JAMES PENG OOI, MD

NPI 1457349540, individual, Corning, CA, Family Medicine

Evidence tier

documented action, then payment

Listed on the CA Medicaid exclusion list since October 18, 2022.
Medicaid still paid claims in 2 later months, $1,720 in total.

score 93 of 100, rank 373, $2K at stake

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
CA Medicaid exclusion list ca medi-cal suspended & ineligible provider list (july 2026)	Exact NPI, name verified	Oct 18, 2022	still open	2	Nov 2022	Dec 2022	$2K	$45K

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	JAMES PENG OOI, MD
Type	Individual, sole proprietor
Status	Active
NPI issued	October 12, 2005, last updated March 25, 2015
Practice location	320 SOLANO ST, Corning, CA 96021-3454, 530-824-3283
Specialties	Family Medicine (207Q00000X, primary, license C39127 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
T1015	Medicaid service code	$198K	76%	$103	$182 (top 5% from $488)	23rd percentile
99212	Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	$56K	22%	$24	$28 (top 5% from $147)	41st percentile
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	$7K	3%	$26	$44 (top 5% from $110)	22nd percentile
99204	New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	$620	0%	$52	$95 (top 5% from $171)	too few months to rank

In this area

8 providers in Tehama County, CA carry an indicator in the public record, with $3.5M at stake between them. The most common is more hours than a day holds, on 6 of them, followed by part of a provider network on 2.

tier	provider	at stake	why
3	RED BLUFF HEALTH CARE, INC. Red Bluff, CA, ranked 1905	$0	Part of provider network D1-00092, ranked 92 nationally.
3	SHASTA VIEW CARE CENTER LLC Red Bluff, CA, ranked 2426	$0	Part of provider network D1-00087, ranked 87 nationally.
4	KERRY WAITS Red Bluff, CA, ranked 7772	$1.3M	Hours beyond a day in 10 months under one organization, which can be supervisory billing. Records needed. and 1 more
5	JACOB STROMAN Red Bluff, CA, ranked 10171	$747K	Medicaid dollars per patient on code 97110 ($1519 per patient-month) sit in the top 5% of every provider billing that code.
5	BRIAN LAIR Red Bluff, CA, ranked 10259	$506K	Medicaid dollars per patient on code G0467 ($343 per patient-month) sit in the top 5% of every provider billing that code.
5	LEE SHOOP Red Bluff, CA, ranked 10321	$371K	Medicaid dollars per patient on code 99213 ($794 per patient-month) sit in the top 5% of every provider billing that code.
5	JAMES MONTANA Red Bluff, CA, ranked 10356	$261K	Medicaid dollars per patient on code 97140 ($1251 per patient-month) sit in the top 5% of every provider billing that code.
5	DANIEL LEAVITT Red Bluff, CA, ranked 11369	$299K

Recent enforcement in CA

All releases

Department 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

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