Providers
All 14 in NY
SHIMON ABRAMS
NPI 1508379330, individual, Spring Valley, NY, Social Worker
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 8 months, but with up to 1170 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- 85% of Medicaid dollars are on codes with a history of abuse.
score 53 of 100, rank 8134, $2.1M 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.
| 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 |
|---|---|---|---|---|---|---|---|---|---|
| May 2022 | More hours than a day holds, even counting one unit per claim line | 36.7 | 32.6 | 21.7 | 30.6 | 1166 | 1 | 90834 90837 90853 | $187K |
| Jun 2022 | More hours than a day holds, even counting one unit per claim line | 54.1 | 47.6 | 31.7 | 43.3 | 1143 | 1 | 90834 90837 90853 | $277K |
| Jul 2022 | More hours than a day holds, even counting one unit per claim line | 39.8 | 35.0 | 23.4 | 34.5 | 1002 | 1 | 90834 90837 90853 | $210K |
| Dec 2022 | More hours than a day holds, even counting one unit per claim line | 61.4 | 53.8 | 35.8 | 50.5 | 1170 | 1 | 90834 90837 90853 | $332K |
| Jan 2023 | More hours than a day holds, even counting one unit per claim line | 74.3 | 63.6 | 42.4 | 59.7 | 1163 | 1 | 90834 90837 90853 | $401K |
| Jun 2023 | More hours than a day holds, even counting one unit per claim line | 33.7 | 29.1 | 19.4 | 26.5 | 663 | 1 | 90834 90837 90853 | $169K |
| Jul 2023 | More hours than a day holds, even counting one unit per claim line | 40.1 | 34.4 | 23.0 | 33.9 | 626 | 1 | 90834 90837 90853 | $213K |
| Aug 2023 | More hours than a day holds, even counting one unit per claim line | 31.3 | 27.0 | 18.0 | 24.3 | 614 | 1 | 90834 90837 90853 | $164K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | SHIMON ABRAMS |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | November 15, 2017, last updated November 15, 2017 |
| Practice location | 295 W ROUTE 59, Spring Valley, NY 10977-5449, 845-533-3227 |
| Mailing address | 18 GARRISON DR, Spring Valley, NY 10977-6053 |
| Specialties | Social Worker (104100000X, 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 | |
|---|---|---|---|---|---|---|---|
| 90853 | Group psychotherapyhistory of abuse | $2.3M | 77% | $210 | $60 (top 5% from $332) | 90th percentile | |
| 90834 | Psychotherapy, 45 minutes | $366K | 12% | $233 | $101 (top 5% from $318) | 89th percentile | |
| 90837 | Psychotherapy, 1 hourhistory of abuse | $240K | 8% | $265 | $191 (top 5% from $442) | 76th percentile | |
| 99051 | Medicaid service code | $43K | 1% | $17 | $6.71 (top 5% from $30) | 78th percentile | |
| 90791 | Psychiatric diagnostic evaluation | $18K | 1% | $120 | $105 (top 5% from $228) | too few months to rank |
In this area
14 providers in Rockland County, NY carry an indicator in the public record, with $77.0M at stake between them. The most common is more hours than a day holds, on 13 of them, followed by part of a provider network on 1.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | PINE VALLEY CENTER LLC Spring Valley, NY, ranked 2336 | $0 |
|
| 4 | SHIRA ANDRUSIER Suffern, NY, ranked 7279 | $10.8M |
|
| 4 | SETH KURTZ Monsey, NY, ranked 7341 | $40.9M |
|
| 4 | ADAM POLINGER Suffern, NY, ranked 7391 | $8.1M |
|
| 4 | MAURICE ABRAMCZYK Monsey, NY, ranked 7896 | $718K |
|
| 4 | LEORA PERL New Square, NY, ranked 8034 | $196K |
|
| 4 | ARON ROTHSCHILD Spring Valley, NY, ranked 8187 | $988K |
|
| 4 | MEIR ADLER Spring Valley, NY, ranked 8364 | $6.3M |
|
Recent enforcement in NY
All releasesDepartment 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
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.