MELISSA FIGUEROA RESTO

NPI 1154859106, individual, Gurabo, PR, Speech-Language Pathologist,

Evidence tier

informational

score 30 of 100, rank 11497, $173K at stake

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	MELISSA FIGUEROA RESTO
Type	Individual, sole proprietor
Status	Active
NPI issued	June 2, 2017, last updated August 10, 2020
Practice location	RD 931 BO NAVARRO, 147 PARCELA CALLE 7, Gurabo, PR 00778, 787-205-7241
Mailing address	HC 2 BOX 13755, Gurabo, PR 00778-9750
Specialties	Speech-Language Pathologist, (235Z00000X, primary)

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
92507	Treatment of speech, language, voice, communication, and/or hearing processing disorder	$444K	99%	$418	$190 (top 5% from $477)	91st percentile
92526	Treatment of swallowing and feeding disorder	$2K	1%	$187	$141 (top 5% from $421)	too few months to rank
92523	Evaluation of speech sound production with evaluation of language comprehension and expression	$721	0%	$52	$137 (top 5% from $251)	too few months to rank

In this area

2 providers in Gurabo, PR carry an indicator in the public record, with $3.9M at stake between them. The most common is more hours than a day holds, on 2 of them.

tier	provider	at stake	why
5	MARIECARMEN FONTANET AVILES Gurabo, PR, ranked 9909	$3.6M	Medicaid dollars per patient on code 97533 ($994 per patient-month) sit in the top 5% of every provider billing that code.
5	IVONNE RODRIGUEZ RAMOS Gurabo, PR, ranked 11404	$258K

Recent enforcement in PR

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJIndictedJun 23, 2026

2026 National Health Care Fraud Takedown

Four defendants were charged in two schemes, one involving the advertising, sale, and distribution of Semaglutide, Mounjaro, steroids, and Tirzepatide that defendants were not authorized to possess and distribute, and the other involving performing dental procedures on patients without a valid dental license and misbranding of devices.

DOJCivil settlementJun 4, 2026

Puerto Rico Pharmacies Agree to Pay $4.6 Million to Federal Authorities in Medicare and Medicaid Fraud Cases

Four pharmacies and their owners agreed to pay $4.6 million to resolve allegations that between January 2021 and January 2024 they billed Medicare and Medicaid for diverted prescriptions sold to patients that had been misrepresented as properly sourced despite unverifiable origins.

DOJPleaded guiltyJul 17, 2025

Physician Assistant who Pretended to be a Licensed Physician Pleads Guilty to Making False Statements to an Agency of the United States

Villalobos-Meléndez, a licensed physician assistant who was never licensed to practice medicine, forged medical license and USMLE documents, worked as a physician in a hospital internship program, and submitted false license information on a CMS-855I form seeking enrollment as a Medicare physician provider with benefits reassigned to Physician HMO.

DOJCivil settlementDec 23, 2024

MMM Holdings, LLC Agrees to Pay 15.2 Million Dollars to Resolve Allegations that it Violated the False Claims Act and Anti-Kickback Statute

MMM Holdings distributed gift cards to administrative assistants of providers to induce the referral, recommendation, or arrangement for enrollment of thousands of Medicare beneficiaries in an MMM Medicare Advantage plan and submitted or caused claims for payment to Medicare.

DOJIndictedSep 25, 2024

27 Individuals Indicted for Buying and Selling Wholesale Quantities of Misbranded and Diverted Prescription Drugs Resold to the Public Through Retail Pharmacies in Puerto Rico

Defendants engaged in unlicensed wholesale distribution of misbranded and diverted prescription drugs sold to pharmacy owners and employees who resold them to customers and billed health care benefit plans as if the drugs were authentic and obtained through licensed distribution channels.

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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