NGONDA'YEBENIT NZELLE NGO MAYEBA, NP
NPI 1598020430, individual, Morganton, NC, Nurse Practitioner, Psych/Mental Health
- Hours beyond a day in 7 months, but with up to 1746 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 99214 ($156 per patient-month) sit in the top 5% of every provider billing that code.
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 |
|---|---|---|---|---|---|---|---|---|---|
| Sep 2021 | More hours than a day holds, even counting one unit per claim line | 29.5 | 25.8 | 17.2 | 23.5 | 1246 | 2 | 90837 99202 99212 99213 99214 | $122K |
| Oct 2021 | More hours than a day holds, even counting one unit per claim line | 51.4 | 50.0 | 33.3 | 49.2 | 1746 | 2 | 90837 99202 99212 99213 99214 99406 99407 | $240K |
| Nov 2021 | More hours than a day holds, even counting one unit per claim line | 64.9 | 63.3 | 42.2 | 57.5 | 1206 | 2 | 90837 99202 99212 99213 99214 99407 | $317K |
| Dec 2021 | More hours than a day holds, even counting one unit per claim line | 35.5 | 31.6 | 21.1 | 28.4 | 1168 | 2 | 90832 99202 99212 99213 99214 99407 | $174K |
| Jan 2022 | More hours than a day holds, even counting one unit per claim line | 51.5 | 25.0 | 16.6 | 24.6 | 1229 | 2 | 90837 99202 99212 99214 | $135K |
| Feb 2022 | More hours than a day holds, even counting one unit per claim line | 67.0 | 25.4 | 16.9 | 23.7 | 1255 | 2 | 90837 99202 99212 99214 99407 | $124K |
| Mar 2022 | More hours than a day holds, even counting one unit per claim line | 62.9 | 26.4 | 17.6 | 23.7 | 1297 | 2 | 90837 99202 99212 99214 99407 | $135K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | NGONDA'YEBENIT NZELLE NGO MAYEBA, NP |
| Type | Individual |
| Status | Active |
| NPI issued | July 6, 2012, last updated September 26, 2024 |
| Practice location | 329 SANFORD DR STE B, Morganton, NC 28655-2576, 828-430-9120 |
| Specialties | Nurse Practitioner, Family (363LF0000X, license 5010187 NC) Nurse Practitioner, Psych/Mental Health (363LP0808X, primary, license 5010187 NC) |
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 | |
|---|---|---|---|---|---|---|---|
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $822K | 39% | $131 | $28 (top 5% from $147) | 94th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $577K | 28% | $156 | $60 (top 5% from $133) | 97th percentile | |
| 90837 | Psychotherapy, 1 hourhistory of abuse | $261K | 13% | $167 | $191 (top 5% from $442) | 39th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $241K | 12% | $120 | $44 (top 5% from $110) | 96th percentile | |
| 99202 | New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more | $71K | 3% | $69 | $45 (top 5% from $138) | 81st percentile | |
| T1015 | Medicaid service code | $26K | 1% | $90 | $182 (top 5% from $488) | 19th percentile | |
| 99407 | Smoking and tobacco use intensive counseling, more than 10 minutes | $22K | 1% | $41 | $14 (top 5% from $36) | 97th percentile | |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | $17K | 1% | $28 | $21 (top 5% from $84) | 64th percentile |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 87 | 16 | $6K | $183 | $98 | 1.9x | 2.3x (90th percentile 3.8x) |
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
2 providers in Burke County, NC carry an indicator in the public record, with $0 at stake between them. The most common is part of a provider network, on 2 of them.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | GRACE HEIGHTS REHABILITATION AND SKILLED NURSING CENTER, LLC Morganton, NC, ranked 4871 | $0 |
|
| 3 | COLLEGE PINES REHABILITATION AND SKILLED NURSING CENTER, LLC Connelly Springs, NC, ranked 5472 | $0 |
|
Recent enforcement in NC
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.