Providers
All 15 in NJ
DONNA MARIA DEPHILLIPS, M.D.
NPI 1386657971, individual, Old Tappan, NJ, Physical Medicine & Rehabilitation, Pain Medicine
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 1 month, but with up to 282 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 99309 ($113 per patient-month) sit in the top 5% of every provider billing that code.
score 55 of 100, rank 7990, $323K at stake
Public list actions
Medicare revocation effective December 14, 2023, barred from re-enrolling until December 13, 2028
424.535(a)(9) failure to report and 424.535(a)(12) other program termination (medicaid), Practitioner - Physical Medicine And Rehabilitation, NJ
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 |
|---|---|---|---|---|---|---|---|---|---|
| Mar 2023 | More hours than a day holds, even counting one unit per claim line | 24.7 | 26.6 | 17.8 | 23.9 | 282 | 1 | 99305 99308 99309 | $20K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | DONNA MARIA DEPHILLIPS, M.D. |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | August 14, 2006, last updated March 8, 2010 |
| Practice location | 7 WESTMINSTER PL, Old Tappan, NJ 07675-6807, 201-666-5564 |
| Specialties | Physical Medicine & Rehabilitation, Pain Medicine (2081P2900X, primary, license MA60823 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 | |
|---|---|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | $547K | 90% | $113 | $21 (top 5% from $84) | 97th percentile | |
| 99305 | Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | $46K | 8% | $29 | $22 (top 5% from $71) | 66th percentile | |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | $13K | 2% | $3.95 | $14 (top 5% from $58) | 11th percentile | |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more | $937 | 0% | $8.37 | $37 (top 5% from $100) | 7th percentile |
In this area
15 providers in Bergen County, NJ carry an indicator in the public record, with $11.5M at stake between them. The most common is more hours than a day holds, on 9 of them, followed by paid after a public list action on 2. 2 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | INFINITY DIAGNOSTICS LABORATORY, INC Teterboro, NJ, ranked 3 | $1.0M |
|
| 1 | BERGEN ALLIANCE COUNSELING SERVICE Waldwick, NJ, ranked 616 | $0 |
|
| 3 | RITESH KALRA Fair Lawn, NJ, ranked 1198 | $376K |
|
| 3 | EMERSON CONVALESCENT CENTER INC Emerson, NJ, ranked 3143 | $0 |
|
| 3 | 120-124 NOYES DRIVE OPERATING COMPANY LLC Park Ridge, NJ, ranked 4966 | $0 |
|
| 4 | ROHIT RAMANATH Franklin Lakes, NJ, ranked 8850 | $1.4M |
|
| 4 | SHELLA CAJITA Ridgefield, NJ, ranked 9544 | $128K |
|
| 5 | DONGJIN KIM Englewood, NJ, ranked 9987 | $1.8M |
|
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.