JOSEPH MARTIN THOMAS, MD
NPI 1245271568, individual, Erie, PA, Anesthesiology, Pain Medicine
- Listed on the NY Medicaid exclusion list since November 14, 2022.
- Medicaid still paid claims in 1 later month, $984 in total.
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.
| list | identity check | action date | window closed | months paid after | first | last | paid after | 12 months before |
|---|---|---|---|---|---|---|---|---|
| NY Medicaid exclusion list ny omig medicaid exclusion list (tab-delimited, sept 2026) | Exact NPI, name verified | Nov 14, 2022 | still open | 1 | Jan 2024 | Jan 2024 | $984 | $0 |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | JOSEPH MARTIN THOMAS, MD |
| Type | Individual |
| Status | Active |
| NPI issued | June 9, 2006, last updated September 13, 2022 |
| Practice location | 5442 PEACH ST, Erie, PA 16509-2602, 814-833-7246 |
| Specialties | (208VP0000X, license MD045797L PA) Anesthesiology, Pain Medicine (207LP2900X, primary, license MD045767L PA) |
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.
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $3K | 60% | $46 | $60 (top 5% from $133) | too few months to rank | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $2K | 40% | $28 | $44 (top 5% from $110) | too few months to rank |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 64483 | Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level | 158 | 92 | $28K | $710 | $250 | 2.8x | 5.7x (90th percentile 15.2x) |
| 62323 | Injection of substance into lower spine canal using imaging guidance | 117 | 80 | $19K | $775 | $228 | 3.4x | 5.4x (90th percentile 15.1x) |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 179 | 131 | $14K | $190 | $116 | 1.6x | 2.3x (90th percentile 3.8x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 233 | 151 | $13K | $160 | $82 | 2.0x | 2.2x (90th percentile 3.8x) |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint | 38 | 25 | $12K | $853 | $394 | 2.2x | 5.2x (90th percentile 13.7x) |
| 64636 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint | 38 | 25 | $6K | $436 | $212 | 2.1x | 5.5x (90th percentile 20.8x) |
| 64493 | Injection of lower or sacral spine facet joint using imaging guidance, single level | 36 | 19 | $6K | $678 | $213 | 3.2x | 5.5x (90th percentile 16.3x) |
| 64633 | Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint | 19 | 12 | $6K | $700 | $385 | 1.8x | 5.2x (90th percentile 12.2x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
2 providers in Erie County, PA carry an indicator in the public record, with $43K at stake between them. The most common is named in an enforcement record, on 1 of them, followed by more hours than a day holds on 1. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | AARON HERTEL Erie, PA, ranked 470 | $0 |
|
| 4 | JEAN STORM Erie, PA, ranked 9655 | $43K |
|
Recent enforcement in PA
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
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.