Providers

PIONEER HEALTH GROUP LLC

NPI 1366123705, organization, Louisa, KY, Occupational Therapist

1
Evidence tier
adjudicated in a public enforcement record
  • Adjudicated (civil judgment) per an HHS-OIG enforcement record dated July 27, 2026.
  • No Medicaid payments in the last 12 observed months.
score 90 of 100, rank 639, $0 at stake

National provider registry

From the CMS NPPES Registry, refreshed daily.

NamePIONEER HEALTH GROUP LLC
TypeOrganization
StatusActive
NPI issuedJuly 28, 2023, last updated November 18, 2024
Practice location125 S MAIN CROSS ST, Louisa, KY 41230-1065, 606-638-0938
Mailing addressPO BOX 726, Louisa, KY 41230-0726
Authorized officialTimmy Robinson (Ceo)
Specialties
Behavior Analyst (103K00000X)
Psychologist (103T00000X)
Assistant Behavior Analyst (106E00000X)
Psychiatry & Neurology, Child & Adolescent Psychiatry (2084P0804X)
Occupational Therapist (225X00000X, primary)
Occupational Therapist, Pediatrics (225XP0200X)
Speech-Language Pathologist, (235Z00000X)
Day Training, Developmentally Disabled Services (251C00000X)

In this area

16 providers in Lawrence County, KY carry an indicator in the public record, with $72.8M at stake between them. The most common is more hours than a day holds, on 13 of them, followed by named in an enforcement record on 2. 2 are tier 1: documented action, then payment.

tierproviderat stakewhy
1PIONEER HEALTH GROUP LLC
Louisa, KY, ranked 47
$2.9M
  • Adjudicated (civil judgment) per an HHS-OIG enforcement record dated July 27, 2026.
  • Medicaid paid $2,921,665 in the last 12 observed months.
1PIONEER HEALTH GROUP LLC
Louisa, KY, ranked 474
$0
  • Adjudicated (civil judgment) per an HHS-OIG enforcement record dated July 27, 2026.
  • No Medicaid payments in the last 12 observed months.
3MCKENZIE HEALTH CARE, LLC
Louisa, KY, ranked 3271
$0
  • Part of provider network D1-00059, ranked 59 nationally.
4MATTHEW PIERZALA
Louisa, KY, ranked 8667
$2.3M
  • Hours beyond a day in 9 months, but with up to 1650 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
4SARA MARTIN
Louisa, KY, ranked 9205
$514K
  • Hours beyond a day in 2 months, but with up to 1122 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
5SARAH CAMPBELL
Louisa, KY, ranked 9886
$5.6M
  • Medicaid dollars per patient on code H0038 ($2346 per patient-month) sit in the top 5% of every provider billing that code.
5TRACEY JOHNSON
Louisa, KY, ranked 10640
$15.6M
5JESSICA RIDDLE
Louisa, KY, ranked 10648
$13.0M
All 16 in KY

Recent enforcement in KY

All releases

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

DOJIndictedAug 27, 2026
Kentucky Medical Biller Indicted for Healthcare Fraud and Money Laundering Charges
Sanders recruited individuals to open behavioral health entities, handled their Kentucky Medicaid credentialing and enrollment, and directed submission of fraudulent Medicaid claims across ten behavioral health providers for services never provided, including for incarcerated, hospitalized, or deceased members, using licensed professionals' NPIs without authorization.
DOJChargedJun 23, 2026
5 Individuals and 2 Companies Charged as Part of Department of Justice National Health Care Fraud Takedown
Seven defendants were charged in four cases with schemes including billing Kentucky Medicaid for peer support and psychoeducation services that were fraudulent, unauthorized, or not rendered using providers' NPIs, using a DEA number to order controlled substances in others' names, credentialing a company with Medicare and billing for services not rendered using a doctor's NPI, and stealing controlled substances from hospitals and falsely documenting administration.
DOJCivil settlementJun 23, 2026
Civil Settlements Reached as Part of Department of Justice National Health Care Fraud Takedown
Three Home and Community Based Waiver providers and their owners, who had shared financial interests, referred Medicaid waiver beneficiaries for attendant care services and billed Medicaid for attendant care hours that were not fully provided or not provided at all.
DOJCivil judgmentMay 15, 2026
Operators of Day Treatment Program for Children Agree to $15.2 Million Civil Judgment to Resolve Medicaid Fraud Allegations
The Government alleged that from August 2022 through June 2025 the Recovery Centers sought Medicaid payments for time children spent on education, recreation, and lunch breaks at the Aspire Day Program and that Recovery Center of Kentucky falsely represented clinician qualifications to obtain higher reimbursements.
DOJSentencedApr 24, 2026
Former Sober Home Owner and Operator Sentenced for Kickback Conspiracy and Health Care Fraud
Jordan solicited and received kickbacks in exchange for referring urine drug testing from her sober home company to three labs, and Serenity Keepers billed Medicaid for peer support services not provided by licensed peer support specialists, with Williams reporting that residents received six hours of peer support services per day knowing that was not true.

Referral packet

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