Providers
BRENDA GARCIA, APRN
NPI 1073158747, individual, Fleming Island, FL, Nurse Practitioner
5
Evidence tier
informational
score 30 of 100, rank 11775, $44K at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | BRENDA GARCIA, APRN |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | November 17, 2019, last updated November 17, 2019 |
| Practice location | 2200 MARSH HAWK LN UNIT 101, Fleming Island, FL 32003-6338, 786-426-7972 |
| Specialties | Nurse Practitioner (363L00000X, primary, license 11005065 FL) |
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 | |
|---|---|---|---|---|---|---|---|
| 97802 | Therapy procedure for nutrition management, each 15 minutes | $25K | 56% | $250 | $3.93 (top 5% from $105) | too few months to rank | |
| 97803 | Therapy procedure reassessment for nutrition management, each 15 minutes | $19K | 43% | $250 | $22 (top 5% from $130) | too few months to rank | |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | $389 | 1% | $28 | $21 (top 5% from $84) | 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 |
|---|---|---|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 167 | 68 | $13K | $98 | $95 | 1.0x | 2.0x (90th percentile 3.3x) |
| 99305 | Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | 40 | 37 | $4K | $121 | $118 | 1.0x | 2.0x (90th percentile 3.3x) |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 17 | 12 | $2K | $118 | $112 | 1.1x | 2.9x (90th percentile 6.5x) |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | 23 | 19 | $1K | $68 | $65 | 1.0x | 2.0x (90th percentile 3.4x) |
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 Clay County, FL carry an indicator in the public record, with $2.5M at stake between them. The most common is more hours than a day holds, on 4 of them.
| tier | provider | at stake | why |
|---|---|---|---|
| 4 | MARIA MORA Green Cove Springs, FL, ranked 8781 | $1.8M |
|
| 4 | ALLISON BUTLER Orange Park, FL, ranked 9525 | $142K |
|
| 4 | EUGENE MCCOSKEY Orange Park, FL, ranked 9741 | $10K |
|
| 5 | SARAH PATRICK Fleming Island, FL, ranked 10605 | $572K |
|
Recent enforcement in FL
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJPleaded guiltyAug 14, 2026
Ocala Mental Health Counselor Pleads Guilty to Aggravated Identity Theft and Wire Fraud
Forsythe used the names and insurance policy information of 22 individuals without their consent to bill two health insurance companies for counseling services she had not provided.
DOJConvictedAug 12, 2026
Cuban National Convicted of Unlawfully Obtaining US Citizenship After Concealing Healthcare Fraud Scheme
Rodriguez concealed on her naturalization application her participation in a seven-year healthcare fraud conspiracy that resulted in approximately $4.6 million in fraudulent healthcare claims.
DOJCivil settlementAug 3, 2026
Medicare Advantage Provider Complete Health to Pay $14,100,000 to Settle False Claims Act Suit
Complete Health caused the submission of diagnosis codes within HCC 55 and HCC 59 that were not clinically valid, not supported by medical records, and/or not considered in the beneficiary's care, increasing Medicare Advantage risk-adjusted payments from which it received a percentage.
DOJCivil settlementJul 31, 2026
Two Additional Ophthalmology Practices Agree to Pay $2.3M to Resolve Allegations of Fraudulent Claims to Medicare and Medicaid for Cranial Ultrasounds
Two ophthalmology practices billed Medicare and Medicaid for medically unnecessary trans-cranial doppler ultrasounds premised on false diagnoses, with one practice receiving remuneration from a third-party testing company to refer patients for the tests.
DOJCivil settlementJul 31, 2026
Two Additional Ophthalmology Practices Agree to Pay $2.3M to Resolve Allegations of Fraudulent Claims to Medicare and Medicaid for Cranial Ultrasounds
Two ophthalmology practices billed Medicare and Medicaid for medically unnecessary trans-cranial doppler ultrasounds premised on false diagnoses and, as to Floral Park Ophthalmology, resulting from remuneration paid by a third-party testing company to induce referrals.
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.