Providers
MILAGROS RIVERA, MD
NPI 1366431660, individual, Savannah, GA, Family Medicine
1
Evidence tier
documented action, then payment
- Listed on the Medicare revocation list and the OIG exclusion list since November 26, 2019.
- Medicaid still paid claims in 19 later months, $51,550 in total.
score 95 of 100, rank 188, $52K at stake
Public list actions
Medicare revocation effective November 26, 2019, barred from re-enrolling until November 26, 2029
424.535(a)(3) felonies, Practitioner - Family Practice, KY
Medicare revocation effective November 26, 2019, barred from re-enrolling until November 26, 2029
424.535(a)(3) felonies, Practitioner - Internal Medicine, IN
Medicare revocation effective November 26, 2019, barred from re-enrolling until November 26, 2029
424.535(a)(3) felonies, Practitioner - Family Practice, OH
Medicare revocation effective November 26, 2019, barred from re-enrolling until November 26, 2029
424.535(a)(9) failure to report and 424.535(a)(3) felonies, Practitioner - Family Practice, GA
OIG exclusion July 20, 2021 under section 1128a1
Physician (MD, DO), General Practice, Tybee Island, GA
Paid after the action
Months in which Medicaid paid claims for this provider after a public action that should have triggered a screening check. This is a record of payments, not a determination that they were improper.
| list | identity check | action date | window closed | months paid after | first | last | paid after | 12 months before |
|---|---|---|---|---|---|---|---|---|
| Medicare revocation list 424.535(a)(9) failure to report and 424.535(a)(3) felonies | Exact NPI, name verified | Nov 26, 2019 | Nov 26, 2029 | 19 | Dec 2019 | Nov 2021 | $52K | $10.1M |
| OIG exclusion list leie 1128a1 (physician (md, do)) | Exact NPI, name verified | Jul 20, 2021 | still open | 4 | Aug 2021 | Nov 2021 | $16K | $22K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | MILAGROS RIVERA, MD |
| Type | Individual |
| Status | Active |
| NPI issued | October 19, 2005, last updated November 28, 2016 |
| Practice location | 102 BRYAN WOODS ROAD, Savannah, GA 31410, 912-898-1122 |
| Mailing address | 602 E 72ND ST, Savannah, GA 31405-4913 |
| Specialties | Family Medicine (207Q00000X, primary, license 33755 KY) |
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 | |
|---|---|---|---|---|---|---|---|
| H0020 | Medicaid service code | $3.2M | 83% | $360 | $214 (top 5% from $529) | 74th percentile | |
| 90792 | Psychiatric diagnostic evaluation with medical services | $462K | 12% | $143 | $112 (top 5% from $313) | 68th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $63K | 2% | $89 | $44 (top 5% from $110) | 91st percentile | |
| 90837 | Psychotherapy, 1 hourhistory of abuse | $63K | 2% | $121 | $191 (top 5% from $442) | 19th percentile | |
| 80307 | Testing for presence of drug, by chemistry analyzers | $17K | 0% | $96 | $45 (top 5% from $110) | too few months to rank | |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $14K | 0% | $27 | $28 (top 5% from $147) | 48th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $8K | 0% | $85 | $60 (top 5% from $133) | too few months to rank | |
| 80305 | Testing for presence of drug, read by direct observation | $6K | 0% | $20 | $9.23 (top 5% from $22) | too few months to rank |
In this area
2 providers in Chatham County, GA carry an indicator in the public record, with $0 at stake between them. The most common is part of a provider network, on 2 of them.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | OS TYBEE LLC Tybee Island, GA, ranked 2146 | $0 |
|
| 3 | SB TYBEE LLC Tybee Island, GA, ranked 4421 | $0 |
|
Recent enforcement in GA
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJIndictedAug 24, 2026
Southern District of Georgia federal indictments include murder, drug- and firearm-related charges and healthcare fraud
Perry Patalano was indicted for Healthcare Fraud, Theft of Government Money, Property or Records, and Aggravated Identity Theft.
DOJChargedJun 24, 2026
Two Georgia Men Charged in National Health Care Fraud Takedown
Rutledge billed Georgia Medicaid for thousands of wound care, cyst removal, psychotherapy, and allergy testing services that were never performed, and Releford obtained nursing jobs by lying about his qualifications and stealing a licensed practical nurse's identity, causing providers to bill Medicare and Medicaid for services he could not legally perform.
DOJSentencedMay 4, 2026
Two Sentenced to Prison for $522M Genetic Testing Fraud and Illegal Kickback Scheme Targeting Medicare and Medicaid
Two men who controlled four laboratories paid kickbacks and bribes to marketers to obtain DNA samples and fraudulent requisition forms from medical providers, resulting in approximately $522 million in false claims for medically unnecessary genetic tests.
DOJPleaded guiltyApr 14, 2026
Behavioral therapist pleads guilty to health care fraud for submitting inflated insurance reimbursement claims
From June 2020 through May 2023, Stallings submitted false and fraudulent billing claims to TRICARE for individual and group therapy services that were not provided or were not provided as presented, and also obtained COVID-19 Economic Injury Disaster Loan funds that she spent on personal purposes.
DOJSentencedDec 2, 2025
Georgia Man Sentenced for $24M Kickback and Medicare Fraud Conspiracy
Moore instructed a network of recruiters to induce Medicare beneficiaries to accept medically unnecessary genetic tests, received approximately $4.3 million in kickbacks for referring beneficiary information, DNA specimens and doctors' orders, and concealed the payments with sham invoices.
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.