Providers
DOMINICK R NICOTERA, L.C.S.W
NPI 1093947640, individual, Utica, NY, Social Worker, Clinical
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 30 months, but with up to 464 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 99347 ($442 per patient-month) sit in the top 5% of every provider billing that code.
score 56 of 100, rank 7528, $3.4M 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 2018 | More hours than a day holds at a conservative unit price | 4.7 | 39.6 | 26.4 | 37.0 | 124 | 1 | 90837 99347 | $43K |
| Mar 2018 | More hours than a day holds at a conservative unit price | 7.0 | 56.9 | 37.9 | 53.4 | 173 | 1 | 90846 90847 99347 | $68K |
| Apr 2018 | More hours than a day holds at a conservative unit price | 3.5 | 36.0 | 24.0 | 34.3 | 123 | 1 | 99347 | $41K |
| May 2018 | More hours than a day holds at a conservative unit price | 6.6 | 68.5 | 45.7 | 61.6 | 170 | 1 | 99347 | $80K |
| Jun 2018 | More hours than a day holds at a conservative unit price | 9.5 | 98.1 | 65.4 | 93.4 | 208 | 1 | 99347 | $111K |
| Jul 2018 | More hours than a day holds at a conservative unit price | 10.6 | 109.8 | 73.2 | 103.2 | 225 | 1 | 99347 | $128K |
| Aug 2018 | More hours than a day holds at a conservative unit price | 13.9 | 144.3 | 96.2 | 129.6 | 272 | 1 | 99347 | $168K |
| Sep 2018 | More hours than a day holds at a conservative unit price | 14.1 | 146.2 | 97.5 | 146.2 | 285 | 1 | 99347 | $165K |
| Oct 2018 | More hours than a day holds at a conservative unit price | 18.6 | 163.1 | 108.7 | 146.6 | 379 | 1 | 90837 90846 90847 99347 | $195K |
| Nov 2018 | More hours than a day holds at a conservative unit price | 18.7 | 169.3 | 112.9 | 153.9 | 409 | 1 | 90837 90846 99347 | $195K |
| Dec 2018 | More hours than a day holds at a conservative unit price | 16.6 | 137.7 | 91.8 | 135.5 | 418 | 1 | 90837 90846 99347 | $166K |
| Jan 2019 | More hours than a day holds at a conservative unit price | 16.1 | 132.4 | 88.3 | 119.0 | 454 | 1 | 90837 90839 90846 99347 | $160K |
| Feb 2019 | More hours than a day holds at a conservative unit price | 19.8 | 163.0 | 108.7 | 152.2 | 464 | 1 | 90837 90846 90847 99347 | $178K |
| Mar 2019 | More hours than a day holds at a conservative unit price | 13.5 | 109.5 | 73.0 | 107.7 | 332 | 1 | 90837 90846 99347 | $132K |
| Apr 2019 | More hours than a day holds at a conservative unit price | 7.6 | 64.7 | 43.1 | 58.8 | 197 | 1 | 90837 90846 99347 | $75K |
| May 2019 | More hours than a day holds at a conservative unit price | 11.6 | 88.4 | 58.9 | 79.4 | 271 | 1 | 90837 90846 99347 | $108K |
| Jun 2019 | More hours than a day holds at a conservative unit price | 9.8 | 79.4 | 52.9 | 79.4 | 219 | 1 | 90837 99347 | $93K |
| Jul 2019 | More hours than a day holds at a conservative unit price | 11.1 | 82.5 | 55.0 | 74.1 | 255 | 1 | 90837 90847 99347 | $102K |
| Aug 2019 | More hours than a day holds at a conservative unit price | 11.3 | 82.9 | 55.2 | 77.8 | 251 | 1 | 90837 90847 99347 | $103K |
| Sep 2019 | More hours than a day holds at a conservative unit price | 11.9 | 83.5 | 55.6 | 79.5 | 278 | 1 | 90837 90846 90847 99347 | $101K |
| Oct 2019 | More hours than a day holds at a conservative unit price | 13.4 | 88.4 | 58.9 | 79.4 | 313 | 1 | 90837 90846 90847 99347 | $112K |
| Nov 2019 | More hours than a day holds at a conservative unit price | 15.0 | 87.6 | 58.4 | 83.4 | 318 | 1 | 90837 90847 99347 | $110K |
| Dec 2019 | More hours than a day holds at a conservative unit price | 14.6 | 86.0 | 57.3 | 80.8 | 305 | 1 | 90791 90837 90847 99347 | $112K |
| Jan 2020 | More hours than a day holds at a conservative unit price | 13.5 | 75.6 | 50.4 | 67.9 | 304 | 1 | 90837 90846 90847 99347 | $100K |
| Feb 2020 | More hours than a day holds at a conservative unit price | 14.7 | 78.1 | 52.0 | 75.5 | 338 | 1 | 90791 90837 90847 99347 99348 | $99K |
| Mar 2020 | More hours than a day holds at a conservative unit price | 21.4 | 56.7 | 37.8 | 53.3 | 449 | 1 | 90791 90832 90834 90837 90847 99347 | $97K |
| Apr 2020 | More hours than a day holds, even counting one unit per claim line | 28.1 | 30.7 | 20.4 | 27.9 | 337 | 1 | 90791 90832 90834 90837 90846 90847 99347 | $81K |
| May 2020 | More hours than a day holds at a conservative unit price | 21.7 | 45.1 | 30.0 | 44.3 | 346 | 1 | 90832 90834 90837 90847 99347 | $85K |
| Jun 2020 | More hours than a day holds at a conservative unit price | 20.0 | 70.6 | 47.0 | 64.2 | 313 | 1 | 90832 90834 90837 90847 99347 | $104K |
| Jul 2020 | More hours than a day holds at a conservative unit price | 15.9 | 50.1 | 33.4 | 45.0 | 245 | 1 | 90791 90837 90847 99347 | $79K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | DOMINICK R NICOTERA, L.C.S.W |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | August 17, 2009, last updated June 19, 2012 |
| Practice location | 2606 GENESEE ST, Utica, NY 13502-6003, 315-534-0440 |
| Specialties | Social Worker, Clinical (1041C0700X, primary, license 079360 NY) |
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 | |
|---|---|---|---|---|---|---|---|
| 99347 | Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes | $3.1M | 82% | $442 | $10 (top 5% from $326) | 98th percentile | |
| 90837 | Psychotherapy, 1 hourhistory of abuse | $313K | 8% | $225 | $191 (top 5% from $442) | 64th percentile | |
| 99341 | Residence visit for new patient with straightforward medical decision making, per day, if using time, at least 15 minutes | $133K | 4% | $149 | $9.86 (top 5% from $1K) | 75th percentile | |
| 90847 | Family psychotherapy with patient, 50 minutes | $84K | 2% | $150 | $130 (top 5% from $458) | 60th percentile | |
| 90834 | Psychotherapy, 45 minutes | $53K | 1% | $170 | $101 (top 5% from $318) | too few months to rank | |
| 90839 | Psychotherapy for crisis, first hour | $32K | 1% | $213 | $116 (top 5% from $266) | 90th percentile | |
| 90846 | Family psychotherapy without patient, 50 minutes | $15K | 0% | $74 | $113 (top 5% from $277) | 17th percentile | |
| 90840 | Psychotherapy for crisis, each additional 30 minutes | $13K | 0% | $101 | $93 (top 5% from $298) | 53rd percentile |
In this area
4 providers in Oneida County, NY carry an indicator in the public record, with $710K at stake between them. The most common is part of a provider network, on 2 of them, followed by paid after a public list action on 1. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | IVAN ANTONEVICH New Hartford, NY, ranked 6 | $460K |
|
| 3 | BETHANY OPERATING CO LLC Rome, NY, ranked 5051 | $0 |
|
| 3 | RRNC LLC Rome, NY, ranked 5920 | $0 |
|
| 4 | STEPHEN WADE Utica, NY, ranked 9415 | $249K |
|
Recent enforcement in NY
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJIndictedAug 20, 2026
Four Members Of The “War Room” Charged In Connection With $12 Million Medicaid Fraud Scheme
Members of a Bronx-based racketeering organization known as the "War Room" fabricated ride data for methadone clinic transportation using a GPS spoofing application, paid Medicaid patients kickbacks in cash and drugs for their enrollment information, provided the fake data to transportation companies that submitted over $12 million in claims to Medicaid, and laundered the proceeds.
DOJIndictedAug 20, 2026
Four Members of the “War Room” Charged in Connection with $12M Medicaid Fraud Scheme
Four members of a Bronx racketeering organization known as the "War Room" fabricated medical transportation ride data using a ride-tracking app and GPS spoofing, paid Medicaid patients at methadone clinics kickbacks in cash and drugs for their enrollment information, provided the fake data to transportation companies that submitted over $12 million in Medicaid claims, and laundered the proceeds.
DOJCivil settlementAug 17, 2026
Safire nursing homes agree to pay $9 million to resolve fraudulent Medicare and Medicaid billing allegations
The United States alleged that Safire submitted false claims to Medicare and Medicaid for skilled rehabilitative therapy services that were not reasonable or necessary, not supported by medical records, not documented as provided, or not provided at all, including by scheduling therapy based on insurer reimbursement policies, pressuring therapists and residents, and manufacturing or altering therapy referrals and medical records.
DOJSentencedJul 21, 2026
Owner of Long Island Ambulette Services Company Sentenced to Prison for Multimillion Dollar Healthcare Fraud Scheme
Arshad and co-conspirators paid kickbacks to Medicaid beneficiaries to order transportation through his companies and billed Medicaid over $19 million for medical transportation rides that were not provided, including for individuals who were deceased, hospitalized or incarcerated, and inflated reimbursements with false pickup addresses and distant treatment centers.
DOJIndictedJul 2, 2026
Two Defendants Charged with Multi-Million Dollar Health Care Fraud Scheme
The defendants, who owned and operated Tri-Hamlet Taxi Inc., allegedly paid kickbacks to Medicaid beneficiaries and submitted more than $35 million in claims to Medicaid for ambulette trips that were not provided or whose costs were inflated by using false pickup or drop-off addresses.
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.