DERRICK ERNEST THOMPSON
NPI 1568752368, individual, Plainville, CT, Counselor
- Hours beyond a day in 6 months under one organization, which can be supervisory billing.
- Records needed.
- Medicaid dollars per patient on code 90837 ($652 per patient-month) sit in the top 5% of every provider billing that code.
- 97% of Medicaid dollars are on codes with a history of abuse.
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 |
|---|---|---|---|---|---|---|---|---|---|
| Jan 2018 | More hours than a day holds, even counting one unit per claim line | 24.5 | 24.9 | 16.6 | 22.4 | 130 | 1 | 90791 90837 | $66K |
| Feb 2018 | More hours than a day holds, even counting one unit per claim line | 26.4 | 27.3 | 18.2 | 25.5 | 96 | 1 | 90837 | $66K |
| Mar 2019 | More hours than a day holds, even counting one unit per claim line | 25.5 | 26.8 | 17.9 | 26.4 | 97 | 1 | 90837 | $71K |
| Apr 2019 | More hours than a day holds, even counting one unit per claim line | 29.5 | 30.8 | 20.5 | 28.0 | 124 | 1 | 90791 90837 | $79K |
| May 2019 | More hours than a day holds, even counting one unit per claim line | 31.4 | 33.4 | 22.3 | 30.0 | 131 | 1 | 90791 90837 | $89K |
| Jun 2019 | More hours than a day holds, even counting one unit per claim line | 32.2 | 33.8 | 22.5 | 33.8 | 121 | 1 | 90837 | $87K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | DERRICK ERNEST THOMPSON |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | April 13, 2011, last updated April 13, 2011 |
| Practice location | 91 NORTHWEST DR, Plainville, CT 06062-1534, 888-793-3500 |
| Mailing address | 395 BRITTANY FARMS RD, APT 329, New Britain, CT 06053-1100 |
| Specialties | Counselor (101Y00000X, primary) Counselor, Mental Health (101YM0800X) Counselor, Professional (101YP2500X) |
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.
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 90837 | Psychotherapy, 1 hourhistory of abuse | $1.3M | 97% | $652 | $191 (top 5% from $442) | 98th percentile | |
| 90832 | Psychotherapy, 30 minutes | $21K | 2% | $227 | $59 (top 5% from $239) | 94th percentile | |
| 98967 | Telephone medical discussion provided by nonphysician professional, 11-20 minutes | $9K | 1% | $175 | $12 (top 5% from $134) | too few months to rank | |
| 90791 | Psychiatric diagnostic evaluation | $7K | 1% | $94 | $105 (top 5% from $228) | too few months to rank | |
| 90834 | Psychotherapy, 45 minutes | $7K | 1% | $176 | $101 (top 5% from $318) | too few months to rank |
In this area
33 providers in Plainville, CT carry an indicator in the public record, with $12.8M at stake between them. The most common is named in an enforcement record, on 12 of them, followed by more hours than a day holds on 9. 12 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | SHAWN TYSON Hartford, CT, ranked 62 | $0 |
|
| 1 | MINDS CORNERSTONE LLC Wethersfield, CT, ranked 74 | $721K |
|
| 1 | HELEN ZERVAS Bristol, CT, ranked 112 | $192K |
|
| 1 | SORAYA SAWICKI Avon, CT, ranked 133 | $131K |
|
| 1 | MICHAEL PINES Glastonbury, CT, ranked 444 | $0 |
|
| 1 | THE GEMINI PROJECT, LLC Newington, CT, ranked 446 | $0 |
|
| 1 | COLLABORATIVE COUNSELING CENTER, LLC Hartford, CT, ranked 550 | $0 |
|
| 1 | DONALD SALZBERG West Hartford, CT, ranked 575 | $0 |
|
Recent enforcement in CT
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
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.