 nationally.
3	120-124 NOYES DRIVE OPERATING COMPANY LLC Park Ridge, NJ, ranked 4966	$0	Part of provider network D1-00043, ranked 43 nationally.
4	DONNA DEPHILLIPS Old Tappan, NJ, ranked 7990	$323K	Hours beyond a day in 1 month, but with up to 282 patients a month, which points to a supervising clinician on the claims rather than one person's hours. Records needed. and 1 more
4	ROHIT RAMANATH Franklin Lakes, NJ, ranked 8850	$1.4M	Hours beyond a day in 3 months, but with up to 1691 patients a month, which points to a supervising clinician on the claims rather than one person's hours. Records needed.
4	SHELLA CAJITA Ridgefield, NJ, ranked 9544	$128K	Hours beyond a day in 2 months under one organization, which can be supervisory billing. Records needed.
5	DONGJIN KIM Englewood, NJ, ranked 9987	$1.8M	Medicaid dollars per patient on code 99213 ($326 per patient-month) sit in the top 5% of every provider billing that code.

All 15 in NJ

Recent enforcement in NJ

All releases

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

DOJIndictedJul 29, 2026

Fraud Division Resolves Fraud Investigation of Eye Care Group Under New Corporate Enforcement Policy; Health Care Executive Charged for Alleged Fraud and Kickbacks

DiDonato allegedly conspired to defraud Medicare by billing for unnecessary and duplicative diagnostic eye tests and paid kickbacks and bribes to ophthalmologists disguised as consulting fees for patient referrals, while Campus Eye received a declination after self-disclosing and agreed to pay back $1 million to victims.

DOJIndictedJul 29, 2026

Founder And Former CEO of New Jersey Based Eye Care Group Charged with Health Care Fraud Conspiracy and Paying Illegal Kickbacks

DiDonato allegedly paid kickbacks disguised as consulting fees to ophthalmologists for patient referrals and billed Medicare approximately $3.4 million for duplicative or unnecessary diagnostic tests performed at his optometry practice and eye surgery center.

DOJChargedJul 9, 2026

Six Individuals, Including a Pharmacist and Doctor, Charged in Connection with $20 Million Healthcare Fraud and Kickback Scheme

A pharmacy owner paid cash kickbacks to a doctor, advanced practice nurses, and an office manager in exchange for medically unnecessary prescriptions for high-reimbursement medications billed to Medicare and Medicaid.

DOJPleaded guiltyJun 24, 2026

Cape May County Psychiatrist Admits to 17 Felony Counts for Unlawful Controlled Substance Prescriptions Linked to Sexual Conduct, Risk of Death, and Serious Bodily Injury

A psychiatrist issued invalid prescriptions for Adderall, Vyvanse, and Xanax to 17 patients outside the usual course of professional practice, with intent to defraud and mislead the dispensing pharmacies and the insurers, government benefits programs, and other third parties who paid for the drugs, sometimes in exchange for sexual activities, images, or videos.

DOJSentencedMay 21, 2026

New Jersey Physical Therapist Sentenced to 12 Months in Prison for Health Care Fraud Scheme Targeting Amtrak

Kim, a licensed physical therapist, allowed her license and business bank accounts to be used to bill Amtrak's health care plan for claims for services that never were provided and were medically unnecessary, in return for a portion of the proceeds.

Referral packet

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