BRENDA VILLASENOR, RN

NPI 1114439148, individual, East Palo Alto, CA, Registered Nurse

Evidence tier

documented action, then payment

Listed on the CA Medicaid exclusion list since April 4, 2018.
Medicaid still paid claims in 3 later months, $1,240 in total.

score 93 of 100, rank 385, $1K at stake

Paid after the action

Months in which Medicaid paid claims for this provider after a public action that should have triggered a screening check. This is a record of payments, not a determination that they were improper.

list	identity check	action date	window closed	months paid after	first	last	paid after	12 months before
CA Medicaid exclusion list ca medi-cal suspended & ineligible provider list (july 2026)	Exact NPI, name verified	Apr 4, 2018	still open	3	May 2018	Jul 2018	$1K	$696

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	BRENDA VILLASENOR, RN
Type	Individual
Status	Active
NPI issued	October 31, 2017, last updated October 31, 2017
Practice location	1885 BAY RD, East Palo Alto, CA 94303-1312, 650-330-7400
Specialties	Registered Nurse (163W00000X, primary, license IP95133014 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
99211	Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	$2K	100%	$7.48	$16 (top 5% from $128)	23rd percentile

In this area

47 providers in Santa Clara County, CA carry an indicator in the public record, with $42.6M at stake between them. The most common is part of a provider network, on 24 of them, followed by more hours than a day holds on 21. 1 is tier 1: documented action, then payment.

tier	provider	at stake	why
1	JUAN E POSADA MD INCORPORATED San Jose, CA, ranked 371	$2K	Listed on the Medicare revocation list since January 27, 2021. Medicaid still paid claims in 10 later months, $1,835 in total.
3	PROHEALTH HOME CARE, INC. San Jose, CA, ranked 1317	$137K	Part of provider network D1-00023, ranked 23 nationally.
3	SUTTER VISITING NURSE ASSOCIATION AND HOSPICE Saratoga, CA, ranked 1464	$30K	Part of provider network D1-00071, ranked 71 nationally.
3	COMFORT HANDS HEALTHCARE INC San Jose, CA, ranked 1568	$7K	Part of provider network D1-00030, ranked 30 nationally.
3	GOLD STAR HOSPICE LLC Sunnyvale, CA, ranked 1848	$0	Part of provider network D1-00045, ranked 45 nationally.
3	FIVE STAR HOME CARE LLC Sunnyvale, CA, ranked 1872	$0	Part of provider network D1-00045, ranked 45 nationally.
3	HELENIUM HOME HEALTH INC San Jose, CA, ranked 2341	$0	Part of provider network D1-00067, ranked 67 nationally.
3	CAMDEN POSTACUTE CARE, INC. Campbell, CA, ranked 2935	$0	Part of provider network D1-00138, ranked 138 nationally.

All 47 in CA

Recent enforcement in CA

All releases

Department 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.

Ask this case

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