Providers

MATTHEW BROOKE LOVATO, M.D.

NPI 1568424182, individual, Gadsden, AL, Pediatrics

5
Evidence tier
informational
score 31 of 100, rank 11138, $688K at stake

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameMATTHEW BROOKE LOVATO, M.D.
TypeIndividual
StatusActive
NPI issuedApril 6, 2006, last updated July 8, 2007
Practice location829 RIVERBEND DR, Gadsden, AL 35901-2556, 256-546-4611
Specialties
Pediatrics (208000000X, primary, license 068280 MI)

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
99213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$1.2M42%$73$44 (top 5% from $110)84th percentile
99214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$537K19%$105$60 (top 5% from $133)88th percentile
85025Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count$149K5%$11$5.69 (top 5% from $25)86th percentile
99392Medicaid service code$139K5%$68$78 (top 5% from $124)36th percentile
99393Medicaid service code$125K4%$67$78 (top 5% from $121)37th percentile
99391Medicaid service code$97K3%$69$76 (top 5% from $126)39th percentile
99394Medicaid service code$81K3%$67$83 (top 5% from $128)36th percentile
99203New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more$64K2%$104$67 (top 5% from $121)90th percentile

In this area

2 providers in Etowah County, AL carry an indicator in the public record, with $55K at stake between them. The most common is part of a provider network, on 1 of them, followed by more hours than a day holds on 1.

tierproviderat stakewhy
3ALTOONA HEALTH & REHAB, INC.
Altoona, AL, ranked 1910
$0
  • Part of provider network D1-00136, ranked 136 nationally.
4FARRUKH JAMIL
Gadsden, AL, ranked 9627
$55K
  • Hours beyond a day in 3 months under one organization, which can be supervisory billing.
  • Records needed.

Recent enforcement in AL

All releases

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

DOJCivil settlementJun 23, 2026
Alabama Provider Pays $300,000 to Resolve False Claims as Part of 2026 National Health Care Fraud Takedown
A Phenix City-based provider billed Alabama Medicaid for Basic Living Skills services for at-risk children that were not actually rendered.
DOJSentencedApr 2, 2026
Former Medicaid Provider Sentenced to Federal Prison for Health Care Fraud and Aggravated Identity Theft
Pulliam, a child and family therapist enrolled as an Alabama Medicaid provider, submitted claims for counseling services that were never provided using beneficiaries' identifying information without consent.
DOJCivil judgmentMar 19, 2026
Mississippi Man Ordered to Pay $31 Million for Role in Healthcare Kickback Scheme
Crites and others referred patients, primarily TRICARE beneficiaries, to Cloverland Pharmacy in exchange for kickbacks paid by the pharmacy for each referral.
DOJCivil settlementFeb 21, 2025
Saad Healthcare Agrees to Pay $3M to Settle False Claims Act Allegations That It Billed Medicare for Ineligible Hospice Patients
Saad submitted, or caused the submission of, false claims to Medicare between 2013 and 2020 for 21 hospice patients who were not terminally ill and thus ineligible for the Medicare hospice benefit.
DOJCivil settlementFeb 21, 2025
Saad Healthcare Agrees to Pay $3M to Settle False Claims Act Allegations That It Billed Medicare for Ineligible Hospice Patients
Saad Healthcare submitted, or caused the submission of, false claims to Medicare between 2013 and 2020 for 21 hospice patients who were not terminally ill and were ineligible for the Medicare hospice benefit.

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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