Providers

ADVANCED SPINE AND PAIN CENTERS, PLLC

NPI 1215266267, organization, Stafford, VA, Orthopaedic Surgery, Orthopaedic Surgery of the Spine

1
Evidence tier
documented action, then payment
  • Listed on the Medicare revocation list since November 19, 2021.
  • Medicaid still paid claims in 23 later months, $1,327,755 in total.
score 96 of 100, rank 58, $1.3M at stake

Public list actions

Medicare revocation effective November 19, 2021, barred from re-enrolling until November 19, 2031
424.535(a)(9) failure to report and 424.535(a)(3) felonies, Part B Supplier - Clinic/Group Practice, DC
Medicare revocation effective November 19, 2021, barred from re-enrolling until November 19, 2031
424.535(a)(9) failure to report and 424.535(a)(3) felonies, Part B Supplier - Clinic/Group Practice, VA
Medicare revocation effective November 19, 2021, barred from re-enrolling until November 19, 2031
424.535(a)(9) failure to report and 424.535(a)(3) felonies, Part B Supplier - Clinic/Group Practice, MD

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.

listidentity checkaction datewindow closedmonths paid afterfirstlastpaid after12 months before
Medicare revocation list
424.535(a)(9) failure to report and 424.535(a)(3) felonies
Exact NPI, name verifiedNov 19, 2021Nov 19, 203123Dec 2021Oct 2023$1.3M$1.8M

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameADVANCED SPINE AND PAIN CENTERS, PLLC
TypeOrganization
StatusActive
NPI issuedDecember 21, 2009, last updated October 11, 2022
Practice location450 GARRISONVILLE RD, SUITE 109, Stafford, VA 22554, 703-522-2727
Mailing address217 E CHURCHVILLE RD, Bel Air, MD 21014-3825
Authorized officialAURA IONITA (Practice Administrator)
Specialties
Orthopaedic Surgery (207X00000X, license 0101243103 VA)
Pain Medicine, Interventional Pain Medicine (208VP0014X, license 0101243103 VA)
Orthopaedic Surgery, Orthopaedic Surgery of the Spine (207XS0117X, primary, license 0101243103 VA)

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
codewhat it ispaidshareper patient-monthtypicalrank among providers
99214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$2.2M86%$78$60 (top 5% from $133)22nd percentile
80307Testing for presence of drug, by chemistry analyzers$206K8%$34$45 (top 5% from $110)too few months to rank
99213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$112K4%$40$44 (top 5% from $110)66th percentile
99204New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more$33K1%$143$95 (top 5% from $171)too few months to rank
J1100Injection, dexamethasone sodium phosphate, 1 mg$2K0%$11$0.62 (top 5% from $14)too few months to rank
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg$460%$1.24$3.46 (top 5% from $11)too few months to rank
99072Medicaid service code$70%$0.02$0.00 (top 5% from $11)too few months to rank
G8430Medicaid service code$00%$0.00$0.00 (top 5% from $0.04)too few months to rank

In this area

3 providers in Stafford County, VA carry an indicator in the public record, with $6.1M at stake between them. The most common is more hours than a day holds, on 2 of them, followed by paid after a public list action on 1. 1 is tier 1: documented action, then payment.

tierproviderat stakewhy
1THOMAS RALEY
Stafford, VA, ranked 104
$253K
  • Listed on the Medicare revocation list since November 19, 2021.
  • Medicaid still paid claims in 9 later months, $252,808 in total.
4NATHER ANSARI
Stafford, VA, ranked 8379
$5.7M
  • Hours beyond a day in 7 months, but with up to 1574 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
5PETROS AYELE
Stafford, VA, ranked 11536
$151K

Recent enforcement in VA

All releases

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

DOJChargedJun 23, 2026
U.S. Attorney’s Office announces charges against three defendants in the Eastern District of Virginia as part of national health care fraud takedown
Three defendants were charged with fraudulently billing Medicaid for mental health services that were not provided and with submitting false claims to Medicare through a straw-owned durable medical equipment company.
DOJSentencedJun 5, 2026
Medicaid service providers sentenced for false statements resulting in overbilling
Wright and Winfield instructed CCR employees to falsely claim in progress notes that children received therapeutic day treatment services from 2:00pm to 7:00pm, including providing prefilled progress note templates, resulting in overbilling to Medicaid.
DOJCivil settlementApr 27, 2026
Tri-Area Community Health Agrees to Pay $513,000 to Resolve Medicare Billing Allegations
Tri-Area Community Health billed Medicare for Annual Wellness Visits provided by pharmacists without appropriate physician supervision that were billed under the names of physicians not involved with the visits.
DOJSentencedMar 17, 2026
Six Sentenced in Healthcare Fraud Conspiracy that Stole $10 Million from Medicaid Over Six-Year Period
Six defendants conspired to submit false claims to Virginia Medicaid on behalf of 1st Adult N Pediatric Healthcare Services for nursing and personal care services that were not provided, including falsifying records and paying parents or guardians of patients for blank, signed nursing notes.
DOJIndictedMar 11, 2026
Victim Advisory- Divine Youth Case Updates
Divine Youth Counseling submitted more than $11 million in fraudulent Medicaid claims for Crisis Stabilization and Mobile Crisis services by falsely claiming two mental health professionals provided Team Treatment services and paid more than $470,000 in kickbacks in the form of hotel rooms for Medicaid recipients.

Referral packet

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