Providers
JERALD W BAMBURG, Ph.D.
NPI 1598926644, individual, Pineville, LA, Psychologist, Intellectual & Developmental Disabilities
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 15 months under one organization, which can be supervisory billing.
- Records needed.
- 67% of Medicaid dollars are on codes with a history of abuse.
score 54 of 100, rank 8065, $10.8M 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 |
|---|---|---|---|---|---|---|---|---|---|
| Feb 2018 | More hours than a day holds at a conservative unit price | 52.9 | 135.6 | 90.4 | 35.7 | 230 | 1 | 0364T 0365T 0368T 0369T 90791 | $199K |
| Mar 2018 | More hours than a day holds at a conservative unit price | 63.5 | 137.0 | 91.3 | 35.5 | 234 | 1 | 0364T 0365T 0368T 0369T | $224K |
| Apr 2018 | More hours than a day holds, even counting one unit per claim line | 75.0 | 151.2 | 100.8 | 39.3 | 233 | 1 | 0364T 0365T 0368T 0369T | $238K |
| May 2018 | More hours than a day holds, even counting one unit per claim line | 75.2 | 155.5 | 103.7 | 37.6 | 247 | 1 | 0364T 0365T 0368T 0369T | $256K |
| Jun 2018 | More hours than a day holds at a conservative unit price | 63.8 | 139.4 | 92.9 | 36.2 | 246 | 1 | 0364T 0365T 0368T 0369T | $221K |
| Jul 2018 | More hours than a day holds at a conservative unit price | 62.5 | 142.3 | 94.9 | 37.4 | 279 | 1 | 0364T 0365T 0368T 0369T 90791 | $232K |
| Aug 2018 | More hours than a day holds at a conservative unit price | 63.3 | 144.3 | 96.2 | 36.3 | 236 | 1 | 0364T 0365T 0368T 0369T | $233K |
| Oct 2018 | More hours than a day holds at a conservative unit price | 66.0 | 156.6 | 104.4 | 38.4 | 250 | 1 | 0364T 0365T 0368T 0369T | $254K |
| Jan 2019 | More hours than a day holds, even counting one unit per claim line | 45.0 | 82.4 | 54.9 | 31.7 | 243 | 1 | 90791 97151 97153 97155 97156 | $258K |
| Feb 2019 | More hours than a day holds, even counting one unit per claim line | 46.1 | 85.2 | 56.8 | 34.1 | 240 | 1 | 90791 97151 97153 97155 97156 | $240K |
| Apr 2019 | More hours than a day holds at a conservative unit price | 31.4 | 91.7 | 61.1 | 35.2 | 232 | 1 | 90791 97151 97153 97155 97156 | $279K |
| Jul 2019 | More hours than a day holds, even counting one unit per claim line | 35.0 | 84.6 | 56.4 | 33.2 | 244 | 2 | 90791 97151 97153 97155 97156 | $261K |
| Jun 2020 | More hours than a day holds, even counting one unit per claim line | 44.9 | 56.0 | 37.4 | 27.5 | 249 | 1 | 90791 97151 97153 97155 97156 | $224K |
| Jul 2020 | More hours than a day holds, even counting one unit per claim line | 42.3 | 57.5 | 38.3 | 26.4 | 235 | 1 | 90791 97153 97155 97156 | $240K |
| Aug 2020 | More hours than a day holds, even counting one unit per claim line | 42.3 | 54.2 | 36.1 | 27.6 | 231 | 1 | 90791 97151 97153 97155 97156 | $227K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | JERALD W BAMBURG, Ph.D. |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | June 20, 2008, last updated January 11, 2010 |
| Practice location | 106 N BEND DR, Pineville, LA 71360-4677, 318-442-4498 |
| Specialties | Psychologist, Clinical Child & Adolescent (103TC2200X, license 951 LA) Psychologist, Intellectual & Developmental Disabilities (103TM1800X, primary, license 951 LA) |
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 | |
|---|---|---|---|---|---|---|---|
| 97153 | Adaptive behavior treatment by protocol by technicianhistory of abuse | $5.6M | 50% | $2K | $2K (top 5% from $6K) | 65th percentile | |
| 97155 | Adaptive behavior treatment with protocol modification by QHPhistory of abuse | $1.9M | 17% | $713 | $512 (top 5% from $1K) | 73rd percentile | |
| 0365T | Adaptive behavior treatment by protocol each addl 30 min (pre-2019) | $1.8M | 16% | $2K | $2K (top 5% from $4K) | 69th percentile | |
| 97156 | Family adaptive behavior treatment guidance | $684K | 6% | $253 | $210 (top 5% from $547) | 60th percentile | |
| 0368T | Adaptive behavior treatment with protocol modification first 30 min (pre-2019) | $401K | 4% | $488 | $192 (top 5% from $534) | 93rd percentile | |
| 0364T | Adaptive behavior treatment by protocol first 30 min (pre-2019) | $221K | 2% | $268 | $303 (top 5% from $1K) | 40th percentile | |
| 0369T | Adaptive behavior treatment with protocol modification each addl 30 min (pre-2019) | $206K | 2% | $533 | $430 (top 5% from $971) | 64th percentile | |
| 0370T | Medicaid service code | $154K | 1% | $205 | $187 (top 5% from $354) | 58th percentile |
In this area
8 providers in Rapides Parish County, LA carry an indicator in the public record, with $759K at stake between them. The most common is more hours than a day holds, on 4 of them, followed by named in an enforcement record on 2. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | ROBERT HARVEY Alexandria, LA, ranked 105 | $251K |
|
| 3 | RIVERSIDE HOSPITAL OF LOUISIANA, INC. Alexandria, LA, ranked 1954 | $0 |
|
| 3 | MICHAEL DOLE Alexandria, LA, ranked 2835 | $0 |
|
| 3 | TRUCARE HOME HEALTH CENTRAL LLC Alexandria, LA, ranked 5352 | $0 |
|
| 4 | RAJAT GULATI Alexandria, LA, ranked 9311 | $358K |
|
| 4 | GEORGE KING Deville, LA, ranked 9605 | $67K |
|
| 4 | MARSHA STAPLETON Alexandria, LA, ranked 9613 | $64K |
|
| 4 | LAURI HALLER Alexandria, LA, ranked 9711 | $18K |
|
Recent enforcement in LA
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJOtherJul 30, 2026
Louisiana U.S. Attorneys Highlight Nine Recent Fraud Prosecutions Across the State
A nurse practitioner was sentenced for a health care fraud scheme involving over $12 million in fraudulent Medicare claims for medically unnecessary cancer genetic tests and receipt of kickbacks, and a New Orleans physician was charged with health care fraud for allegedly submitting $5.9 million in fraudulent claims to Medicare, Medicaid, and Humana for care not provided, in-person care for patients outside the state, and claims using other providers' identities.
DOJChargedJun 23, 2026
National Health Care Fraud Takedown Results in 455 Defendants Charged in Fraud Scheme Totaling Over $6.5 Billion
Defendants were charged in connection with schemes to submit claims for medically unnecessary respiratory pathogen panel testing, claims for care a physician did not provide, and false Medicaid claims for personal care services not rendered.
DOJSentencedJun 17, 2026
Nurse Practitioner Sentenced to 87 Months in Prison for $12M Medicare Fraud
A nurse practitioner received kickbacks for signing hundreds of orders for medically unnecessary cancer genetic tests after brief phone calls with patients without examining them, causing over $12.1 million in false and fraudulent claims to Medicare.
DOJSentencedApr 10, 2026
Slidell Doctor Sentenced For $6.6 Million In Health Care Fraud
Tassin, working through purported telemedicine companies, signed doctors' orders for cancer genetic tests for Medicare beneficiaries he never saw, spoke to, or treated, falsely certifying medical necessity in exchange for a set fee of typically $30 per order.
DOJSentencedJan 28, 2026
Slidell Chiropractor Sentenced For Health Care Fraud
Peyroux conspired with others to purchase Medicare beneficiary information and fabricated recordings and billed Medicare through his chiropractic clinic for over-the-counter COVID-19 test kits that were not requested or were otherwise ineligible for reimbursement, falsely listing a former nurse practitioner as the referring provider.
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.