Providers
All 33 in CT
JOSE A ESTELA, MD
NPI 1235142431, individual, Bristol, CT, Internal Medicine
5
Evidence tier
informational
score 31 of 100, rank 10917, $1.4M at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | JOSE A ESTELA, MD |
| Type | Individual |
| Status | Active |
| NPI issued | August 15, 2006, last updated August 30, 2012 |
| Practice location | 94 BELLEVUE AVE, Bristol, CT 06010-5816, 860-582-8764 |
| Specialties | Internal Medicine (207R00000X, primary, license 15340 CT) |
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 | $571K | 19% | $81 | $44 (top 5% from $110) | 89th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $538K | 17% | $111 | $60 (top 5% from $133) | 90th percentile | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $479K | 16% | $116 | $67 (top 5% from $121) | 94th percentile | |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | $410K | 13% | $54 | $44 (top 5% from $70) | 82nd percentile | |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $390K | 13% | $168 | $95 (top 5% from $171) | 94th percentile | |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $217K | 7% | $49 | $28 (top 5% from $147) | 79th percentile | |
| 99202 | New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more | $158K | 5% | $78 | $45 (top 5% from $138) | 86th percentile | |
| 0241U | Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected | $120K | 4% | $126 | $113 (top 5% from $189) | 59th percentile |
In this area
33 providers in Bristol, CT carry an indicator in the public record, with $12.6M at stake between them. The most common is named in an enforcement record, on 12 of them, followed by more hours than a day holds on 9. 12 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | SHAWN TYSON Hartford, CT, ranked 62 | $0 |
|
| 1 | MINDS CORNERSTONE LLC Wethersfield, CT, ranked 74 | $721K |
|
| 1 | HELEN ZERVAS Bristol, CT, ranked 112 | $192K |
|
| 1 | SORAYA SAWICKI Avon, CT, ranked 133 | $131K |
|
| 1 | MICHAEL PINES Glastonbury, CT, ranked 444 | $0 |
|
| 1 | THE GEMINI PROJECT, LLC Newington, CT, ranked 446 | $0 |
|
| 1 | COLLABORATIVE COUNSELING CENTER, LLC Hartford, CT, ranked 550 | $0 |
|
| 1 | DONALD SALZBERG West Hartford, CT, ranked 575 | $0 |
|
Recent enforcement in CT
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJCivil settlementJun 23, 2026
Connecticut Lab and its Owner Pay Over $145K to Settle Allegations of Medicaid Enrollment Fraud
Coastal Diagnostics and its owner made material misrepresentations in a Connecticut Medicaid Provider Enrollment Application by denying any relationship to another enrolled provider, Genco Lab, and then submitted claims for laboratory services.
DOJPleaded guiltyJun 23, 2026
Middletown Man Pleads Guilty to Operating Unlawful Money Transmitting Business
Habib registered a company and opened a bank account through which fraudulent claims were submitted to Medicare Advantage plans for durable medical equipment, including orthotics and braces, that beneficiaries did not request, consent to, or receive, and he wired proceeds to Pakistan without a money transmitting license.
DOJComplaint filedMay 22, 2026
APRN Charged with Defrauding Connecticut’s Medicaid Program
An APRN was charged with submitting fraudulent Medicaid claims for medication management services that were not provided, including for patients who had stopped seeing her or who were hospitalized, incarcerated, or deceased.
DOJSentencedApr 30, 2026
Cheshire Nurse Who Illegally Distributed Controlled Substances is Sentenced
An Advanced Practice Registered Nurse enrolled as a Medicare and Medicaid provider unlawfully distributed amphetamines and benzodiazepines to individuals without legitimate medical need, charging $200 cash for office visits, and Medicaid paid $287.58 for prescriptions written for an undercover agent.
DOJSentencedFeb 10, 2026
Bloomfield Man Sentenced to Federal Prison for Health Care Fraud
Tyson and Epps submitted fraudulent Medicaid claims for psychotherapy counseling sessions that were not provided, billed under Tyson's provider number for services purportedly provided by the suspended Epps, and Tyson provided fraudulent patient records during a Medicaid audit.
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.