Providers
JACQUELINE D ROMAN, D.O.
NPI 1376785881, individual, Ocean, NJ, Obstetrics & Gynecology
5
Evidence tier
informational
- Medicaid dollars per patient on code 59409 ($1408 per patient-month) sit in the top 5% of every provider billing that code.
score 34 of 100, rank 10459, $94K at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | JACQUELINE D ROMAN, D.O. |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | March 30, 2009, last updated August 21, 2013 |
| Practice location | 1300 HIGHWAY 35 # II, Ocean, NJ 07712-3537, 973-432-7640 |
| Specialties | Obstetrics & Gynecology (207V00000X, primary, license 25MB09178100 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.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $504K | 28% | $95 | $44 (top 5% from $110) | 93rd percentile | |
| 59409 | Medicaid service code | $391K | 21% | $1K | $637 (top 5% from $1K) | 99th percentile | |
| 59400 | Medicaid service code | $317K | 17% | $2K | $2K (top 5% from $3K) | 81st percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $126K | 7% | $107 | $60 (top 5% from $133) | 89th percentile | |
| 99395 | Medicaid service code | $115K | 6% | $150 | $73 (top 5% from $138) | 96th percentile | |
| 76816 | Follow-up ultrasound scan of pregnant uterus | $78K | 4% | $81 | $69 (top 5% from $135) | 64th percentile | |
| 76830 | Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina | $77K | 4% | $92 | $54 (top 5% from $126) | 80th percentile | |
| 76819 | Ultrasound scan of fetus | $76K | 4% | $74 | $72 (top 5% from $161) | 52nd 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 |
|---|---|---|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 19 | 16 | $1K | $165 | $96 | 1.7x | 2.2x (90th percentile 3.8x) |
| 99459 | Pelvic exam | 11 | 11 | $215 | $50 | $25 | 2.0x | 2.8x (90th percentile 4.1x) |
| 96127 | Assessment of emotional or behavioral problems | 23 | 15 | $89 | $25 | $5 | 4.9x | 3.7x (90th percentile 7.2x) |
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
8 providers in Monmouth County, NJ carry an indicator in the public record, with $484K at stake between them. The most common is paid after a public list action, on 3 of them, followed by more hours than a day holds on 3. 2 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | RAED JITAN Holmdel, NJ, ranked 339 | $4K |
|
| 1 | JOHN HOCHBERG Freehold, NJ, ranked 384 | $1K |
|
| 3 | BORIS VEYSMAN Freehold, NJ, ranked 1336 | $124K |
|
| 3 | WARDELL GARDENS REHAB CENTER LLC Tinton Falls, NJ, ranked 4217 | $0 |
|
| 4 | MOTY TAL Ocean, NJ, ranked 8031 | $200K |
|
| 5 | MAGDY NASRA Holmdel, NJ, ranked 10470 | $75K |
|
| 5 | JAYVINTH JOHNSON Ocean, NJ, ranked 11783 | $42K | |
| 5 | SUPPORTIVE CARE PSYCHOLOGY OF NJ PC Howell, NJ, ranked 11805 | $37K |
Recent enforcement in NJ
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJIndictedJul 29, 2026
Fraud Division Resolves Fraud Investigation of Eye Care Group Under New Corporate Enforcement Policy; Health Care Executive Charged for Alleged Fraud and Kickbacks
DiDonato allegedly conspired to defraud Medicare by billing for unnecessary and duplicative diagnostic eye tests and paid kickbacks and bribes to ophthalmologists disguised as consulting fees for patient referrals, while Campus Eye received a declination after self-disclosing and agreed to pay back $1 million to victims.
DOJIndictedJul 29, 2026
Founder And Former CEO of New Jersey Based Eye Care Group Charged with Health Care Fraud Conspiracy and Paying Illegal Kickbacks
DiDonato allegedly paid kickbacks disguised as consulting fees to ophthalmologists for patient referrals and billed Medicare approximately $3.4 million for duplicative or unnecessary diagnostic tests performed at his optometry practice and eye surgery center.
DOJChargedJul 9, 2026
Six Individuals, Including a Pharmacist and Doctor, Charged in Connection with $20 Million Healthcare Fraud and Kickback Scheme
A pharmacy owner paid cash kickbacks to a doctor, advanced practice nurses, and an office manager in exchange for medically unnecessary prescriptions for high-reimbursement medications billed to Medicare and Medicaid.
DOJPleaded guiltyJun 24, 2026
Cape May County Psychiatrist Admits to 17 Felony Counts for Unlawful Controlled Substance Prescriptions Linked to Sexual Conduct, Risk of Death, and Serious Bodily Injury
A psychiatrist issued invalid prescriptions for Adderall, Vyvanse, and Xanax to 17 patients outside the usual course of professional practice, with intent to defraud and mislead the dispensing pharmacies and the insurers, government benefits programs, and other third parties who paid for the drugs, sometimes in exchange for sexual activities, images, or videos.
DOJSentencedMay 21, 2026
New Jersey Physical Therapist Sentenced to 12 Months in Prison for Health Care Fraud Scheme Targeting Amtrak
Kim, a licensed physical therapist, allowed her license and business bank accounts to be used to bill Amtrak's health care plan for claims for services that never were provided and were medically unnecessary, in return for a portion of the proceeds.
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.