Providers
CARL YALE MALMQUIST, MSPT
NPI 1235298001, individual, Yuma, AZ, Physical Therapist
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 1 month, but with up to 1503 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
score 51 of 100, rank 8806, $1.6M at stake
Public list actions
Medicare revocation effective August 24, 2022, barred from re-enrolling until August 24, 2032
424.535(a)(9) failure to report and 424.535(a)(3) felonies and 424.535(a)(2) provider or supplier conduct (exclusion), Practitioner - Physical Therapist In Private Practice, AZ
Medicare revocation effective August 24, 2022, barred from re-enrolling until August 24, 2032
424.535(a)(3) felonies and 424.535(a)(2) provider or supplier conduct (exclusion), Practitioner - Physical Therapist In Private Practice, CA
OIG exclusion December 20, 2022 under section 1128a1
Ind- Lic HC Serv Pro, Physical Therapy, Yuma, AZ
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 |
|---|---|---|---|---|---|---|---|---|---|
| Apr 2018 | More hours than a day holds, even counting one unit per claim line | 37.6 | 24.9 | 16.6 | 15.1 | 1503 | 2 | 97032 97035 97110 97112 97113 97116 97140 97161 97162 97530 | $87K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | CARL YALE MALMQUIST, MSPT |
| Type | Individual |
| Status | Active |
| NPI issued | December 8, 2006, last updated August 31, 2011 |
| Practice location | 6319 E TELEGRAPH ST, Yuma, AZ 85365-1117, 928-920-6600 |
| Specialties | Physical Therapist (225100000X, primary, license 6056 AZ) |
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 | $719K | 37% | $102 | $76 (top 5% from $314) | 64th percentile | |
| 97113 | Therapy procedure using water pool to exercises, each 15 minutes | $333K | 17% | $279 | $150 (top 5% from $406) | 87th percentile | |
| 97530 | Therapy procedure using functional activities | $280K | 14% | $61 | $124 (top 5% from $387) | 25th percentile | |
| 97140 | Therapy procedure using manual technique, each 15 minutes | $241K | 12% | $51 | $47 (top 5% from $120) | 55th percentile | |
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | $125K | 6% | $54 | $59 (top 5% from $187) | 44th percentile | |
| 97014 | Medicaid service code | $71K | 4% | $30 | $24 (top 5% from $71) | 66th percentile | |
| 97161 | Evaluation for physical therapy, typically 20 minutes | $40K | 2% | $34 | $51 (top 5% from $132) | 22nd percentile | |
| 97035 | Application of ultrasound, each 15 minutes | $38K | 2% | $27 | $21 (top 5% from $107) | 65th percentile |
In this area
6 providers in Yuma County, AZ carry an indicator in the public record, with $12.4M at stake between them. The most common is more hours than a day holds, on 6 of them.
| tier | provider | at stake | why |
|---|---|---|---|
| 4 | ENGIDA ALEMU Yuma, AZ, ranked 7987 | $331K |
|
| 4 | MALLAPPA NEELAPPA Yuma, AZ, ranked 8585 | $2.8M |
|
| 4 | REBECCA DOWNS Yuma, AZ, ranked 8987 | $993K |
|
| 5 | OLIVIA WILSON Yuma, AZ, ranked 10101 | $1.1M |
|
| 5 | SERGIO MACIAS San Luis, AZ, ranked 10692 | $5.0M | |
| 5 | MARIA MACIAS San Luis, AZ, ranked 10793 | $2.2M |
Recent enforcement in AZ
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJChargedJun 23, 2026
District of Arizona Announces Charges Involving Over $1.2 Billion in False or Fraudulent Claims as Part of National Health Care Fraud Takedown
Four defendants were charged in connection with alleged schemes involving over $1.2 billion in false or fraudulent claims for amniotic wound allografts procured through kickbacks and for substance abuse treatment services billed to Arizona Medicaid that were not provided as billed.
DOJSentencedJun 4, 2026
New River Couple Sentenced for $12 Million AHCCCS Fraud Scheme
The Currys submitted a fraudulent AHCCCS provider enrollment application concealing Thvoughn Curry's ownership role and then billed AHCCCS through 1 Family Clinic, LLC for behavioral health and substance abuse therapy services that were not provided, receiving more than $12 million.
DOJCivil settlementMar 12, 2026
Arizona Cardiology Group to Pay $4.75M to Resolve Allegations of Unnecessary Vein Ablations
Tri-City Cardiology and three physicians allegedly violated the False Claims Act by performing medically unnecessary ablations on perforator veins and incorrectly measuring or documenting blood flow duration, vein diameter, patient symptoms, and conservative therapy measures to make the procedures appear justified.
DOJConvictedFeb 27, 2026
New River Couple Convicted of $12 Million AHCCCS Fraud Scheme
The Currys submitted a fraudulent AHCCCS provider enrollment application concealing Thvoughn Curry's ownership and then billed AHCCCS for behavioral health services that were not actually provided through 1 Family Clinic, LLC, receiving more than $12 million.
DOJSentencedFeb 27, 2026
Mesa Residents Sentenced to Prison for Fraud Targeting AHCCCS
Riley and Gooch, through their behavioral health clinic New Horizons Behavioral Health, exploited AHCCCS's American Indian Health Program between 2020 and 2022 by falsely billing for services that were not provided, obtaining approximately $3.3 million.
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.