Providers
All 10 in CA
PEDRO DEOLIVEIRA GUIMARAES, M.D.
NPI 1285624155, individual, San Luis Obispo, CA, Psychiatry & Neurology, Psychiatry
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 15 months, but with up to 587 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 99214 ($420 per patient-month) sit in the top 5% of every provider billing that code.
score 55 of 100, rank 7565, $3.0M at stake
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 |
|---|---|---|---|---|---|---|---|---|---|
| Jan 2022 | More hours than a day holds at a conservative unit price | 7.6 | 44.6 | 29.7 | 43.9 | 495 | 1 | 90833 99213 99214 | $73K |
| Feb 2022 | More hours than a day holds at a conservative unit price | 8.3 | 45.3 | 30.2 | 42.2 | 477 | 1 | 90792 90833 99213 99214 99215 | $73K |
| Mar 2022 | More hours than a day holds at a conservative unit price | 9.4 | 52.3 | 34.9 | 47.0 | 574 | 1 | 90792 90833 90836 99213 99214 | $89K |
| Apr 2022 | More hours than a day holds at a conservative unit price | 7.8 | 45.0 | 30.0 | 42.8 | 471 | 1 | 90833 90836 99213 99214 | $70K |
| May 2022 | More hours than a day holds at a conservative unit price | 6.7 | 39.8 | 26.5 | 37.4 | 439 | 1 | 90833 90836 99213 99214 | $63K |
| Jun 2022 | More hours than a day holds at a conservative unit price | 8.5 | 48.5 | 32.3 | 44.1 | 511 | 1 | 90792 90833 99213 99214 99215 | $81K |
| Aug 2022 | More hours than a day holds at a conservative unit price | 8.8 | 50.3 | 33.5 | 45.2 | 520 | 1 | 90833 99213 99214 99215 | $86K |
| Sep 2022 | More hours than a day holds at a conservative unit price | 9.2 | 49.4 | 32.9 | 44.9 | 522 | 1 | 90792 90833 99213 99214 | $83K |
| Oct 2022 | More hours than a day holds at a conservative unit price | 8.2 | 45.6 | 30.4 | 44.8 | 485 | 1 | 90833 99213 99214 99215 | $80K |
| Nov 2022 | More hours than a day holds at a conservative unit price | 7.6 | 42.2 | 28.2 | 38.4 | 444 | 1 | 90833 99213 99214 99215 | $72K |
| Dec 2022 | More hours than a day holds at a conservative unit price | 9.1 | 51.4 | 34.3 | 48.3 | 514 | 1 | 90833 99213 99214 99215 | $90K |
| Jan 2023 | More hours than a day holds at a conservative unit price | 9.4 | 55.2 | 36.8 | 51.9 | 542 | 1 | 90833 99213 99214 99215 | $89K |
| Feb 2023 | More hours than a day holds at a conservative unit price | 10.3 | 56.2 | 37.5 | 52.5 | 503 | 1 | 90833 99213 99214 99215 | $83K |
| Mar 2023 | More hours than a day holds at a conservative unit price | 10.4 | 46.3 | 30.9 | 41.6 | 537 | 1 | 90792 90833 99213 99214 99215 | $82K |
| Apr 2023 | More hours than a day holds at a conservative unit price | 10.5 | 45.8 | 30.6 | 45.8 | 537 | 1 | 90792 90833 99213 99214 99215 | $81K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | PEDRO DEOLIVEIRA GUIMARAES, M.D. (also PEDRO GUIMARAES NETO) |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | October 24, 2005, last updated November 2, 2010 |
| Practice location | 1329 BROAD ST, SUITE A, San Luis Obispo, CA 93401-3909, 805-540-0279 |
| Mailing address | PO BOX 14209, San Luis Obispo, CA 93406-4209 |
| Specialties | Psychiatry & Neurology, Psychiatry (2084P0800X, license 216516 MA) Psychiatry & Neurology, Psychiatry (2084P0800X, primary, license C52093 CA) Psychiatry & Neurology, Psychiatry (2084P0800X, license 013761 ME) Psychiatry & Neurology, Psychiatry (2084P0800X, license 13428 NH) |
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 | |
|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $1.4M | 44% | $199 | $60 (top 5% from $133) | 99th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $710K | 22% | $142 | $44 (top 5% from $110) | 97th percentile | |
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | $690K | 21% | $88 | $49 (top 5% from $109) | 90th percentile | |
| 99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or morehistory of abuse | $258K | 8% | $420 | $88 (top 5% from $210) | 98th percentile | |
| 90792 | Psychiatric diagnostic evaluation with medical services | $99K | 3% | $193 | $112 (top 5% from $313) | 84th percentile | |
| 99417 | Prolonged outpatient E/M each 15 min | $39K | 1% | $394 | $45 (top 5% from $309) | 97th percentile | |
| 90836 | Psychotherapy with evaluation and management visit, 45 minutes | $7K | 0% | $104 | $72 (top 5% from $190) | too few months to rank | |
| G9919 | Medicaid service code | $0 | 0% | $0.00 | $0.00 (top 5% from $29) | too few months to rank |
In this area
10 providers in San Luis Obispo County, CA carry an indicator in the public record, with $14.1M at stake between them. The most common is more hours than a day holds, on 8 of them, followed by part of a provider network on 2.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | GUARDIAN ANGEL HOME CARE OF SAN LUIS OBISPO San Luis Obispo, CA, ranked 4192 | $0 |
|
| 3 | COMMUNITY HOME HEALTH INC Arroyo Grande, CA, ranked 6870 | $0 |
|
| 4 | MATTHEW HADILAKSONO Templeton, CA, ranked 7340 | $447K |
|
| 4 | SHAUNA LYNCH Atascadero, CA, ranked 7462 | $4.7M |
|
| 4 | WILLIAM MORGAN Arroyo Grande, CA, ranked 7546 | $3.2M |
|
| 4 | RICHARD ALTESMAN San Luis Obispo, CA, ranked 7592 | $2.7M |
|
| 4 | ABDELLATIF AICHOURI San Luis Obispo, CA, ranked 7899 | $682K |
|
| 4 | JOSE FELIBERTI Arroyo Grande, CA, ranked 7944 | $492K |
|
Recent enforcement in CA
All releasesDepartment 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
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.