KAIN KUMAR, M.D., PhD

NPI 1265431316, individual, Palmdale, CA, Internal Medicine

Evidence tier

documented action, then payment

Listed on the Medicare revocation list since April 4, 2019.
Medicaid still paid claims in 1 later month, $865 in total.

score 93 of 100, rank 402, $865 at stake

Public list actions

Medicare revocation effective April 4, 2019, barred from re-enrolling until April 4, 2029

424.535(a)(9) failure to report and 424.535(a)(3) felonies, Practitioner - Internal Medicine, CA

OIG exclusion November 19, 2020 under section 1128a1

Physician (MD, DO), Internal Medicine, Rosamond, CA

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
Medicare revocation list 424.535(a)(9) failure to report and 424.535(a)(3) felonies	Exact NPI, name verified	Apr 4, 2019	Apr 4, 2029	1	May 2019	May 2019	$865	$1K

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	KAIN KUMAR, M.D., PhD
Type	Individual
Status	Active
NPI issued	July 20, 2005, last updated February 28, 2011
Practice location	540 W PALMDALE BLVD, B, Palmdale, CA 93551-4232, 661-947-5600
Specialties	Internal Medicine (207R00000X, primary, license A67882 CA)

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
99309	Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	$1K	57%	$90	$21 (top 5% from $84)	too few months to rank
99306	Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more	$865	43%	$72	$37 (top 5% from $100)	too few months to rank

In this area

399 providers in Los Angeles County, CA carry an indicator in the public record, with $129.6M at stake between them. The most common is part of a provider network, on 347 of them, followed by paid after a public list action on 36. 52 are tier 1: documented action, then payment.

tier	provider	at stake	why
1	BURBANK PREFERRED PROVIDER MEDICAL GROUP, INC Burbank, CA, ranked 17	$67K	Listed on the Medicare revocation list since October 21, 2020. Medicaid still paid claims in 24 later months, $67,101 in total. and 1 more
1	GOLDEN STAR LABS LLC Los Angeles, CA, ranked 32	$41.0M	Adjudicated (pleaded guilty) per a Department of Justice release dated June 24, 2026. Medicaid paid $41,015,276 in the last 12 observed months.
1	MATIAS CLINICAL LABORATORY INC Baldwin Park, CA, ranked 43	$3.8M	Listed on the Medicare revocation list since August 31, 2018. Medicaid still paid claims in 44 later months, $3,846,471 in total. and 1 more
1	HEALTHSMART PACIFIC INC Long Beach, CA, ranked 52	$1.6M	Listed on the OIG exclusion list since April 20, 2021. Medicaid still paid claims in 34 later months, $1,639,221 in total.
1	LINDA WARREN-WATSON Lancaster, CA, ranked 71	$828K	Listed on the CA Medicaid exclusion list since October 31, 2020. Medicaid still paid claims in 16 later months, $828,250 in total.
1	SOHRAB MOSHIRI Woodland Hills, CA, ranked 82	$483K	Listed on the WA Medicaid exclusion list since January 9, 2009. Medicaid still paid claims in 83 later months, $482,999 in total.
1	QUALITY FAMILY HOSPICE CARE INC Tarzana, CA, ranked 92	$375K	Listed on the CA Medicaid exclusion list and the Medicare revocation list since July 18, 2024. Medicaid still paid claims in 4 later months, $375,479 in total.
1	MARATHON HOSPICE CARE INC. North Hollywood, CA, ranked 95	$368K	Listed on the Medicare revocation list since July 6, 2024. Medicaid still paid claims in 4 later months, $367,866 in total.

All 399 in CA

Recent enforcement in CA

All releases

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

DOJPleaded guiltyAug 27, 2026

Anaheim Woman Pleads Guilty to Submitting More Than $2.2 Million in Fraudulent Hospice Care Claims to Medicare

Galbraith submitted approximately $2,266,694 in claims to Medicare for hospice services for beneficiaries who did not have a terminal illness with a life expectancy of six months or less, and Medicare paid her company approximately $2,140,606.

DOJCivil settlementAug 26, 2026

DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests

DermTech Inc. submitted claims to Medicare for skin cancer tests conducted with an unvalidated positive control range and for tests lacking sufficient patient RNA, and did not retract results or adequately refund Medicare.

DOJCivil settlementAug 26, 2026

DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests

DermTech Inc. billed Medicare for skin cancer tests conducted using an unvalidated positive control range and for tests with insufficient patient RNA, and did not retract the results or adequately refund Medicare.

DOJCivil settlementAug 24, 2026

Medicare Advantage Provider Monogram Health Agrees to Pay $2.4 Million to Settle False Claims Act Lawsuit

Monogram knowingly submitted diagnosis codes in four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to Medicare Advantage Organizations.

DOJCivil settlementAug 24, 2026

Medicare Advantage Provider Monogram Health Agrees to Pay $2.4M to Settle False Claims Act Suit

Monogram Health knowingly submitted diagnosis codes within four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to MAOs.

Referral packet

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