ROBERT GINTHER, PA

NPI 1568891729, individual, New London, CT, Physician Assistant

Evidence tier

structure or single-organization volume

Hours beyond a day in 1 month, but with up to 744 patients a month across 5 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
Records needed.

score 50 of 100, rank 9341, $314K 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
Jan 2022	More hours than a day holds at a conservative unit price	12.6	36.8	24.5	36.2	744	5	99203 99204 99205 99213 99214 99215	$70K

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	ROBERT GINTHER, PA
Type	Individual, sole proprietor
Status	Active
NPI issued	November 7, 2013, last updated April 19, 2026
Practice location	365 MONTAUK AVE, New London, CT 06320-4769, 860-442-0711
Specialties	Physician Assistant (363A00000X, license PA01477 RI) Physician Assistant (363A00000X, primary, license 5706 CT) Physician Assistant (363A00000X, license PA23254 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

code	what it is	paid	share	per patient-month	typical	rank among providers
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	$248K	60%	$95	$60 (top 5% from $133)	83rd percentile
99204	New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	$52K	13%	$97	$95 (top 5% from $171)	52nd percentile
99284	Emergency department visit with moderate level of medical decision making	$40K	10%	$57	$86 (top 5% from $224)	15th percentile
99283	Emergency department visit with low level of medical decision making	$36K	9%	$32	$60 (top 5% from $193)	9th percentile
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	$22K	5%	$95	$44 (top 5% from $110)	93rd percentile
99215	Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or morehistory of abuse	$5K	1%	$95	$88 (top 5% from $210)	too few months to rank
99203	New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	$5K	1%	$95	$67 (top 5% from $121)	too few months to rank
99285	Emergency department visit with high level of medical decision making	$2K	1%	$90	$100 (top 5% from $264)	too few months to rank

Medicare Part B 2024, largest codes

code	what it is	services	beneficiaries	paid	submitted per service	allowed per service	charge to allowed	usual for this code
99285	Emergency department visit with high level of medical decision making	112	112	$13K	$1K	$149	7.8x	6.9x (90th percentile 11.7x)
99284	Emergency department visit with moderate level of medical decision making	143	142	$10K	$750	$104	7.2x	6.7x (90th percentile 11.3x)
99283	Emergency department visit with low level of medical decision making	104	103	$4K	$480	$61	7.9x	5.8x (90th percentile 10.9x)

A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.

In this area

6 providers in New London, CT carry an indicator in the public record, with $803K at stake between them. The most common is part of a provider network, on 5 of them, followed by more hours than a day holds on 1.

tier	provider	at stake	why
3	WV-CROSSINGS EAST LLC New London, CT, ranked 1466	$29K	Part of provider network D1-00123, ranked 123 nationally.
3	ORCHARD GROVE SPECIALTY CARE CENTER LLC Uncasville, CT, ranked 3172	$0	Part of provider network D1-00123, ranked 123 nationally.
3	LIBERTY HALL NURSING CENTER INC Colchester, CT, ranked 4538	$0	Part of provider network D1-00123, ranked 123 nationally.
3	MARY ELIZABETH NURSING CENTER INC. Mystic, CT, ranked 5954	$0	Part of provider network D1-00123, ranked 123 nationally.
3	BEECHWOOD SNF OPCO LLC New London, CT, ranked 5989	$0	Part of provider network D1-00123, ranked 123 nationally.
4	JEFFREY SLOCUM Uncasville, CT, ranked 7333	$774K	Hours beyond a day in 4 months under one organization, which can be supervisory billing. Records needed. and 2 more

Recent enforcement in CT

All releases

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

DOJCivil settlementJun 23, 2026

Connecticut Lab and its Owner Pay Over $145K to Settle Allegations of Medicaid Enrollment Fraud

Coastal Diagnostics and its owner made material misrepresentations in a Connecticut Medicaid Provider Enrollment Application by denying any relationship to another enrolled provider, Genco Lab, and then submitted claims for laboratory services.

DOJPleaded guiltyJun 23, 2026

Middletown Man Pleads Guilty to Operating Unlawful Money Transmitting Business

Habib registered a company and opened a bank account through which fraudulent claims were submitted to Medicare Advantage plans for durable medical equipment, including orthotics and braces, that beneficiaries did not request, consent to, or receive, and he wired proceeds to Pakistan without a money transmitting license.

DOJComplaint filedMay 22, 2026

APRN Charged with Defrauding Connecticut’s Medicaid Program

An APRN was charged with submitting fraudulent Medicaid claims for medication management services that were not provided, including for patients who had stopped seeing her or who were hospitalized, incarcerated, or deceased.

DOJSentencedApr 30, 2026

Cheshire Nurse Who Illegally Distributed Controlled Substances is Sentenced

An Advanced Practice Registered Nurse enrolled as a Medicare and Medicaid provider unlawfully distributed amphetamines and benzodiazepines to individuals without legitimate medical need, charging $200 cash for office visits, and Medicaid paid $287.58 for prescriptions written for an undercover agent.

DOJSentencedFeb 10, 2026

Bloomfield Man Sentenced to Federal Prison for Health Care Fraud

Tyson and Epps submitted fraudulent Medicaid claims for psychotherapy counseling sessions that were not provided, billed under Tyson's provider number for services purportedly provided by the suspended Epps, and Tyson provided fraudulent patient records during a Medicaid audit.

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.

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