Providers
All 14 in NY
OSA CHRISTOPHER GUOBADIA, MD
NPI 1306402268, individual, Middletown, NY, Family Medicine
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 1 month, but with up to 199 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
score 49 of 100, rank 9692, $27K 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 2024 | More hours than a day holds at a conservative unit price | 7.3 | 41.8 | 27.9 | 37.6 | 176 | 1 | 99308 99309 | $20K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | OSA CHRISTOPHER GUOBADIA, MD |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | May 16, 2019, last updated September 8, 2026 |
| Practice location | 707 E MAIN ST, Middletown, NY 10940-2650, 845-333-6333 |
| Mailing address | 1123 E 221ST ST, Bronx, NY 10469-1505 |
| Specialties | Family Medicine (207Q00000X, primary, license 318198 NY) Family Medicine (207Q00000X, license U0126 TX) Family Medicine (207Q00000X, license 67831 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 | |
|---|---|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | $53K | 74% | $42 | $21 (top 5% from $84) | 81st percentile | |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | $8K | 11% | $7.72 | $9.36 (top 5% from $41) | 43rd percentile | |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | $4K | 6% | $20 | $14 (top 5% from $58) | 65th percentile | |
| 99457 | Management using the results of remote vital sign monitoring per calendar month, first 20 minutes | $4K | 6% | $3.59 | $5.75 (top 5% from $34) | 38th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $1K | 2% | $6.31 | $60 (top 5% from $133) | 6th percentile | |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $454 | 1% | $35 | $96 (top 5% from $249) | too few months to rank | |
| 99453 | Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment | $104 | 0% | $1.52 | $7.06 (top 5% from $23) | too few months to rank | |
| 99491 | Chronic care management services for two or more chronic conditions, first 30 minutes provided personally by health care professional, per calendar month | $0 | 0% | $0.00 | $4.44 (top 5% from $93) | 0th percentile |
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 |
|---|---|---|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 6,855 | 565 | $632K | $199 | $118 | 1.7x | 2.0x (90th percentile 3.3x) |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | 1,443 | 302 | $93K | $134 | $82 | 1.6x | 2.0x (90th percentile 3.4x) |
| 99457 | Management using the results of remote vital sign monitoring per calendar month, first 20 minutes | 1,444 | 260 | $63K | $109 | $55 | 2.0x | 2.2x (90th percentile 3.5x) |
| 99454 | Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days | 1,348 | 239 | $59K | $125 | $56 | 2.2x | 2.6x (90th percentile 4.2x) |
| 99491 | Chronic care management services for two or more chronic conditions, first 30 minutes provided personally by health care professional, per calendar month | 563 | 104 | $42K | $190 | $94 | 2.0x | 1.8x (90th percentile 2.7x) |
| 99305 | Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | 120 | 110 | $14K | $280 | $146 | 1.9x | 2.0x (90th percentile 3.3x) |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more | 44 | 43 | $7K | $405 | $199 | 2.0x | 1.9x (90th percentile 3.1x) |
| 99487 | Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month | 38 | 19 | $5K | $349 | $151 | 2.3x | 1.6x (90th percentile 2.7x) |
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
14 providers in Orange County, NY carry an indicator in the public record, with $13.4M at stake between them. The most common is more hours than a day holds, on 10 of them, followed by paid after a public list action on 4. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | PAUL FELDMAN Newburgh, NY, ranked 23 | $25K |
|
| 4 | TANISHA CASTELLANOS Goshen, NY, ranked 7303 | $2.5M |
|
| 4 | LAZAR KHAIMOV Monroe, NY, ranked 7526 | $3.4M |
|
| 4 | TZVI FARKAS Monroe, NY, ranked 8048 | $157K |
|
| 4 | YITZCHOK SCHLAFRIG Monroe, NY, ranked 9014 | $921K |
|
| 4 | SAMUEL WERZBERGER Monroe, NY, ranked 9038 | $852K |
|
| 4 | SAMUEL WEISER Monroe, NY, ranked 9193 | $536K |
|
| 5 | ERROL YOUNG Warwick, NY, ranked 10206 | $641K |
|
Recent enforcement in NY
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJIndictedAug 20, 2026
Four Members Of The “War Room” Charged In Connection With $12 Million Medicaid Fraud Scheme
Members of a Bronx-based racketeering organization known as the "War Room" fabricated ride data for methadone clinic transportation using a GPS spoofing application, paid Medicaid patients kickbacks in cash and drugs for their enrollment information, provided the fake data to transportation companies that submitted over $12 million in claims to Medicaid, and laundered the proceeds.
DOJIndictedAug 20, 2026
Four Members of the “War Room” Charged in Connection with $12M Medicaid Fraud Scheme
Four members of a Bronx racketeering organization known as the "War Room" fabricated medical transportation ride data using a ride-tracking app and GPS spoofing, paid Medicaid patients at methadone clinics kickbacks in cash and drugs for their enrollment information, provided the fake data to transportation companies that submitted over $12 million in Medicaid claims, and laundered the proceeds.
DOJCivil settlementAug 17, 2026
Safire nursing homes agree to pay $9 million to resolve fraudulent Medicare and Medicaid billing allegations
The United States alleged that Safire submitted false claims to Medicare and Medicaid for skilled rehabilitative therapy services that were not reasonable or necessary, not supported by medical records, not documented as provided, or not provided at all, including by scheduling therapy based on insurer reimbursement policies, pressuring therapists and residents, and manufacturing or altering therapy referrals and medical records.
DOJSentencedJul 21, 2026
Owner of Long Island Ambulette Services Company Sentenced to Prison for Multimillion Dollar Healthcare Fraud Scheme
Arshad and co-conspirators paid kickbacks to Medicaid beneficiaries to order transportation through his companies and billed Medicaid over $19 million for medical transportation rides that were not provided, including for individuals who were deceased, hospitalized or incarcerated, and inflated reimbursements with false pickup addresses and distant treatment centers.
DOJIndictedJul 2, 2026
Two Defendants Charged with Multi-Million Dollar Health Care Fraud Scheme
The defendants, who owned and operated Tri-Hamlet Taxi Inc., allegedly paid kickbacks to Medicaid beneficiaries and submitted more than $35 million in claims to Medicaid for ambulette trips that were not provided or whose costs were inflated by using false pickup or drop-off addresses.
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.