Providers
All 59 in KY
ASAD E ISMAIL, MD
NPI 1144227026, individual, Louisville, KY, Psychiatry & Neurology, Addiction Medicine
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 13 months, but with up to 2720 patients a month across 5 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
score 52 of 100, rank 8406, $5.1M 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 |
|---|---|---|---|---|---|---|---|---|---|
| Jan 2018 | More hours than a day holds, even counting one unit per claim line | 73.7 | 106.3 | 70.9 | 23.8 | 2641 | 3 | 90791 90832 90834 90847 90853 99213 99214 99231 H0004 H0034 H2014 H2019 T1016 | $481K |
| Feb 2018 | More hours than a day holds, even counting one unit per claim line | 76.2 | 104.5 | 69.7 | 24.5 | 2565 | 4 | 90791 90832 90834 90847 90853 99213 99214 99222 99231 H0004 H0034 H2014 H2019 T1016 | $435K |
| Mar 2018 | More hours than a day holds, even counting one unit per claim line | 70.7 | 101.5 | 67.7 | 22.1 | 2565 | 4 | 90791 90832 90834 90847 90853 99213 99214 99231 H0004 H0034 H2014 H2019 T1016 | $473K |
| Apr 2018 | More hours than a day holds, even counting one unit per claim line | 77.2 | 105.3 | 70.2 | 24.4 | 2720 | 4 | 90791 90832 90834 90847 90853 99213 99214 99231 99238 H0004 H0034 H2014 H2019 T1016 | $475K |
| Nov 2020 | More hours than a day holds, even counting one unit per claim line | 28.2 | 29.7 | 19.8 | 28.3 | 1098 | 4 | 90832 90833 90834 90837 90853 99203 99213 99222 99232 99238 | $65K |
| Dec 2020 | More hours than a day holds, even counting one unit per claim line | 26.1 | 29.6 | 19.7 | 26.6 | 1133 | 4 | 90791 90832 90833 90834 90836 90837 90853 99213 99214 99222 99232 99238 | $73K |
| Feb 2021 | More hours than a day holds, even counting one unit per claim line | 28.2 | 30.3 | 20.2 | 28.3 | 1123 | 4 | 90832 90833 90834 90836 90837 90853 99203 99213 99222 99232 99238 | $70K |
| Mar 2021 | More hours than a day holds, even counting one unit per claim line | 32.4 | 30.7 | 20.4 | 26.0 | 1357 | 4 | 90791 90832 90833 90834 90836 90837 90853 99213 99222 99231 99232 99238 H0038 | $75K |
| Apr 2021 | More hours than a day holds, even counting one unit per claim line | 29.4 | 27.5 | 18.3 | 22.6 | 1194 | 4 | 90791 90832 90833 90834 90836 90837 90853 99213 99222 99232 99238 H0038 | $64K |
| May 2021 | More hours than a day holds, even counting one unit per claim line | 26.4 | 25.6 | 17.1 | 22.6 | 1099 | 4 | 90832 90834 90837 90853 99203 99213 99222 99232 99238 H0038 | $60K |
| Jun 2021 | More hours than a day holds, even counting one unit per claim line | 27.4 | 24.7 | 16.5 | 19.7 | 1109 | 4 | 90791 90832 90834 90837 90853 99213 99222 99232 99238 H0038 | $57K |
| Jul 2021 | More hours than a day holds, even counting one unit per claim line | 25.2 | 23.8 | 15.9 | 20.1 | 1021 | 5 | 90832 90834 90837 90853 99212 99213 99222 99232 99238 H0038 | $59K |
| Aug 2021 | More hours than a day holds, even counting one unit per claim line | 28.1 | 24.4 | 16.3 | 20.5 | 1087 | 4 | 90832 90834 90837 90853 99203 99213 99222 99232 99238 H0038 | $61K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | ASAD E ISMAIL, MD |
| Type | Individual |
| Status | Active |
| NPI issued | July 7, 2005, last updated March 25, 2025 |
| Practice location | 645 S ROY WILKINS AVE STE 200, Louisville, KY 40203-2072, 502-561-0520 |
| Mailing address | 720 W BROADWAY STE 202, Louisville, KY 40202-3245 |
| Specialties | Psychiatry & Neurology, Psychiatry (2084P0800X, license 34174 KY) Psychiatry & Neurology, Psychiatry (2084P0800X, license 01050254A IN) Psychiatry & Neurology, Addiction Medicine (2084A0401X, primary, license 01050254A IN) |
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 | |
|---|---|---|---|---|---|---|---|
| H0010 | Alcohol/drug sub-acute detox residential per diem | $6.6M | 41% | $5K | $3K (top 5% from $6K) | 82nd percentile | |
| H2014 | Skills training and development per 15 minhistory of abuse | $1.6M | 10% | $817 | $298 (top 5% from $3K) | 79th percentile | |
| 80307 | Testing for presence of drug, by chemistry analyzers | $1.5M | 9% | $81 | $45 (top 5% from $110) | 87th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $1.3M | 8% | $81 | $44 (top 5% from $110) | 89th percentile | |
| H0015 | Alcohol/drug intensive outpatient per diemhistory of abuse | $869K | 5% | $722 | $666 (top 5% from $2K) | 55th percentile | |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $489K | 3% | $139 | $67 (top 5% from $174) | 90th percentile | |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | $474K | 3% | $112 | $58 (top 5% from $129) | 89th percentile | |
| 90837 | Psychotherapy, 1 hourhistory of abuse | $430K | 3% | $130 | $191 (top 5% from $442) | 22nd 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 |
|---|---|---|---|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 603 | 135 | $34K | $100 | $73 | 1.4x | 2.6x (90th percentile 4.3x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 237 | 80 | $13K | $146 | $82 | 1.8x | 2.2x (90th percentile 3.8x) |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 143 | 51 | $12K | $221 | $112 | 2.0x | 2.3x (90th percentile 3.8x) |
| 90837 | Psychotherapy, 1 hour | 82 | 20 | $9K | $202 | $137 | 1.5x | 1.6x (90th percentile 2.9x) |
| 80307 | Testing for presence of drug, by chemistry analyzers | 99 | 23 | $6K | $146 | $58 | 2.5x | 3.2x (90th percentile 7.6x) |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 52 | 41 | $5K | $150 | $120 | 1.2x | 2.7x (90th percentile 4.4x) |
| 99238 | Hospital discharge day management, 30 minutes or less | 44 | 28 | $3K | $80 | $75 | 1.1x | 2.6x (90th percentile 4.7x) |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | 12 | 12 | $951 | $218 | $102 | 2.1x | 2.4x (90th percentile 3.9x) |
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
59 providers in Jefferson County, KY carry an indicator in the public record, with $96.1M at stake between them. The most common is more hours than a day holds, on 45 of them, followed by paid after a public list action on 6. 4 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | MAJA CUPAC Louisville, KY, ranked 65 | $9K |
|
| 1 | BAKER CHIROPRACTIC CENTER PSC Louisville, KY, ranked 139 | $119K |
|
| 1 | MICHAEL BAKER Louisville, KY, ranked 140 | $119K |
|
| 1 | JORDAN EDELEN Louisville, KY, ranked 261 | $14K |
|
| 3 | CHRISTIAN BERKHAHN Louisville, KY, ranked 1301 | $161K |
|
| 3 | LAWRENCE PETERS Louisville, KY, ranked 1509 | $16K |
|
| 3 | MATTHEW ELKINS Louisville, KY, ranked 1571 | $7K |
|
| 3 | LOUISVILLE KY OPCO LLC Louisville, KY, ranked 1885 | $0 |
|
Recent enforcement in KY
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJIndictedAug 27, 2026
Kentucky Medical Biller Indicted for Healthcare Fraud and Money Laundering Charges
Sanders recruited individuals to open behavioral health entities, handled their Kentucky Medicaid credentialing and enrollment, and directed submission of fraudulent Medicaid claims across ten behavioral health providers for services never provided, including for incarcerated, hospitalized, or deceased members, using licensed professionals' NPIs without authorization.
DOJChargedJun 23, 2026
5 Individuals and 2 Companies Charged as Part of Department of Justice National Health Care Fraud Takedown
Seven defendants were charged in four cases with schemes including billing Kentucky Medicaid for peer support and psychoeducation services that were fraudulent, unauthorized, or not rendered using providers' NPIs, using a DEA number to order controlled substances in others' names, credentialing a company with Medicare and billing for services not rendered using a doctor's NPI, and stealing controlled substances from hospitals and falsely documenting administration.
DOJCivil settlementJun 23, 2026
Civil Settlements Reached as Part of Department of Justice National Health Care Fraud Takedown
Three Home and Community Based Waiver providers and their owners, who had shared financial interests, referred Medicaid waiver beneficiaries for attendant care services and billed Medicaid for attendant care hours that were not fully provided or not provided at all.
DOJCivil judgmentMay 15, 2026
Operators of Day Treatment Program for Children Agree to $15.2 Million Civil Judgment to Resolve Medicaid Fraud Allegations
The Government alleged that from August 2022 through June 2025 the Recovery Centers sought Medicaid payments for time children spent on education, recreation, and lunch breaks at the Aspire Day Program and that Recovery Center of Kentucky falsely represented clinician qualifications to obtain higher reimbursements.
DOJSentencedApr 24, 2026
Former Sober Home Owner and Operator Sentenced for Kickback Conspiracy and Health Care Fraud
Jordan solicited and received kickbacks in exchange for referring urine drug testing from her sober home company to three labs, and Serenity Keepers billed Medicaid for peer support services not provided by licensed peer support specialists, with Williams reporting that residents received six hours of peer support services per day knowing that was not true.
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.