Providers

MAGDALENA SUNSHINE SERRANO, M.S.W,L.C.S.W.

NPI 1609126655, individual, Santa Maria, CA, Social Worker, Clinical

2
Evidence tier
impossible volume with concurrency
  • Billed more hands-on hours than a day holds in 2 months, peaking at 1.1 hour per day across 4 billing organizations.
score 78 of 100, rank 751, $933 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.

monthwhat was foundhours per day, lower boundhours per day, at pricehours per day, conservativeper working daypatientsbilling organizationscodespaid
Mar 2023More hours than a day holds, even counting one unit per claim line27.40.20.10.2470390832 90834 G0396$458
Apr 2023More hours than a day holds, even counting one unit per claim line27.30.20.20.2443490832 90834 90837$475

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameMAGDALENA SUNSHINE SERRANO, M.S.W,L.C.S.W.
TypeIndividual, sole proprietor
StatusActive
NPI issuedSeptember 18, 2012, last updated June 15, 2015
Practice location2801 SANTA MARIA WAY, Santa Maria, CA 93455-2118, 805-938-9200
Mailing address2050 S BLOSSER RD, Santa Maria, CA 93458-7310
Specialties
Social Worker, Clinical (1041C0700X, primary, license LCS28864 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
codewhat it ispaidshareper patient-monthtypicalrank among providers
T1015Medicaid service code$11.7M77%$222$182 (top 5% from $488)66th percentile
0521Medicaid service code$3.4M22%$21$11 (top 5% from $68)69th percentile
G0511Medicaid service code$123K1%$15$8.90 (top 5% from $98)71st percentile
0900Medicaid service code$11K0%$0.27$0.50 (top 5% from $765)37th percentile
G0442Annual alcohol misuse screening, 5 to 15 minutes$7K0%$10$3.03 (top 5% from $22)71st percentile
G0396Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes$4K0%$16$48 (top 5% from $313)36th percentile
G0071Medicaid service code$3K0%$16$6.52 (top 5% from $25)too few months to rank
90834Psychotherapy, 45 minutes$2K0%$0.07$101 (top 5% from $318)4th percentile

In this area

25 providers in Santa Barbara County, CA carry an indicator in the public record, with $22.0M at stake between them. The most common is more hours than a day holds, on 18 of them, followed by part of a provider network on 6.

tierproviderat stakewhy
3COVENANT LIVING WEST
Santa Barbara, CA, ranked 2614
$0
  • Part of provider network D1-00075, ranked 75 nationally.
3SANTA BARBARA HOME HEALTH INC.
Santa Barbara, CA, ranked 3486
$0
  • Part of provider network D1-00039, ranked 39 nationally.
3SANTA BARBARA HOSPICE AND PALLIATIVE CARE INC
Santa Barbara, CA, ranked 4210
$0
  • Part of provider network D1-00039, ranked 39 nationally.
3MISSION PARK HEALTH CENTER LLC
Santa Barbara, CA, ranked 5823
$0
  • Part of provider network D1-00043, ranked 43 nationally.
3VALLEY OAKS POST ACUTE LLC
Santa Maria, CA, ranked 6889
$0
  • Part of provider network D1-00043, ranked 43 nationally.
3SANTA MARIA POST ACUTE LLC
Santa Maria, CA, ranked 7020
$0
  • Part of provider network D1-00043, ranked 43 nationally.
4JUAN GUZMAN
Santa Maria, CA, ranked 7332
$783K
  • Hours beyond a day in 1 month under one organization, which can be supervisory billing.
  • Records needed.
  • and 2 more
4SHANE ROSTERMUNDT
Santa Maria, CA, ranked 7522
$3.5M
  • Hours beyond a day in 41 months, but with up to 1812 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • and 1 more
All 25 in CA

Recent enforcement in CA

All releases

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

DOJPleaded guiltyAug 27, 2026
Anaheim Woman Pleads Guilty to Submitting More Than $2.2 Million in Fraudulent Hospice Care Claims to Medicare
Galbraith submitted approximately $2,266,694 in claims to Medicare for hospice services for beneficiaries who did not have a terminal illness with a life expectancy of six months or less, and Medicare paid her company approximately $2,140,606.
DOJCivil settlementAug 26, 2026
DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests
DermTech Inc. submitted claims to Medicare for skin cancer tests conducted with an unvalidated positive control range and for tests lacking sufficient patient RNA, and did not retract results or adequately refund Medicare.
DOJCivil settlementAug 26, 2026
DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests
DermTech Inc. billed Medicare for skin cancer tests conducted using an unvalidated positive control range and for tests with insufficient patient RNA, and did not retract the results or adequately refund Medicare.
DOJCivil settlementAug 24, 2026
Medicare Advantage Provider Monogram Health Agrees to Pay $2.4 Million to Settle False Claims Act Lawsuit
Monogram knowingly submitted diagnosis codes in four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to Medicare Advantage Organizations.
DOJCivil settlementAug 24, 2026
Medicare Advantage Provider Monogram Health Agrees to Pay $2.4M to Settle False Claims Act Suit
Monogram Health knowingly submitted diagnosis codes within four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to MAOs.

Referral packet

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