Providers

VIJETA KUSHWAHA, M.D.

NPI 1487919767, individual, Rochester, NY, Psychiatry & Neurology, Psychiatry

4
Evidence tier
structure or single-organization volume
  • Hours beyond a day in 1 month under one organization, which can be supervisory billing.
  • Records needed.
  • Medicaid dollars per patient on code 96150 ($14402 per patient-month) sit in the top 5% of every provider billing that code.
score 54 of 100, rank 8039, $181K 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.

monthwhat was foundhours per day, lower boundhours per day, at pricehours per day, conservativeper working daypatientsbilling organizationscodespaid
Dec 2019More hours than a day holds at a conservative unit price3.069.346.265.113196150$181K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameVIJETA KUSHWAHA, M.D.
TypeIndividual
StatusActive
NPI issuedJuly 12, 2012, last updated February 11, 2019
Practice location3300 DEWEY AVE, Rochester, NY 14616, 585-865-1550
Specialties
Psychiatry & Neurology, Psychiatry (2084P0800X, primary, license 286366 NY)

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
codewhat it ispaidshareper patient-monthtypicalrank among providers
96150Health and behavior assessment each 15 min (pre-2020)$2.8M100%$14K$10 (top 5% from $77)99th percentile
99213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$1K0%$53$44 (top 5% from $110)too few months to rank

In this area

9 providers in Monroe County, NY carry an indicator in the public record, with $38.0M at stake between them. The most common is more hours than a day holds, on 5 of them, followed by part of a provider network on 3.

tierproviderat stakewhy
3AGA OPERATING LLC
Rochester, NY, ranked 3921
$0
  • Part of provider network D1-00091, ranked 91 nationally.
3LFG OPERATING LLC
Spencerport, NY, ranked 5247
$0
  • Part of provider network D1-00091, ranked 91 nationally.
3170 WEST AVENUE OPERATING COMPANY, LLC
Brockport, NY, ranked 6965
$0
  • Part of provider network D1-00132, ranked 132 nationally.
4ROBERT WEISMAN
Rochester, NY, ranked 7356
$14.2M
  • Hours beyond a day in 76 months, but with up to 1052 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • and 1 more
4LAURA CARDELLA
Rochester, NY, ranked 7377
$9.3M
  • Hours beyond a day in 24 months, but with up to 781 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • and 1 more
4MYRA MATHIS-UWANOGHO
Rochester, NY, ranked 7418
$6.4M
  • Hours beyond a day in 20 months, but with up to 738 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • and 1 more
4GLORIA BACIEWICZ
Rochester, NY, ranked 7551
$3.1M
  • Hours beyond a day in 1 month, but with up to 832 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • and 1 more
5JOHN LYNCH
Rochester, NY, ranked 10698
$4.7M
All 9 in NY

Recent enforcement in NY

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJIndictedAug 20, 2026
Four Members Of The “War Room” Charged In Connection With $12 Million Medicaid Fraud Scheme
Members of a Bronx-based racketeering organization known as the "War Room" fabricated ride data for methadone clinic transportation using a GPS spoofing application, paid Medicaid patients kickbacks in cash and drugs for their enrollment information, provided the fake data to transportation companies that submitted over $12 million in claims to Medicaid, and laundered the proceeds.
DOJIndictedAug 20, 2026
Four Members of the “War Room” Charged in Connection with $12M Medicaid Fraud Scheme
Four members of a Bronx racketeering organization known as the "War Room" fabricated medical transportation ride data using a ride-tracking app and GPS spoofing, paid Medicaid patients at methadone clinics kickbacks in cash and drugs for their enrollment information, provided the fake data to transportation companies that submitted over $12 million in Medicaid claims, and laundered the proceeds.
DOJCivil settlementAug 17, 2026
Safire nursing homes agree to pay $9 million to resolve fraudulent Medicare and Medicaid billing allegations
The United States alleged that Safire submitted false claims to Medicare and Medicaid for skilled rehabilitative therapy services that were not reasonable or necessary, not supported by medical records, not documented as provided, or not provided at all, including by scheduling therapy based on insurer reimbursement policies, pressuring therapists and residents, and manufacturing or altering therapy referrals and medical records.
DOJSentencedJul 21, 2026
Owner of Long Island Ambulette Services Company Sentenced to Prison for Multimillion Dollar Healthcare Fraud Scheme
Arshad and co-conspirators paid kickbacks to Medicaid beneficiaries to order transportation through his companies and billed Medicaid over $19 million for medical transportation rides that were not provided, including for individuals who were deceased, hospitalized or incarcerated, and inflated reimbursements with false pickup addresses and distant treatment centers.
DOJIndictedJul 2, 2026
Two Defendants Charged with Multi-Million Dollar Health Care Fraud Scheme
The defendants, who owned and operated Tri-Hamlet Taxi Inc., allegedly paid kickbacks to Medicaid beneficiaries and submitted more than $35 million in claims to Medicaid for ambulette trips that were not provided or whose costs were inflated by using false pickup or drop-off addresses.

Referral packet

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