EDGARDO TAN, M.D.
NPI 1356402952, individual, Elizabeth, NJ, Pediatrics, Adolescent Medicine
- Hours beyond a day in 6 months under one organization, which can be supervisory billing.
- Records needed.
- Medicaid dollars per patient on code 99215 ($233 per patient-month) sit in the top 5% of every provider billing that code.
- 79% of Medicaid dollars are on codes with a history of abuse.
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 |
|---|---|---|---|---|---|---|---|---|---|
| Dec 2023 | More hours than a day holds, even counting one unit per claim line | 24.1 | 34.3 | 22.8 | 33.7 | 465 | 1 | 99205 99215 | $116K |
| Jan 2024 | More hours than a day holds, even counting one unit per claim line | 24.6 | 30.5 | 20.3 | 27.4 | 451 | 1 | 99205 99215 | $117K |
| Feb 2024 | More hours than a day holds, even counting one unit per claim line | 27.0 | 31.4 | 20.9 | 28.9 | 499 | 1 | 99214 99215 | $113K |
| Mar 2024 | More hours than a day holds, even counting one unit per claim line | 27.8 | 34.4 | 22.9 | 33.9 | 420 | 1 | 99215 | $132K |
| Apr 2024 | More hours than a day holds, even counting one unit per claim line | 32.2 | 40.1 | 26.7 | 36.5 | 432 | 1 | 99205 99215 | $149K |
| May 2024 | More hours than a day holds, even counting one unit per claim line | 29.6 | 37.0 | 24.6 | 33.2 | 417 | 1 | 99205 99215 | $142K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | EDGARDO TAN, M.D. |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | December 13, 2006, last updated July 9, 2007 |
| Practice location | 314 1ST AVE, Elizabeth, NJ 07206-1659, 908-353-5280 |
| Specialties | Pediatrics, Adolescent Medicine (2080A0000X, primary, license 25MA 042112 NJ) |
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 | |
|---|---|---|---|---|---|---|---|
| 99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or morehistory of abuse | $2.1M | 79% | $233 | $88 (top 5% from $210) | 96th percentile | |
| 99393 | Medicaid service code | $140K | 5% | $38 | $78 (top 5% from $121) | 20th percentile | |
| 99394 | Medicaid service code | $107K | 4% | $39 | $83 (top 5% from $128) | 21st percentile | |
| 99392 | Medicaid service code | $101K | 4% | $33 | $78 (top 5% from $124) | 17th percentile | |
| 90471 | Administration of vaccine | $52K | 2% | $13 | $10 (top 5% from $23) | 62nd percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $51K | 2% | $16 | $60 (top 5% from $133) | 9th percentile | |
| 99205 | New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more | $38K | 1% | $136 | $128 (top 5% from $249) | 55th percentile | |
| 99391 | Medicaid service code | $30K | 1% | $35 | $76 (top 5% from $126) | 14th percentile |
In this area
10 providers in Union County, NJ carry an indicator in the public record, with $17.1M at stake between them. The most common is more hours than a day holds, on 7 of them, followed by paid after a public list action on 2. 3 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | STUART RICE Summit, NJ, ranked 296 | $9K |
|
| 1 | STEVEN BROWNSTEIN Springfield, NJ, ranked 435 | $199 |
|
| 1 | ELITE PHARMACY, INC Linden, NJ, ranked 588 | $0 |
|
| 4 | TREVOR FORBES Springfield, NJ, ranked 7459 | $4.8M |
|
| 4 | IROKA IFEGWU Union, NJ, ranked 7672 | $2.1M |
|
| 4 | FEHINTOLA OGUNSAKIN Elizabeth, NJ, ranked 7700 | $1.9M |
|
| 4 | KAMRAN TASHAROFI Garwood, NJ, ranked 8571 | $2.9M |
|
| 4 | VIPIN GARG Elizabeth, NJ, ranked 8582 | $2.8M |
|
Recent enforcement in NJ
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.