TIMOTHY DUNCAN ESTES, M.D.

NPI 1285746511, individual, Jackson, MS, General Practice

Evidence tier

structure or single-organization volume

Hours beyond a day in 1 month, but with up to 1648 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 99307 ($69 per patient-month) sit in the top 5% of every provider billing that code.

score 54 of 100, rank 8050, $149K 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
Jun 2024	More hours than a day holds at a conservative unit price	18.1	36.7	24.4	36.7	1411	1	90791 90832 99307 99308 99309	$43K
Nov 2024	More hours than a day holds at a conservative unit price	10.3	56.5	37.7	53.8	708	2	90791 90832 99307 99308 99309	$154K
Dec 2024	More hours than a day holds at a conservative unit price	8.0	45.7	30.5	42.9	619	2	90832 99307 99308 99309	$130K

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	TIMOTHY DUNCAN ESTES, M.D.
Type	Individual
Status	Active
NPI issued	August 31, 2006, last updated April 6, 2011
Practice location	2860 MCDOWELL ROAD EXT, Jackson, MS 39204-4238, 601-372-1117
Specialties	General Practice (208D00000X, primary, license 09740 MS)

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
99307	Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	$511K	41%	$69	$7.86 (top 5% from $34)	99th percentile
99308	Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more	$459K	37%	$66	$14 (top 5% from $58)	96th percentile
90832	Psychotherapy, 30 minutes	$188K	15%	$128	$59 (top 5% from $239)	87th percentile
99309	Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	$51K	4%	$47	$21 (top 5% from $84)	85th percentile
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	$29K	2%	$42	$44 (top 5% from $110)	47th percentile
90791	Psychiatric diagnostic evaluation	$7K	1%	$29	$105 (top 5% from $228)	13th percentile
99396	Medicaid service code	$3K	0%	$99	$70 (top 5% from $132)	too few months to rank
99203	New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	$2K	0%	$81	$67 (top 5% from $121)	too few months to rank

Medicare Part B 2024, largest codes

code	what it is	services	beneficiaries	paid	submitted per service	allowed per service	charge to allowed	usual for this code
99308	Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more	94	40	$5K	$225	$68	3.3x	2.0x (90th percentile 3.4x)
99307	Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	76	38	$2K	$200	$37	5.4x	2.4x (90th percentile 4.1x)
99309	Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	15	15	$1K	$265	$99	2.7x	2.0x (90th percentile 3.3x)
G0127	Trimming of dystrophic nails, any number	21	18	$116	$125	$7	18.0x	2.7x (90th percentile 6.0x)

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

5 providers in Hinds County, MS carry an indicator in the public record, with $45.8M at stake between them. The most common is more hours than a day holds, on 5 of them.

tier	provider	at stake	why
2	JOHN WILKAITIS Jackson, MS, ranked 697	$1.6M	Billed more hands-on hours than a day holds in 2 months, peaking at 24.6 hours per day across 3 billing organizations. Medicaid dollars per patient on code 99232 ($286 per patient-month) sit in the top 5% of every provider billing that code.
4	SAGAR PATEL Jackson, MS, ranked 7867	$846K	Hours beyond a day in 2 months under one organization, which can be supervisory billing. Records needed. and 1 more
5	KULMORIS JOINER Jackson, MS, ranked 10295	$42.7M	90% of Medicaid dollars are on codes with a history of abuse.
5	PATRICK WELDON Jackson, MS, ranked 10297	$425K	Medicaid dollars per patient on code 99232 ($178 per patient-month) sit in the top 5% of every provider billing that code.
5	KRISHAN GUPTA Jackson, MS, ranked 10392	$197K	Medicaid dollars per patient on code 99232 ($244 per patient-month) sit in the top 5% of every provider billing that code.

Recent enforcement in MS

All releases

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

DOJSentencedJun 30, 2026

Madison Man Sentenced to 30 Months in Federal Prison for Role in Medicare Kickback Conspiracy

Smith, a marketer for diagnostic laboratories, solicited and received kickbacks from laboratories in exchange for referrals of specimens and orders for molecular diagnostic testing of toenails and paid kickbacks to providers to induce those referrals, resulting in over $1.4 million in claims to Medicare.

DOJSentencedJun 29, 2026

Two Corinth Pharmacists Sentenced for Conspiracy to Commit Healthcare Fraud

Two pharmacists billed Medicare and Medicaid for the same single prescription drug product numerous times, including diabetic insulin pens, asthma inhalers and psychotropic medications.

DOJSentencedMay 8, 2026

Former NFL Player Sentenced to Over 16 Years in Prison for $197M Medicare Fraud

French worked with overseas call centers to obtain patient information, paid kickbacks to sham telemedicine companies for signed doctors' orders for orthotic braces, sold the orders to marketers and supply companies, and billed Medicare and CHAMPVA through eight DME companies he owned using straw owners.

DOJPleaded guiltyNov 20, 2025

Mississippi Businessman Pleads Guilty to $19M Health Care Fraud Conspiracy

Gibbs paid kickbacks for fraudulent doctors' orders and used them to bill Medicare over $19 million for medically unnecessary orthotic braces through seven durable medical equipment supply companies he owned or controlled, sometimes through straw owners.

DOJCivil settlementAug 22, 2025

MISSISSIPPI MEDICAID RECIPIENTS AGREE TO PAY OVER $170,000 TO RESOLVE FALSE CLAIMS ACT ALLEGATIONS OF HEALTH CARE BENEFITS FRAUD

Former Medicaid recipients allegedly falsified their income on Mississippi Medicaid applications and renewals to create eligibility for health care benefits for their dependents.

Referral packet

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