Providers
WALTER DAVID GIANELLE, MD
NPI 1124007232, individual, Salisbury, MD, Emergency Medicine
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 4 months, but with up to 1901 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
score 52 of 100, rank 8401, $5.2M at stake
Public list actions
Medicare revocation effective June 26, 2024, barred from re-enrolling until March 4, 2030
424.535(a)(9) failure to report and 424.535(a)(12) other program termination (medicaid), Practitioner - Emergency Medicine, MD
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 |
|---|---|---|---|---|---|---|---|---|---|
| Jan 2020 | More hours than a day holds, even counting one unit per claim line | 60.9 | 79.8 | 53.2 | 71.7 | 1377 | 2 | 99202 99203 99204 99213 99214 | $455K |
| Feb 2020 | More hours than a day holds, even counting one unit per claim line | 57.2 | 54.9 | 36.6 | 53.1 | 1389 | 2 | 99202 99203 99204 99213 99214 | $292K |
| Sep 2021 | More hours than a day holds, even counting one unit per claim line | 28.7 | 40.5 | 27.0 | 36.8 | 1901 | 2 | 99202 99203 99204 99212 99213 99214 | $242K |
| Oct 2021 | More hours than a day holds, even counting one unit per claim line | 25.7 | 35.2 | 23.5 | 34.7 | 1715 | 2 | 99202 99203 99204 99212 99213 99214 | $217K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | WALTER DAVID GIANELLE, MD |
| Type | Individual |
| Status | Active |
| NPI issued | January 17, 2006, last updated February 10, 2014 |
| Practice location | 2425 N SALISBURY BLVD, Salisbury, MD 21801-2138, 410-334-6351 |
| Specialties | Emergency Medicine (207P00000X, primary, license D0044413 MD) |
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 | $2.4M | 40% | $108 | $44 (top 5% from $110) | 95th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $2.1M | 35% | $78 | $60 (top 5% from $133) | 69th percentile | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $799K | 13% | $83 | $67 (top 5% from $121) | 71st percentile | |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $204K | 3% | $116 | $28 (top 5% from $147) | 93rd percentile | |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $184K | 3% | $119 | $95 (top 5% from $171) | 71st percentile | |
| 99202 | New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more | $132K | 2% | $123 | $45 (top 5% from $138) | 94th percentile | |
| 87811 | Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) | $47K | 1% | $27 | $33 (top 5% from $45) | 36th percentile | |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | $28K | 0% | $47 | $44 (top 5% from $70) | 56th 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 |
|---|---|---|---|---|---|---|---|---|
| 87811 | Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) | 20 | 20 | $811 | $65 | $41 | 1.6x | 2.1x (90th percentile 4.3x) |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 33 | 18 | $535 | $37 | $16 | 2.3x | 2.5x (90th percentile 3.9x) |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | 18 | 18 | $317 | $299 | $166 | 1.8x | 2.4x (90th percentile 3.9x) |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | 17 | 17 | $269 | $197 | $111 | 1.8x | 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 | 28 | 28 | $247 | $197 | $127 | 1.5x | 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 | 14 | 14 | $146 | $135 | $90 | 1.5x | 2.2x (90th percentile 3.8x) |
| 71046 | X-ray of chest, 2 views | 17 | 17 | $95 | $58 | $25 | 2.3x | 3.6x (90th percentile 8.1x) |
| 73630 | X-ray of foot, minimum of 3 views | 11 | 11 | $53 | $50 | $14 | 3.5x | 3.6x (90th percentile 8.1x) |
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 Wicomico County, MD carry an indicator in the public record, with $1.9M at stake between them. The most common is more hours than a day holds, on 4 of them.
| tier | provider | at stake | why |
|---|---|---|---|
| 4 | KATHLEEN MIRSKY Salisbury, MD, ranked 9588 | $79K |
|
| 4 | JANET O'BRIEN Salisbury, MD, ranked 9589 | $78K |
|
| 5 | STEPHEN COOPER Salisbury, MD, ranked 10016 | $1.6M |
|
| 5 | JETHALAL HARKHANI Salisbury, MD, ranked 10457 | $96K |
|
Recent enforcement in MD
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJCivil settlementMar 20, 2026
Health Care Management Corporation Agrees to Pay $4 Million to Resolve False Claims Act Allegations
CVR knowingly submitted claims to Medicare, Medicaid, and TRICARE for sclerotherapy, radiofrequency ablation, and endovenous laser ablation procedures to treat chronic venous insufficiency that were not clinically indicated and were medically unnecessary between January 1, 2010, and December 31, 2016.
DOJCivil settlementNov 20, 2025
Diagnostic Laboratory Agrees to Pay More Than $1 Million to Settle Alleged False Claims Act Violations
GTI agreed to pay $1.635 million to resolve allegations that it submitted Medicare claims for respiratory pathogen panels that were medically unnecessary or obtained through kickbacks paid under a marketing services agreement with an infection prevention company for laboratory test referrals from long-term care facilities.
DOJSentencedNov 13, 2025
Baltimore County Woman Sentenced for Impersonating Nurses and Aggravated Identity Theft
Amponsah used stolen nursing licenses and false educational and professional histories to obtain employment as a purported licensed nurse at no less than 40 facilities in Maryland that billed health care benefit programs including Medicare and Medicaid for services she provided, earning more than $145,000 in wages.
DOJPleaded guiltyAug 14, 2025
Baltimore County Woman Admits to Impersonating Nurses, Pleads Guilty to Aggravated Identity Theft
Amponsah used stolen nursing licenses and false educational and professional histories to obtain employment as a purported licensed nurse at no less than 40 facilities in Maryland, which billed health care benefit programs including Medicare and Medicaid for services she provided.
DOJCivil judgmentAug 11, 2025
United States Obtains More Than $1.4 Million Judgment Against Family Medical Practitioner for Fraudulent Billing
Akoto billed Medicare for auricular stimulation (P-Stim) devices using a code for a surgically implanted neurostimulator device, which Medicare does not reimburse as acupuncture.
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.