Providers

JOSE MANUEL PEREZ YORDAN, M.D.

NPI 1497193924, individual, Caguas, PR, Obstetrics & Gynecology, Maternal & Fetal Medicine

5
Evidence tier
informational
  • Medicaid dollars per patient on code 99214 ($179 per patient-month) sit in the top 5% of every provider billing that code.
score 34 of 100, rank 10384, $212K at stake

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameJOSE MANUEL PEREZ YORDAN, M.D.
TypeIndividual, sole proprietor
StatusActive
NPI issuedJune 6, 2013, last updated October 5, 2021
Practice locationCARR 172 CAGUAS A CIDRA URB TURABO GARDENS, SUITE 108, Caguas, PR 00726, 787-486-0529
Mailing address138 AVE WINSTON CHURCHILL STE 811, San Juan, PR 00926-6013
Specialties
Obstetrics & Gynecology (207V00000X, license MD2017-0907 NM)
Obstetrics & Gynecology, Maternal & Fetal Medicine (207VM0101X, license ME145616 FL)
Obstetrics & Gynecology, Maternal & Fetal Medicine (207VM0101X, primary, license 19329 PR)

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
76811Ultrasound scan of pregnant uterus with detailed fetal anatomic examination, single or first fetus$662K20%$188$119 (top 5% from $227)87th percentile
99204New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more$575K17%$179$95 (top 5% from $171)96th percentile
99214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$481K14%$157$60 (top 5% from $133)97th percentile
76816Follow-up ultrasound scan of pregnant uterus$431K13%$136$69 (top 5% from $135)95th percentile
76819Ultrasound scan of fetus$363K11%$126$72 (top 5% from $161)86th percentile
76821Ultrasound scan of fetal brain artery blood flow rate$355K11%$126$82 (top 5% from $171)81st percentile
76820Ultrasound scan of fetal umbilical artery blood flow rate$237K7%$65$51 (top 5% from $129)69th percentile
76817Vaginal ultrasound of pregnant uterus$127K4%$105$55 (top 5% from $116)92nd percentile

In this area

9 providers in Caguas, PR carry an indicator in the public record, with $8.5M at stake between them. The most common is more hours than a day holds, on 8 of them, followed by paid after a public list action on 1. 1 is tier 1: documented action, then payment.

tierproviderat stakewhy
1DIANA GALLARDO
Caguas, PR, ranked 321
$5K
  • Listed on the OIG exclusion list and the Medicare revocation list since July 9, 2021.
  • Medicaid still paid claims in 8 later months, $5,215 in total.
2YAMIR GARCIA SEGARRA
Caguas, PR, ranked 696
$1.9M
  • Billed more hands-on hours than a day holds in 3 months, peaking at 22.2 hours per day across 3 billing organizations.
  • Medicaid dollars per patient on code 92526 ($630 per patient-month) sit in the top 5% of every provider billing that code.
4FRANCISCO ALVARADO MELENDEZ
Caguas, PR, ranked 8033
$198K
  • Hours beyond a day in 1 month under one organization, which can be supervisory billing.
  • Records needed.
  • and 1 more
4NYDIA GONZALEZ LOPEZ
Caguas, PR, ranked 8408
$5.1M
  • Hours beyond a day in 28 months, but with up to 641 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
5LUIS JIMENEZ REYES
Caguas, PR, ranked 10147
$809K
  • Medicaid dollars per patient on code 99232 ($276 per patient-month) sit in the top 5% of every provider billing that code.
5ALWIN VARGAS
Caguas, PR, ranked 10350
$279K
  • Medicaid dollars per patient on code 97140 ($121 per patient-month) sit in the top 5% of every provider billing that code.
5LEONARDO PIRILLO
Caguas, PR, ranked 10460
$94K
  • Medicaid dollars per patient on code 99223 ($253 per patient-month) sit in the top 5% of every provider billing that code.
5IVELISSE LOPEZ
Caguas, PR, ranked 11650
$90K
All 9 in PR

Recent enforcement in PR

All releases

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

DOJIndictedJun 23, 2026
2026 National Health Care Fraud Takedown
Four defendants were charged in two schemes, one involving the advertising, sale, and distribution of Semaglutide, Mounjaro, steroids, and Tirzepatide that defendants were not authorized to possess and distribute, and the other involving performing dental procedures on patients without a valid dental license and misbranding of devices.
DOJCivil settlementJun 4, 2026
Puerto Rico Pharmacies Agree to Pay $4.6 Million to Federal Authorities in Medicare and Medicaid Fraud Cases
Four pharmacies and their owners agreed to pay $4.6 million to resolve allegations that between January 2021 and January 2024 they billed Medicare and Medicaid for diverted prescriptions sold to patients that had been misrepresented as properly sourced despite unverifiable origins.
DOJPleaded guiltyJul 17, 2025
Physician Assistant who Pretended to be a Licensed Physician Pleads Guilty to Making False Statements to an Agency of the United States
Villalobos-Meléndez, a licensed physician assistant who was never licensed to practice medicine, forged medical license and USMLE documents, worked as a physician in a hospital internship program, and submitted false license information on a CMS-855I form seeking enrollment as a Medicare physician provider with benefits reassigned to Physician HMO.
DOJCivil settlementDec 23, 2024
MMM Holdings, LLC Agrees to Pay 15.2 Million Dollars to Resolve Allegations that it Violated the False Claims Act and Anti-Kickback Statute
MMM Holdings distributed gift cards to administrative assistants of providers to induce the referral, recommendation, or arrangement for enrollment of thousands of Medicare beneficiaries in an MMM Medicare Advantage plan and submitted or caused claims for payment to Medicare.
DOJIndictedSep 25, 2024
27 Individuals Indicted for Buying and Selling Wholesale Quantities of Misbranded and Diverted Prescription Drugs Resold to the Public Through Retail Pharmacies in Puerto Rico
Defendants engaged in unlicensed wholesale distribution of misbranded and diverted prescription drugs sold to pharmacy owners and employees who resold them to customers and billed health care benefit plans as if the drugs were authentic and obtained through licensed distribution channels.

Referral packet

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