Providers
All 25 in CA
SHANE D ROSTERMUNDT, DO
NPI 1396846507, individual, Santa Maria, CA, Pediatrics
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 41 months, but with up to 1812 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 99051 ($77 per patient-month) sit in the top 5% of every provider billing that code.
score 56 of 100, rank 7522, $3.5M at stake
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 |
|---|---|---|---|---|---|---|---|---|---|
| Jan 2018 | More hours than a day holds, even counting one unit per claim line | 27.8 | 5.5 | 3.7 | 5.0 | 1502 | 1 | 99211 99213 99214 99402 | $10K |
| Mar 2019 | More hours than a day holds, even counting one unit per claim line | 26.8 | 60.0 | 40.0 | 59.0 | 1643 | 1 | 99202 99211 99213 99214 99401 99402 | $106K |
| Apr 2019 | More hours than a day holds at a conservative unit price | 20.2 | 46.8 | 31.2 | 42.5 | 1217 | 1 | 99211 99213 99214 99401 99402 | $78K |
| May 2019 | More hours than a day holds at a conservative unit price | 23.4 | 54.0 | 36.0 | 48.5 | 1433 | 1 | 99211 99213 99214 99401 99402 | $93K |
| Jun 2019 | More hours than a day holds at a conservative unit price | 19.7 | 46.6 | 31.1 | 46.6 | 1223 | 1 | 99211 99213 99214 99401 99402 | $76K |
| Oct 2019 | More hours than a day holds, even counting one unit per claim line | 26.9 | 35.6 | 23.7 | 32.0 | 1664 | 1 | 99204 99211 99213 99214 99401 99402 | $62K |
| Nov 2019 | More hours than a day holds at a conservative unit price | 19.8 | 46.0 | 30.7 | 43.8 | 1245 | 1 | 99204 99211 99213 99214 99401 99402 | $77K |
| Dec 2019 | More hours than a day holds at a conservative unit price | 19.8 | 46.5 | 31.0 | 43.6 | 1311 | 1 | 99204 99211 99213 99214 99401 99402 | $80K |
| Jan 2020 | More hours than a day holds, even counting one unit per claim line | 24.8 | 54.2 | 36.1 | 48.7 | 1549 | 1 | 99203 99204 99211 99213 99214 99401 99402 | $100K |
| Feb 2020 | More hours than a day holds, even counting one unit per claim line | 28.2 | 61.8 | 41.2 | 59.8 | 1620 | 1 | 99211 99213 99214 99401 99402 | $107K |
| Mar 2020 | More hours than a day holds at a conservative unit price | 19.1 | 43.5 | 29.0 | 40.9 | 1225 | 1 | 99211 99213 99214 99401 99402 | $78K |
| Sep 2020 | More hours than a day holds at a conservative unit price | 15.3 | 37.3 | 24.9 | 33.9 | 1061 | 1 | 99211 99213 99214 99401 99402 | $59K |
| Oct 2020 | More hours than a day holds at a conservative unit price | 16.7 | 41.3 | 27.5 | 38.8 | 1167 | 1 | 99211 99213 99214 99401 99402 | $67K |
| Nov 2020 | More hours than a day holds at a conservative unit price | 17.1 | 39.9 | 26.6 | 38.0 | 1210 | 1 | 99211 99213 99214 99401 99402 | $66K |
| Dec 2020 | More hours than a day holds at a conservative unit price | 17.9 | 42.0 | 28.0 | 37.8 | 1299 | 1 | 99204 99211 99213 99214 99401 99402 | $72K |
| Jan 2021 | More hours than a day holds at a conservative unit price | 18.2 | 44.2 | 29.5 | 43.5 | 1416 | 1 | 99211 99213 99214 99401 99402 | $71K |
| Feb 2021 | More hours than a day holds at a conservative unit price | 21.4 | 52.6 | 35.1 | 49.1 | 1464 | 1 | 99211 99213 99214 99401 99402 | $75K |
| Mar 2021 | More hours than a day holds at a conservative unit price | 22.0 | 56.3 | 37.5 | 50.6 | 1681 | 1 | 99211 99213 99214 99401 99402 | $84K |
| Apr 2021 | More hours than a day holds at a conservative unit price | 19.2 | 49.7 | 33.2 | 45.2 | 1405 | 1 | 99211 99213 99214 99401 99402 | $72K |
| May 2021 | More hours than a day holds at a conservative unit price | 20.5 | 51.5 | 34.4 | 50.7 | 1457 | 1 | 99211 99213 99214 99401 99402 | $80K |
| Jun 2021 | More hours than a day holds at a conservative unit price | 19.5 | 52.3 | 34.9 | 47.5 | 1464 | 1 | 99211 99213 99214 99401 99402 | $73K |
| Jul 2021 | More hours than a day holds at a conservative unit price | 20.8 | 46.0 | 30.7 | 43.2 | 1557 | 1 | 99211 99213 99214 99401 99402 | $69K |
| Aug 2021 | More hours than a day holds at a conservative unit price | 20.7 | 51.4 | 34.3 | 48.3 | 1615 | 1 | 99211 99213 99214 99401 99402 | $80K |
| Sep 2021 | More hours than a day holds at a conservative unit price | 21.2 | 56.4 | 37.6 | 51.3 | 1678 | 1 | 99211 99213 99214 99401 | $82K |
| Oct 2021 | More hours than a day holds at a conservative unit price | 21.7 | 60.0 | 40.0 | 59.0 | 1812 | 1 | 99203 99211 99212 99213 99214 99401 99402 | $88K |
| Nov 2021 | More hours than a day holds at a conservative unit price | 18.0 | 50.1 | 33.4 | 45.5 | 1386 | 1 | 99211 99212 99213 99214 99401 | $71K |
| Dec 2021 | More hours than a day holds at a conservative unit price | 18.9 | 52.2 | 34.8 | 46.9 | 1496 | 1 | 99211 99212 99213 99214 99401 99402 | $76K |
| Jan 2022 | More hours than a day holds at a conservative unit price | 18.5 | 55.2 | 36.8 | 54.4 | 1408 | 1 | 99211 99212 99213 99214 99401 | $76K |
| Feb 2022 | More hours than a day holds at a conservative unit price | 20.5 | 61.3 | 40.9 | 57.2 | 1417 | 1 | 99203 99211 99212 99213 99214 | $78K |
| Mar 2022 | More hours than a day holds at a conservative unit price | 22.4 | 66.4 | 44.3 | 59.7 | 1637 | 1 | 99211 99212 99213 99214 | $92K |
| Apr 2022 | More hours than a day holds at a conservative unit price | 19.1 | 58.1 | 38.7 | 55.3 | 1368 | 1 | 99211 99212 99213 99214 99401 99402 | $78K |
| May 2022 | More hours than a day holds at a conservative unit price | 19.1 | 55.5 | 37.0 | 52.1 | 1418 | 1 | 99211 99212 99213 99214 99401 | $78K |
| Jun 2022 | More hours than a day holds at a conservative unit price | 20.8 | 58.8 | 39.2 | 53.5 | 1417 | 1 | 99213 99214 99401 99402 | $82K |
| Jul 2022 | More hours than a day holds at a conservative unit price | 14.2 | 42.4 | 28.2 | 41.7 | 1046 | 1 | 99211 99213 99214 99401 | $59K |
| Aug 2022 | More hours than a day holds at a conservative unit price | 20.6 | 59.0 | 39.3 | 53.0 | 1455 | 1 | 99211 99213 99214 99401 99402 | $84K |
| Sep 2022 | More hours than a day holds at a conservative unit price | 18.7 | 55.1 | 36.8 | 50.1 | 1300 | 1 | 99203 99211 99213 99214 99402 | $75K |
| Oct 2022 | More hours than a day holds at a conservative unit price | 18.8 | 57.7 | 38.4 | 56.8 | 1428 | 1 | 99211 99213 99214 99401 99402 | $78K |
| Nov 2022 | More hours than a day holds at a conservative unit price | 19.8 | 60.9 | 40.6 | 55.4 | 1452 | 1 | 99203 99211 99213 99214 99401 99402 | $81K |
| Dec 2022 | More hours than a day holds at a conservative unit price | 18.4 | 56.5 | 37.7 | 53.1 | 1436 | 1 | 99211 99212 99213 99214 99401 99402 | $77K |
| Jan 2023 | More hours than a day holds at a conservative unit price | 18.9 | 64.3 | 42.9 | 60.4 | 1368 | 1 | 99203 99211 99213 99214 99401 | $78K |
| Feb 2023 | More hours than a day holds at a conservative unit price | 22.2 | 73.2 | 48.8 | 68.3 | 1457 | 1 | 99203 99211 99213 99214 99401 | $81K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | SHANE D ROSTERMUNDT, DO |
| Type | Individual |
| Status | Active |
| NPI issued | September 26, 2006, last updated January 11, 2011 |
| Practice location | 1430 E MAIN ST, 201, Santa Maria, CA 93454, 805-922-3548 |
| Specialties | Pediatrics (208000000X, primary, license 20A9637 CA) |
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 | |
|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $2.3M | 17% | $45 | $60 (top 5% from $133) | 30th percentile | |
| 99393 | Medicaid service code | $1.3M | 10% | $99 | $78 (top 5% from $121) | 81st percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $1.2M | 9% | $31 | $44 (top 5% from $110) | 29th percentile | |
| 99392 | Medicaid service code | $1.1M | 8% | $96 | $78 (top 5% from $124) | 76th percentile | |
| 99051 | Medicaid service code | $1.1M | 8% | $77 | $6.71 (top 5% from $30) | 99th percentile | |
| 99394 | Medicaid service code | $1.1M | 8% | $114 | $83 (top 5% from $128) | 89th percentile | |
| 96110 | Medicaid service code | $920K | 7% | $148 | $10 (top 5% from $38) | 99th percentile | |
| 99391 | Medicaid service code | $745K | 5% | $89 | $76 (top 5% from $126) | 69th percentile |
In this area
25 providers in Santa Barbara County, CA carry an indicator in the public record, with $18.5M at stake between them. The most common is more hours than a day holds, on 18 of them, followed by part of a provider network on 6.
| tier | provider | at stake | why |
|---|---|---|---|
| 2 | MAGDALENA SERRANO Santa Maria, CA, ranked 751 | $933 |
|
| 3 | COVENANT LIVING WEST Santa Barbara, CA, ranked 2614 | $0 |
|
| 3 | SANTA BARBARA HOME HEALTH INC. Santa Barbara, CA, ranked 3486 | $0 |
|
| 3 | SANTA BARBARA HOSPICE AND PALLIATIVE CARE INC Santa Barbara, CA, ranked 4210 | $0 |
|
| 3 | MISSION PARK HEALTH CENTER LLC Santa Barbara, CA, ranked 5823 | $0 |
|
| 3 | VALLEY OAKS POST ACUTE LLC Santa Maria, CA, ranked 6889 | $0 |
|
| 3 | SANTA MARIA POST ACUTE LLC Santa Maria, CA, ranked 7020 | $0 |
|
| 4 | JUAN GUZMAN Santa Maria, CA, ranked 7332 | $783K |
|
Recent enforcement in CA
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJPleaded guiltyAug 27, 2026
Anaheim Woman Pleads Guilty to Submitting More Than $2.2 Million in Fraudulent Hospice Care Claims to Medicare
Galbraith submitted approximately $2,266,694 in claims to Medicare for hospice services for beneficiaries who did not have a terminal illness with a life expectancy of six months or less, and Medicare paid her company approximately $2,140,606.
DOJCivil settlementAug 26, 2026
DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests
DermTech Inc. submitted claims to Medicare for skin cancer tests conducted with an unvalidated positive control range and for tests lacking sufficient patient RNA, and did not retract results or adequately refund Medicare.
DOJCivil settlementAug 26, 2026
DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests
DermTech Inc. billed Medicare for skin cancer tests conducted using an unvalidated positive control range and for tests with insufficient patient RNA, and did not retract the results or adequately refund Medicare.
DOJCivil settlementAug 24, 2026
Medicare Advantage Provider Monogram Health Agrees to Pay $2.4 Million to Settle False Claims Act Lawsuit
Monogram knowingly submitted diagnosis codes in four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to Medicare Advantage Organizations.
DOJCivil settlementAug 24, 2026
Medicare Advantage Provider Monogram Health Agrees to Pay $2.4M to Settle False Claims Act Suit
Monogram Health knowingly submitted diagnosis codes within four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to MAOs.
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.