GREGORY KAFTAN, MD

NPI 1083830335, individual, Kenosha, WI, Preventive Medicine, Occupational Medicine

Evidence tier

structure or single-organization volume

Hours beyond a day in 1 month, but with up to 764 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
Records needed.

score 50 of 100, rank 9455, $212K 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
Feb 2019	More hours than a day holds, even counting one unit per claim line	95.1	18.6	12.4	17.3	519	1	99203 99213 99214	$36K

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	GREGORY KAFTAN, MD
Type	Individual
Status	Active
NPI issued	April 17, 2007, last updated July 8, 2007
Practice location	5555 30TH AVE, Kenosha, WI 53144-2871, 262-658-7102
Mailing address	2861 N PROSPECT AVE, Milwaukee, WI 53211-3771
Specialties	Preventive Medicine, Occupational Medicine (2083X0100X, primary, license 34419 WI)

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	$511K	47%	$73	$60 (top 5% from $133)	64th percentile
80307	Testing for presence of drug, by chemistry analyzers	$306K	28%	$79	$45 (top 5% from $110)	85th percentile
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	$110K	10%	$31	$44 (top 5% from $110)	30th percentile
H0020	Medicaid service code	$61K	6%	$38	$214 (top 5% from $529)	16th percentile
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms	$55K	5%	$43	$58 (top 5% from $129)	36th percentile
99203	New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	$17K	2%	$47	$67 (top 5% from $121)	19th percentile
99204	New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	$8K	1%	$57	$95 (top 5% from $171)	12th percentile
81025	Urine pregnancy test	$4K	0%	$5.46	$5.49 (top 5% from $12)	50th 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	131	28	$9K	$209	$88	2.4x	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	49	12	$2K	$150	$60	2.5x	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

4 providers in Kenosha County, WI carry an indicator in the public record, with $4.4M at stake between them. The most common is part of a provider network, on 3 of them, followed by more hours than a day holds on 1.

tier	provider	at stake	why
3	BROOKSIDE CARE CENTER Kenosha, WI, ranked 1556	$9K	Part of provider network D1-00095, ranked 95 nationally.
3	THE MANOR OF KENOSHA LLC Kenosha, WI, ranked 1577	$6K	Part of provider network D1-00095, ranked 95 nationally.
3	CROSSROADS CARE CENTER OF KENOSHA Kenosha, WI, ranked 3212	$0	Part of provider network D1-00095, ranked 95 nationally.
4	LEAH FEATHERSTONE Kenosha, WI, ranked 8439	$4.3M	Hours beyond a day in 36 months, but with up to 782 patients a month, which points to a supervising clinician on the claims rather than one person's hours. Records needed.

Recent enforcement in WI

All releases

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

DOJChargedJun 25, 2026

Federal Charges Announced in Multi-Million Dollar Medicaid Fraud Scheme and Prescription Drug Diversion Conspiracy; Announcement Made as Part of Justice Department’s National Health Care Fraud Takedown

Cooper submitted over $5.8 million in false claims to Wisconsin Medicaid for prenatal care coordination services that beneficiaries never received and used another person's means of identification, while Jones conspired to distribute controlled substances outside the usual course of professional practice.

DOJCivil settlementApr 17, 2026

Appleton Clinic to Pay Over $380,000 to Resolve False Claims Act Allegations Relating to the Marketing and Use of Electric Stimulation Devices

Apple Medical Clinic and its principal caused the submission of false claims to Medicare for electrical muscle stimulation, vitamin injections, and other related services that were not medically reasonable or necessary, and marketed the Sanexas device outside its FDA clearance and contrary to coverage determinations.

DOJSentencedMar 23, 2026

Owner of Now-Closed Milwaukee Prenatal Care Coordination Company Sentenced to 60 Months’ Imprisonment for Healthcare Fraud Scheme

Jackson offered women kickbacks in exchange for their Medicaid numbers and falsely billed Wisconsin Medicaid for prenatal care coordination services, almost always at the monthly maximum, when she and her employees provided few to no covered services.

DOJCivil settlementMar 5, 2026

Waukesha Medical Equipment Company Agrees to Pay Nearly $7 Million to Resolve Allegations of False Billings to Federal Healthcare Programs

From 2019 through 2024, Kinex provided patients covered by federal programs with medical braces the patients did not need and billed Medicare, TRICARE, FEHBP, and OWCP as if the braces had been necessary, inducing patients to accept them by waiving co-pays and giving free equipment.

DOJSentencedFeb 3, 2026

Delafield Man Sentenced to 18 Months’ Imprisonment for Conspiracy to Pay Healthcare Kickbacks

Johnson paid kickbacks to companies purporting to provide marketing services in exchange for signed prescriptions and doctors' orders for durable medical equipment that his company Kestrel Medical submitted to Medicare.

Referral packet

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