SYDNEY CUMMINGS
NPI 1467988204, individual, Conway, AR, Day Training/Habilitation Specialist
- Hours beyond a day in 5 months, but with up to 304 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 T1015 ($1135 per patient-month) sit in the top 5% of every provider billing that code.
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 |
|---|---|---|---|---|---|---|---|---|---|
| Feb 2018 | More hours than a day holds, even counting one unit per claim line | 27.5 | 17.6 | 11.7 | 16.4 | 201 | 1 | 97530 97535 | $72K |
| Mar 2018 | More hours than a day holds, even counting one unit per claim line | 28.6 | 18.2 | 12.1 | 17.1 | 202 | 1 | 97530 97535 | $82K |
| Apr 2018 | More hours than a day holds, even counting one unit per claim line | 33.1 | 19.7 | 13.1 | 18.7 | 203 | 1 | 97530 97535 | $86K |
| May 2018 | More hours than a day holds, even counting one unit per claim line | 26.7 | 18.6 | 12.4 | 16.7 | 206 | 1 | 97530 97535 | $84K |
| Jun 2018 | More hours than a day holds, even counting one unit per claim line | 33.2 | 16.3 | 10.9 | 15.6 | 193 | 1 | 97530 97535 | $71K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | SYDNEY CUMMINGS |
| Type | Individual |
| Status | Active |
| NPI issued | May 11, 2017, last updated May 11, 2017 |
| Practice location | 2740 COLLEGE AVE, Conway, AR 72034-6141, 501-329-5459 |
| Specialties | Day Training/Habilitation Specialist (373H00000X, 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.
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| T1015 | Medicaid service code | $8.3M | 91% | $1K | $182 (top 5% from $488) | 99th percentile | |
| 97532 | Medicaid service code | $308K | 3% | $415 | $211 (top 5% from $490) | 84th percentile | |
| 97535 | Training for self-care or home management, each 15 minutes | $297K | 3% | $394 | $48 (top 5% from $459) | 93rd percentile | |
| 97530 | Therapy procedure using functional activities | $222K | 2% | $302 | $124 (top 5% from $387) | 87th percentile | |
| 99367 | Medicaid service code | $20K | 0% | $32 | $41 (top 5% from $92) | 34th percentile | |
| T1027 | Family training and counseling for child development per 15 min | $3K | 0% | $20 | $164 (top 5% from $569) | too few months to rank |
In this area
2 providers in Faulkner County, AR carry an indicator in the public record, with $1.2M at stake between them. The most common is more hours than a day holds, on 2 of them.
| tier | provider | at stake | why |
|---|---|---|---|
| 4 | MARY MCNABB Conway, AR, ranked 9125 | $640K |
|
| 4 | DEANDRE GRIDER Conway, AR, ranked 9204 | $515K |
|
Recent enforcement in AR
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
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.