Providers
All 256 in FL
MARIA DEL CARMEN MACHADO, DPT
NPI 1215230529, individual, Miami, FL, Physical Therapist
2
Evidence tier
impossible volume with concurrency
- Billed more hands-on hours than a day holds in 9 months, peaking at 25.9 hours per day across 10 billing organizations.
- Medicaid dollars per patient on code 97110 ($428 per patient-month) sit in the top 5% of every provider billing that code.
score 86 of 100, rank 691, $4.0M 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 |
|---|---|---|---|---|---|---|---|---|---|
| Feb 2023 | More hours than a day holds, even counting one unit per claim line | 24.9 | 30.4 | 20.3 | 28.4 | 309 | 8 | 92507 97110 97530 | $140K |
| Mar 2023 | More hours than a day holds, even counting one unit per claim line | 26.6 | 31.7 | 21.1 | 28.5 | 338 | 8 | 92507 97110 97164 97530 | $161K |
| Apr 2023 | More hours than a day holds, even counting one unit per claim line | 25.5 | 31.0 | 20.7 | 31.0 | 363 | 9 | 92507 97110 97164 97530 | $152K |
| May 2023 | More hours than a day holds, even counting one unit per claim line | 32.2 | 38.8 | 25.9 | 34.9 | 391 | 10 | 92507 97110 97164 97530 | $194K |
| Jun 2023 | More hours than a day holds, even counting one unit per claim line | 29.8 | 36.1 | 24.1 | 32.8 | 334 | 10 | 92507 97110 97530 | $175K |
| Jul 2023 | More hours than a day holds, even counting one unit per claim line | 27.5 | 31.9 | 21.3 | 31.4 | 335 | 9 | 92507 97110 97164 97530 | $159K |
| Aug 2023 | More hours than a day holds, even counting one unit per claim line | 29.9 | 34.7 | 23.1 | 31.2 | 330 | 10 | 92507 97110 97530 | $172K |
| Sep 2023 | More hours than a day holds, even counting one unit per claim line | 26.5 | 33.3 | 22.2 | 31.7 | 350 | 10 | 92507 97110 97164 97530 | $162K |
| Feb 2024 | More hours than a day holds, even counting one unit per claim line | 27.4 | 27.4 | 18.2 | 25.2 | 341 | 8 | 92507 97110 97164 97530 | $134K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | MARIA DEL CARMEN MACHADO, DPT |
| Type | Individual |
| Status | Active |
| NPI issued | December 8, 2010, last updated February 8, 2023 |
| Practice location | 1840 SW 63 AVE, Miami, FL 33155, 786-343-6676 |
| Specialties | Physical Therapist (225100000X, primary, license Pt25954 FL) |
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 | |
|---|---|---|---|---|---|---|---|
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $4.2M | 89% | $428 | $76 (top 5% from $314) | 98th percentile | |
| 92507 | Treatment of speech, language, voice, communication, and/or hearing processing disorder | $272K | 6% | $477 | $190 (top 5% from $477) | 95th percentile | |
| 97530 | Therapy procedure using functional activities | $232K | 5% | $404 | $124 (top 5% from $387) | 96th percentile | |
| 97164 | Re-evaluation for physical therapy, typically 20 minutes | $20K | 0% | $49 | $36 (top 5% from $102) | 75th percentile | |
| 97163 | Evaluation for physical therapy, typically 45 minutes | $1K | 0% | $44 | $51 (top 5% from $152) | too few months to rank | |
| 97162 | Evaluation for physical therapy, typically 30 minutes | $514 | 0% | $43 | $48 (top 5% from $145) | too few months to rank |
In this area
256 providers in Miami-Dade County, FL carry an indicator in the public record, with $450.6M at stake between them. The most common is more hours than a day holds, on 202 of them, followed by part of a provider network on 44. 6 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | ALAN SWARTZ Miami, FL, ranked 419 | $452 |
|
| 1 | ROSALVA ZEGARRA Hialeah, FL, ranked 424 | $302 |
|
| 1 | LARKIN BEHAVIOR HEALTH INC Hialeah Gardens, FL, ranked 501 | $0 |
|
| 1 | ABRH CARE INC Miami, FL, ranked 507 | $0 |
|
| 1 | DAVILA MEDICAL CENTER INC Miami, FL, ranked 649 | $0 |
|
| 1 | NEW BEHAVIOR HEALTH DIRECTION INC Miami, FL, ranked 683 | $0 |
|
| 2 | MASSIEL MERLO-GOMEZ Miami, FL, ranked 740 | $387K |
|
| 3 | PRIMARY MEDICAL STAFFING, INC. Miami Lakes, FL, ranked 756 | $17.5M |
|
Recent enforcement in FL
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJPleaded guiltyAug 14, 2026
Ocala Mental Health Counselor Pleads Guilty to Aggravated Identity Theft and Wire Fraud
Forsythe used the names and insurance policy information of 22 individuals without their consent to bill two health insurance companies for counseling services she had not provided.
DOJConvictedAug 12, 2026
Cuban National Convicted of Unlawfully Obtaining US Citizenship After Concealing Healthcare Fraud Scheme
Rodriguez concealed on her naturalization application her participation in a seven-year healthcare fraud conspiracy that resulted in approximately $4.6 million in fraudulent healthcare claims.
DOJCivil settlementAug 3, 2026
Medicare Advantage Provider Complete Health to Pay $14,100,000 to Settle False Claims Act Suit
Complete Health caused the submission of diagnosis codes within HCC 55 and HCC 59 that were not clinically valid, not supported by medical records, and/or not considered in the beneficiary's care, increasing Medicare Advantage risk-adjusted payments from which it received a percentage.
DOJCivil settlementJul 31, 2026
Two Additional Ophthalmology Practices Agree to Pay $2.3M to Resolve Allegations of Fraudulent Claims to Medicare and Medicaid for Cranial Ultrasounds
Two ophthalmology practices billed Medicare and Medicaid for medically unnecessary trans-cranial doppler ultrasounds premised on false diagnoses, with one practice receiving remuneration from a third-party testing company to refer patients for the tests.
DOJCivil settlementJul 31, 2026
Two Additional Ophthalmology Practices Agree to Pay $2.3M to Resolve Allegations of Fraudulent Claims to Medicare and Medicaid for Cranial Ultrasounds
Two ophthalmology practices billed Medicare and Medicaid for medically unnecessary trans-cranial doppler ultrasounds premised on false diagnoses and, as to Floral Park Ophthalmology, resulting from remuneration paid by a third-party testing company to induce referrals.
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.