Providers
All 35 in OH
GREATER CINCINNATI PAIN MANAGEMENT
NPI 1619044005, organization, Cincinnati, OH, Anesthesiology, Pain Medicine
1
Evidence tier
documented action, then payment
- Listed on the KY Medicaid exclusion list since October 31, 2020.
- Medicaid still paid claims in 7 later months, $16,688 in total.
score 94 of 100, rank 253, $17K at stake
Paid after the action
Months in which Medicaid paid claims for this provider after a public action that should have triggered a screening check. This is a record of payments, not a determination that they were improper.
| list | identity check | action date | window closed | months paid after | first | last | paid after | 12 months before |
|---|---|---|---|---|---|---|---|---|
| KY Medicaid exclusion list state list extracted from https://chfs.ky.gov/agencies/dms/dpi/pe/documents/kymedicaidterminationlist.xlsx (pandas claude colmap) | Exact NPI, name verified | Oct 31, 2020 | still open | 7 | Nov 2020 | May 2021 | $17K | $63K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | GREATER CINCINNATI PAIN MANAGEMENT |
| Type | Organization |
| Status | Active |
| NPI issued | November 29, 2006, last updated November 2, 2016 |
| Practice location | 4243 HUNT RD, Cincinnati, OH 45242-6645, 513-794-5107 |
| Authorized official | MITCHELL SIMONS (physician-owner-president) |
| Specialties | Anesthesiology (207L00000X) Nurse Practitioner (363L00000X) Nurse Practitioner, Adult Health (363LA2200X) Anesthesiology, Pain Medicine (207LP2900X, primary) |
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 | |
|---|---|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $61K | 32% | $27 | $44 (top 5% from $110) | too few months to rank | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $50K | 26% | $47 | $60 (top 5% from $133) | too few months to rank | |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $25K | 13% | $68 | $95 (top 5% from $171) | too few months to rank | |
| 99152 | Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes | $15K | 8% | $20 | $9.26 (top 5% from $48) | too few months to rank | |
| 64483 | Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level | $14K | 7% | $67 | $150 (top 5% from $603) | too few months to rank | |
| 64484 | Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level | $11K | 6% | $59 | $59 (top 5% from $193) | too few months to rank | |
| 72275 | Medicaid service code | $6K | 3% | $15 | $34 (top 5% from $109) | too few months to rank | |
| J1040 | Injection, methylprednisolone acetate, 80 mg | $5K | 3% | $8.85 | $7.31 (top 5% from $17) | too few months to rank |
In this area
35 providers in Hamilton County, OH carry an indicator in the public record, with $18.2M at stake between them. The most common is part of a provider network, on 17 of them, followed by more hours than a day holds on 10. 2 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | MITCHELL SIMONS Cincinnati, OH, ranked 256 | $16K |
|
| 1 | ADVANCED SPINE & PAIN MANAGEMENT INC Cincinnati, OH, ranked 326 | $5K |
|
| 3 | HOSPICE OF SOUTHWEST OHIO, INC. Cincinnati, OH, ranked 932 | $4.0M |
|
| 3 | AFFINITY CARE OF OHIO LLC Cincinnati, OH, ranked 952 | $2.6M |
|
| 3 | EXCLUSIVE SERVICES Blue Ash, OH, ranked 1330 | $126K |
|
| 3 | WAYMON WALLACE Cincinnati, OH, ranked 1518 | $13K |
|
| 3 | NORTHSTAR HOME HOSPICE, LLC Cincinnati, OH, ranked 1967 | $0 |
|
| 3 | VERNON RAWLS Blue Ash, OH, ranked 2078 | $0 |
|
Recent enforcement in OH
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJCivil settlementJun 23, 2026
Ohio Dentist Agrees to Pay $500,000 to Resolve Allegations of Submitting False Claims to Medicaid
Meckler billed the Ohio Department of Medicaid for services provided by Ball, who was excluded from the Medicaid program, by listing Meckler as the rendering provider instead of Ball.
DOJSentencedJun 15, 2026
Ohio Doctor Ordered to Pay Nearly $1M for Facilitating Fraud on Medicare
A physician working as an independent contractor for a telemedicine company signed doctor's orders for durable medical equipment braces and genetic testing without meaningfully reviewing patient records or performing required in-person assessments, and those orders were used to bill Medicare more than $1,842,524.
DOJCivil settlementApr 2, 2026
Trinity Hospital Agrees to Pay $1.7M to Resolve Alleged Stark Law Violations
Trinity agreed to pay $1.7 million to resolve allegations that from 2014 through 2020 it made improper financial contributions to two referring physicians through office space rental arrangements that exceeded fair market value, in violation of the Stark Law.
DOJComplaint filedFeb 20, 2026
Justice Department Sues OhioHealth for Anticompetitive Healthcare Contracts That Increase Costs for Ohio Patients
The Justice Department and Ohio Attorney General filed a civil antitrust complaint alleging OhioHealth used its market power to impose contractual restrictions that prevent insurers from offering lower-cost health plans and limit access to price information.
DOJSentencedJan 14, 2026
Ohio Doctor Sentenced to Prison for $14M Healthcare Fraud Scheme
A licensed Ohio physician employed by two Florida telemedicine companies signed pre-completed orders for durable medical equipment and cancer genetic testing, falsely affirming he had examined the patients, causing more than $14.5 million in fraudulent Medicare claims.
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.