Providers
All 73 in CA
ST. FRANCIS MEDICAL GROUP, P.C.
NPI 1417388364, organization, Hayward, CA, Clinic/Center, Urgent Care
1
Evidence tier
documented action, then payment
- Listed on the Medicare revocation list since November 29, 2022.
- Medicaid still paid claims in 8 later months, $54,906 in total.
score 95 of 100, rank 183, $55K at stake
Public list actions
Medicare revocation effective November 29, 2022, barred from re-enrolling until June 6, 2032
424.535(a)(9) failure to report and 424.535(a)(3) felonies, Part B Supplier - Clinic/Group Practice, CA
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 29, 2022 | Jun 6, 2032 | 8 | Dec 2022 | Jul 2023 | $55K | $70K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | ST. FRANCIS MEDICAL GROUP, P.C. |
| Type | Organization |
| Status | Active |
| NPI issued | December 3, 2013, last updated December 3, 2013 |
| Practice location | 1649 INDUSTRIAL PKWY W, Hayward, CA 94544-7046, 510-459-3547 |
| Mailing address | 1151 HARBOR BAY PKWY, Alameda, CA 94502-6540 |
| Authorized official | COYNESS ENNIX (Authorized Official) |
| Specialties | Clinic/Center, Multi-Specialty (261QM1300X) Clinic/Center, Urgent Care (261QU0200X, primary) |
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 | $130K | 36% | $74 | $60 (top 5% from $133) | too few months to rank | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $129K | 36% | $61 | $67 (top 5% from $121) | too few months to rank | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $55K | 15% | $48 | $44 (top 5% from $110) | too few months to rank | |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $26K | 7% | $108 | $95 (top 5% from $171) | too few months to rank | |
| 99202 | New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more | $7K | 2% | $48 | $45 (top 5% from $138) | too few months to rank | |
| 99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or morehistory of abuse | $7K | 2% | $105 | $88 (top 5% from $210) | 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 | $2K | 1% | $27 | $28 (top 5% from $147) | too few months to rank | |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | $1K | 0% | $18 | $22 (top 5% from $33) | too few months to rank |
In this area
73 providers in Alameda County, CA carry an indicator in the public record, with $31.3M at stake between them. The most common is part of a provider network, on 50 of them, followed by more hours than a day holds on 20. 2 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | BHUPINDER BHANDARI MD INC Fremont, CA, ranked 79 | $526K |
|
| 1 | HEALTH NOW HOME HEALTHCARE INC. Hayward, CA, ranked 586 | $0 |
|
| 3 | SUTTER VISITING NURSE ASSOCIATION AND HOSPICE Alameda, CA, ranked 775 | $2.6M |
|
| 3 | HEALTHFLEX HOME HEALTH SERVICES Oakland, CA, ranked 991 | $1.7M |
|
| 3 | HEALTH ESSENTIALS RESOURCE & SERVICES INC Hayward, CA, ranked 1213 | $337K |
|
| 3 | BLC HOMEHEALTH INC. San Leandro, CA, ranked 1287 | $180K |
|
| 3 | NEOGREEN SOLUTIONS INC Hayward, CA, ranked 1326 | $128K |
|
| 3 | DUBLIN HELPING HAND INC Newark, CA, ranked 1656 | $1K |
|
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.