Providers
TIMOTHY ALLEN ALDRICH, NP
NPI 1194212522, individual, Succasunna, NJ, Nurse Practitioner, Acute Care
1
Evidence tier
documented action, then payment
- Listed on the NY Medicaid exclusion list since October 25, 2023.
- Medicaid still paid claims in 5 later months, $12,879 in total.
score 94 of 100, rank 266, $13K 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 |
|---|---|---|---|---|---|---|---|---|
| NY Medicaid exclusion list ny omig medicaid exclusion list (tab-delimited, sept 2026) | Exact NPI, name verified | Oct 25, 2023 | still open | 5 | Dec 2023 | May 2024 | $13K | $176 |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | TIMOTHY ALLEN ALDRICH, NP |
| Type | Individual |
| Status | Active |
| NPI issued | April 20, 2018, last updated November 19, 2024 |
| Practice location | 278 ROUTE 10 W, Succasunna, NJ 07876, 624-775-2888 |
| Specialties | Nurse Practitioner, Acute Care (363LA2100X, license 431391 NY) Nurse Practitioner, Acute Care (363LA2100X, primary, license 26NJ01058500 NJ) |
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 | $12K | 44% | $60 | $44 (top 5% from $110) | 71st percentile | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $8K | 29% | $39 | $67 (top 5% from $121) | 13th percentile | |
| 87811 | Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) | $3K | 10% | $28 | $33 (top 5% from $45) | 38th percentile | |
| 99202 | New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more | $3K | 9% | $63 | $45 (top 5% from $138) | too few months to rank | |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | $2K | 6% | $127 | $63 (top 5% from $137) | too few months to rank | |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | $292 | 1% | $19 | $22 (top 5% from $33) | too few months to rank | |
| 99211 | Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional | $236 | 1% | $1.64 | $16 (top 5% from $128) | 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 | 164 | 157 | $10K | $195 | $84 | 2.3x | 2.2x (90th percentile 3.8x) |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | 115 | 115 | $8K | $278 | $103 | 2.7x | 2.4x (90th percentile 3.9x) |
| 87811 | Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) | 24 | 24 | $973 | $146 | $41 | 3.6x | 2.1x (90th percentile 4.3x) |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | 15 | 15 | $519 | $103 | $35 | 3.0x | 2.8x (90th percentile 4.4x) |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 24 | 12 | $389 | $45 | $16 | 2.8x | 2.5x (90th percentile 3.9x) |
| 81003 | Automated urinalysis test | 19 | 18 | $42 | $24 | $2 | 10.9x | 4.6x (90th percentile 12.7x) |
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 Morris County, NJ carry an indicator in the public record, with $3.5M at stake between them. The most common is more hours than a day holds, on 3 of them, followed by part of a provider network on 1.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | PRIME HEALTHCARE SERVICES - SAINT CLARE'S LLC Dover, NJ, ranked 6697 | $0 |
|
| 4 | LILLIAN ALT Morristown, NJ, ranked 7663 | $2.2M |
|
| 4 | GERALD TRAMONTANO MT Arlington, NJ, ranked 7815 | $1.1M |
|
| 5 | DAVID YAKOBASHVILI Chester, NJ, ranked 10386 | $206K |
|
Recent enforcement in NJ
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJIndictedJul 29, 2026
Fraud Division Resolves Fraud Investigation of Eye Care Group Under New Corporate Enforcement Policy; Health Care Executive Charged for Alleged Fraud and Kickbacks
DiDonato allegedly conspired to defraud Medicare by billing for unnecessary and duplicative diagnostic eye tests and paid kickbacks and bribes to ophthalmologists disguised as consulting fees for patient referrals, while Campus Eye received a declination after self-disclosing and agreed to pay back $1 million to victims.
DOJIndictedJul 29, 2026
Founder And Former CEO of New Jersey Based Eye Care Group Charged with Health Care Fraud Conspiracy and Paying Illegal Kickbacks
DiDonato allegedly paid kickbacks disguised as consulting fees to ophthalmologists for patient referrals and billed Medicare approximately $3.4 million for duplicative or unnecessary diagnostic tests performed at his optometry practice and eye surgery center.
DOJChargedJul 9, 2026
Six Individuals, Including a Pharmacist and Doctor, Charged in Connection with $20 Million Healthcare Fraud and Kickback Scheme
A pharmacy owner paid cash kickbacks to a doctor, advanced practice nurses, and an office manager in exchange for medically unnecessary prescriptions for high-reimbursement medications billed to Medicare and Medicaid.
DOJPleaded guiltyJun 24, 2026
Cape May County Psychiatrist Admits to 17 Felony Counts for Unlawful Controlled Substance Prescriptions Linked to Sexual Conduct, Risk of Death, and Serious Bodily Injury
A psychiatrist issued invalid prescriptions for Adderall, Vyvanse, and Xanax to 17 patients outside the usual course of professional practice, with intent to defraud and mislead the dispensing pharmacies and the insurers, government benefits programs, and other third parties who paid for the drugs, sometimes in exchange for sexual activities, images, or videos.
DOJSentencedMay 21, 2026
New Jersey Physical Therapist Sentenced to 12 Months in Prison for Health Care Fraud Scheme Targeting Amtrak
Kim, a licensed physical therapist, allowed her license and business bank accounts to be used to bill Amtrak's health care plan for claims for services that never were provided and were medically unnecessary, in return for a portion of the proceeds.
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.