Providers

DAVID LOUIS SINCAVAGE, M.D.

NPI 1528036191, individual, Brentwood, TN, Emergency Medicine

1
Evidence tier
documented action, then payment
  • Listed on the KY Medicaid exclusion list since February 7, 2017.
  • Medicaid still paid claims in 2 later months, $33,294 in total.
score 95 of 100, rank 215, $33K 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.

listidentity checkaction datewindow closedmonths paid afterfirstlastpaid after12 months before
KY Medicaid exclusion list
state list extracted from https://chfs.ky.gov/agencies/dms/dpi/pe/documents/kymedicaidterminationlist.xlsx (pandas claude colmap)
Exact NPI, name verifiedFeb 7, 2017still open2Jan 2018Feb 2018$33K$0

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameDAVID LOUIS SINCAVAGE, M.D.
TypeIndividual
StatusActive
NPI issuedMarch 9, 2006, last updated March 2, 2016
Practice location9421 RAVEN HOLLOW RD, Brentwood, TN 37027-8604, 619-850-4224
Specialties
Emergency Medicine (207P00000X, primary, license E07546 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
codewhat it ispaidshareper patient-monthtypicalrank among providers
99285Emergency department visit with high level of medical decision making$11K32%$351$100 (top 5% from $264)too few months to rank
99284Emergency department visit with moderate level of medical decision making$10K30%$105$86 (top 5% from $224)too few months to rank
99283Emergency department visit with low level of medical decision making$8K23%$99$60 (top 5% from $193)too few months to rank
87804Detection test by immunoassay with direct visual observation for influenza virus$7702%$19$22 (top 5% from $33)too few months to rank
96372Injection of drug or substance under skin or into muscle$6072%$16$12 (top 5% from $49)too few months to rank
80053Blood test, comprehensive group of blood chemicals$5982%$13$8.38 (top 5% from $44)too few months to rank
96374Injection of drug or substance into vein$5542%$29$21 (top 5% from $138)too few months to rank
85025Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count$4931%$9.30$5.69 (top 5% from $25)too few months to rank

In this area

4 providers in Williamson County, TN carry an indicator in the public record, with $2.8M at stake between them. The most common is part of a provider network, on 2 of them, followed by named in an enforcement record on 1. 1 is tier 1: documented action, then payment.

tierproviderat stakewhy
1HELEN BOERMAN
Franklin, TN, ranked 604
$0
  • Adjudicated (pleaded guilty) per a Department of Justice release dated May 7, 2026.
  • No Medicaid payments in the last 12 observed months.
3SHALOM HOSPICE LLC
Brentwood, TN, ranked 5157
$0
  • Part of provider network D1-00113, ranked 113 nationally.
3CLAIBORNE MANAGEMENT LLC
Franklin, TN, ranked 6677
$0
  • Part of provider network D1-00083, ranked 83 nationally.
4GINGER JONES
Franklin, TN, ranked 8591
$2.8M
  • Hours beyond a day in 24 months, but with up to 628 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.

Recent enforcement in TN

All releases

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

DOJCivil settlementAug 10, 2026
Celina Pharmacy Owner/Two Pharmacies Agree to Pay $450,000 & Receive Ban on Handling Controlled Substances
The defendants knowingly dispensed controlled substances without valid prescriptions and outside the usual course of professional pharmacy practice, and falsely billed Medicare for prescriptions that were not medically necessary or otherwise eligible for reimbursement.
DOJSentencedJul 8, 2026
Memphis Gynecologist Sentenced to 20 Years in Prison for Adulterating Medical Devices and Health Care Fraud
Kumar used adulterated and unlabeled single-use and improperly reprocessed reusable hysteroscopy devices in more than 15,000 hysteroscopy with biopsy procedures and billed Medicare and Medicaid for the procedures.
DOJSentencedJun 24, 2026
Celina Pharmacy Owner Sentenced for Opioid Distribution/Health Care Fraud
The majority owner of two pharmacies conspired to unlawfully dispense controlled substances despite red flags of abuse and diversion, submitted false claims to Medicare Part D and TennCare, and paid patient co-payments, cash, and "Monkey Bucks" to increase prescription volume.
DOJChargedJun 23, 2026
Clarksville Physician Charged with Health Care Fraud Related to Controlled Substance Prescribing Scheme
Aquino owned and operated North Clarksville Medical Center and for more than five years prescribed medically unnecessary controlled substances, totaling more than 1.08 million pills and doses, that were not issued for a legitimate medical purpose in the usual course of professional practice, causing losses of approximately $335,621.73 to health care benefit programs.
DOJIndictedJun 23, 2026
Gordonsville Physician Indicted on Health Care Fraud and Controlled Substance Charges
Moss owned and operated Gordonsville Clinic and prescribed medically unnecessary controlled substances, totaling more than 5.6 million pills and doses over more than eight years, that were not issued for a legitimate medical purpose in the usual course of professional practice.

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.

Ask this case

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