Providers
STEPHEN WADE, M.D.
NPI 1114067261, individual, Utica, NY, Physical Medicine & Rehabilitation, Pain Medicine
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 8 months under one organization, which can be supervisory billing.
- Records needed.
score 50 of 100, rank 9415, $249K 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 |
|---|---|---|---|---|---|---|---|---|---|
| Apr 2018 | More hours than a day holds at a conservative unit price | 3.7 | 51.6 | 34.4 | 49.1 | 238 | 1 | 99204 99213 99214 | $25K |
| May 2018 | More hours than a day holds at a conservative unit price | 4.3 | 62.6 | 41.7 | 56.2 | 275 | 1 | 99204 99213 99214 | $29K |
| Jun 2018 | More hours than a day holds at a conservative unit price | 3.5 | 50.8 | 33.9 | 48.4 | 229 | 1 | 99204 99213 99214 | $22K |
| Jul 2018 | More hours than a day holds at a conservative unit price | 3.9 | 58.2 | 38.8 | 54.7 | 252 | 1 | 99204 99213 99214 | $27K |
| Aug 2018 | More hours than a day holds at a conservative unit price | 3.3 | 49.2 | 32.8 | 44.2 | 220 | 1 | 99204 99213 99214 | $23K |
| Oct 2018 | More hours than a day holds at a conservative unit price | 4.7 | 65.7 | 43.8 | 59.1 | 274 | 1 | 99204 99213 99214 | $32K |
| Nov 2018 | More hours than a day holds at a conservative unit price | 3.7 | 57.1 | 38.1 | 51.9 | 228 | 1 | 99204 99213 99214 | $26K |
| Dec 2018 | More hours than a day holds at a conservative unit price | 2.1 | 36.0 | 24.0 | 35.5 | 157 | 1 | 99213 99214 | $15K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | STEPHEN WADE, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | February 7, 2007, last updated May 22, 2013 |
| Practice location | 1508 GENESEE ST, Utica, NY 13502-5178, 315-798-8737 |
| Specialties | Physical Medicine & Rehabilitation, Pain Medicine (2081P2900X, primary, license 242667 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 | |
|---|---|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $607K | 52% | $67 | $44 (top 5% from $110) | 79th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $282K | 24% | $111 | $60 (top 5% from $133) | 90th percentile | |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $133K | 11% | $169 | $95 (top 5% from $171) | 94th percentile | |
| 80307 | Testing for presence of drug, by chemistry analyzers | $39K | 3% | $77 | $45 (top 5% from $110) | 85th percentile | |
| 64483 | Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level | $27K | 2% | $201 | $150 (top 5% from $603) | 67th percentile | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $26K | 2% | $108 | $67 (top 5% from $121) | 91st percentile | |
| 80305 | Testing for presence of drug, read by direct observation | $14K | 1% | $15 | $9.23 (top 5% from $22) | 86th percentile | |
| 80306 | Testing for presence of drug, read by instrument assisted observation | $11K | 1% | $24 | $12 (top 5% from $69) | 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 |
|---|---|---|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 315 | 131 | $24K | $128 | $102 | 1.3x | 2.2x (90th percentile 3.8x) |
| 95911 | Nerve conduction, 9-10 studies | 40 | 38 | $8K | $2K | $239 | 6.8x | 3.1x (90th percentile 6.8x) |
| 95886 | Needle measurement of electrical activity in arm or leg muscles, complete study | 80 | 38 | $7K | $200 | $110 | 1.8x | 3.0x (90th percentile 6.3x) |
| 20611 | Aspiration and/or injection of fluid large joint using ultrasound guidance | 61 | 35 | $6K | $555 | $128 | 4.3x | 3.5x (90th percentile 8.1x) |
| 73721 | Mri scan of leg joint without contrast | 24 | 16 | $5K | $2K | $241 | 6.2x | 5.4x (90th percentile 12.0x) |
| 72148 | Mri scan of lower spinal canal without contrast | 24 | 24 | $4K | $2K | $227 | 6.6x | 5.3x (90th percentile 13.0x) |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | 41 | 41 | $4K | $192 | $126 | 1.5x | 2.4x (90th percentile 3.9x) |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 16 | 13 | $2K | $165 | $146 | 1.1x | 2.3x (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 Oneida County, NY carry an indicator in the public record, with $3.9M 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 | DOMINICK NICOTERA Utica, NY, ranked 7528 | $3.4M |
|
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.