Providers
JAMES VINCENT MONTANA
NPI 1114028305, individual, Red Bluff, CA, Physical Therapist
5
Evidence tier
informational
- Medicaid dollars per patient on code 97140 ($1251 per patient-month) sit in the top 5% of every provider billing that code.
score 34 of 100, rank 10356, $261K at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | JAMES VINCENT MONTANA |
| Type | Individual |
| Status | Active |
| NPI issued | September 26, 2006, last updated January 4, 2021 |
| Practice location | 100 JACKSON ST, Red Bluff, CA 96080-3954, 530-241-1473 |
| Mailing address | PO BOX 496084, Redding, CA 96049-6084 |
| Specialties | Physical Therapist (225100000X, primary, license PT14685 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 | |
|---|---|---|---|---|---|---|---|
| 97140 | Therapy procedure using manual technique, each 15 minutes | $2.2M | 85% | $1K | $47 (top 5% from $120) | 100th percentile | |
| 97750 | Test or measurement for functional capacity, each 15 minutes | $205K | 8% | $447 | $37 (top 5% from $129) | 100th percentile | |
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $167K | 6% | $88 | $76 (top 5% from $314) | 58th percentile | |
| 97035 | Application of ultrasound, each 15 minutes | $3K | 0% | $1.48 | $21 (top 5% from $107) | 8th percentile | |
| 97014 | Medicaid service code | $1K | 0% | $1.14 | $24 (top 5% from $71) | 7th percentile | |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | $851 | 0% | $2.69 | $13 (top 5% from $63) | 22nd percentile | |
| G8990 | Medicaid service code | $0 | 0% | $0.00 | too few months to rank | ||
| G8991 | Medicaid service code | $0 | 0% | $0.00 | $0.00 (top 5% from $0.42) | 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 |
|---|---|---|---|---|---|---|---|---|
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 1,350 | 94 | $28K | $59 | $26 | 2.3x | 2.9x (90th percentile 4.8x) |
| 97140 | Therapy procedure using manual technique, each 15 minutes | 751 | 93 | $12K | $61 | $21 | 2.9x | 3.2x (90th percentile 5.0x) |
| 97035 | Application of ultrasound, each 15 minutes | 687 | 86 | $6K | $36 | $11 | 3.4x | 3.4x (90th percentile 6.1x) |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | 684 | 84 | $5K | $41 | $9 | 4.6x | 4.1x (90th percentile 7.2x) |
| 97162 | Evaluation for physical therapy, typically 30 minutes | 50 | 49 | $4K | $189 | $103 | 1.8x | 1.7x (90th percentile 2.9x) |
| 97164 | Re-evaluation for physical therapy, typically 20 minutes | 31 | 22 | $2K | $128 | $69 | 1.9x | 1.6x (90th percentile 2.7x) |
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
8 providers in Tehama County, CA carry an indicator in the public record, with $3.2M at stake between them. The most common is more hours than a day holds, on 5 of them, followed by part of a provider network on 2. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | JAMES OOI Corning, CA, ranked 373 | $2K |
|
| 3 | RED BLUFF HEALTH CARE, INC. Red Bluff, CA, ranked 1905 | $0 |
|
| 3 | SHASTA VIEW CARE CENTER LLC Red Bluff, CA, ranked 2426 | $0 |
|
| 4 | KERRY WAITS Red Bluff, CA, ranked 7772 | $1.3M |
|
| 5 | JACOB STROMAN Red Bluff, CA, ranked 10171 | $747K |
|
| 5 | BRIAN LAIR Red Bluff, CA, ranked 10259 | $506K |
|
| 5 | LEE SHOOP Red Bluff, CA, ranked 10321 | $371K |
|
| 5 | DANIEL LEAVITT Red Bluff, CA, ranked 11369 | $299K |
Recent enforcement in CA
All releasesDepartment 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
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.