Providers
SOPHIE TOYA, M.D.
NPI 1225367147, individual, Saginaw, MI, Internal Medicine, Pulmonary Disease
1
Evidence tier
adjudicated in a public enforcement record
- Adjudicated (sentenced, convicted) per a Department of Justice release dated May 10, 2024.
- No Medicaid payments in the last 12 observed months.
score 90 of 100, rank 529, $0 at stake
Public list actions
Medicare revocation effective June 26, 2025, barred from re-enrolling until June 26, 2035
424.535(a)(3) felonies, Practitioner - Internal Medicine, IL
Medicare revocation effective June 26, 2025, barred from re-enrolling until June 26, 2035
424.535(a)(3) felonies, Practitioner - Critical Care (Intensivists), IN
OIG exclusion April 20, 2026 under section 1128a1
Physician (MD, DO), Internal Medicine, Lexington, KY
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | SOPHIE TOYA, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | December 24, 2009, last updated June 18, 2019 |
| Practice location | 125 N COLONY DR, Saginaw, MI 48638-7101, 989-583-7380 |
| Mailing address | 1447 N HARRISON ST, Saginaw, MI 48602-4727 |
| Specialties | Internal Medicine (207R00000X, license 01071517A IN) Internal Medicine, Critical Care Medicine (207RC0200X, license 036.108537 IL) Internal Medicine, Pulmonary Disease (207RP1001X, license 036.108537 IL) Internal Medicine, Pulmonary Disease (207RP1001X, primary, license 4301111559 MI) |
In this area
5 providers in Saginaw County, MI carry an indicator in the public record, with $0 at stake between them. The most common is part of a provider network, on 5 of them.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | GREAT LAKES HOME HEALTH CARE AGENCY, LLC Saginaw, MI, ranked 1707 | $0 |
|
| 3 | SAGINAW GERIATRICS HOME LLC Saginaw, MI, ranked 3308 | $0 |
|
| 3 | HARMONY AT HOME HOSPICE LLC Chesaning, MI, ranked 5155 | $0 |
|
| 3 | COMPASSIONATE CARE HOSPICE Saginaw, MI, ranked 5860 | $0 |
|
| 3 | RESIDENTIAL HOME HEALTH AND HOSPICE, INC. Saginaw, MI, ranked 6201 | $0 |
|
Recent enforcement in MI
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJChargedJun 23, 2026
National Health Care Fraud Enforcement Action Results in 455 Defendants Charged and Over $6.5 Billion in Intended Fraud Loss Charged
Six cases in the Eastern District of Michigan involving alleged fraudulent billing of Medicare, Medicaid and private insurers for laboratory tests, prescriptions not dispensed, and reimbursement claims for services never rendered, plus unlawful opioid prescribing and False Claims Act settlements.
DOJConvictedMay 15, 2026
Michigan Home Health Care Agency Owner Convicted of $1.6M Medicare Fraud Scheme and Kickback Conspiracy
Scott bribed a hospital discharge nurse to fax confidential Medicare patient records to her home health agency and billed Medicare for home health services using false representations that doctors had certified the patients as homebound, causing approximately $1.6 million in losses.
DOJPleaded guiltyMay 1, 2026
Pharmacy Technician Pleads Guilty to $5.6M Health Care Fraud Scheme and Illegal Distribution of Oxycodone
A pharmacy technician and a co-conspirator submitted false claims to health care benefit programs for prescription drugs that were never ordered by a doctor and never dispensed, using forged prescriptions, and he provided unlawful oxycodone prescriptions to drug traffickers for cash.
DOJSentencedNov 24, 2025
Michigan Pharmacist Sentenced to 46 Months in Prison for $4M Health Care Fraud Scheme
Fakih billed Medicare for prescription medications, such as blood thinners and lung disease inhalers, that he did not dispense at the pharmacy he owned and operated, concealing the fraud by manipulating inventory purchases and diverting proceeds for personal use.
DOJSentencedNov 21, 2025
Pharmacist and Brother Sentenced to Prison for $15M Health Care and Wire Fraud Scheme
A pharmacist and his brother, a pharmacy manager, billed Medicare, Medicaid and Blue Cross Blue Shield of Michigan for prescription medications that they did not dispense at pharmacies they owned or operated, targeting expensive medications and concealing inventory shortages from auditors.
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.