Providers
All 38 in CA
JAMES YUEN KUEN YIP, M.D.
NPI 1619929429, individual, Modesto, CA, Obstetrics & Gynecology
1
Evidence tier
documented action, then payment
- Listed on the CA Medicaid exclusion list since February 12, 2021.
- Medicaid still paid claims in 1 later month, $22,621 in total.
score 94 of 100, rank 237, $23K 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 |
|---|---|---|---|---|---|---|---|---|
| CA Medicaid exclusion list ca medi-cal suspended & ineligible provider list (july 2026) | Exact NPI, name verified | Feb 12, 2021 | still open | 1 | Mar 2021 | Mar 2021 | $23K | $583K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | JAMES YUEN KUEN YIP, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | May 17, 2006, last updated July 13, 2026 |
| Practice location | 1552 COFFEE RD, Modesto, CA 95355-3107, 209-521-4372 |
| Specialties | Obstetrics & Gynecology (207V00000X, primary, license G41324 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 | |
|---|---|---|---|---|---|---|---|
| T1015 | Medicaid service code | $1.9M | 64% | $180 | $182 (top 5% from $488) | 49th percentile | |
| 59425 | Medicaid service code | $286K | 9% | $100 | $90 (top 5% from $160) | 63rd percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $234K | 8% | $35 | $44 (top 5% from $110) | 35th percentile | |
| J3490 | Unclassified drugs | $100K | 3% | $74 | $4.55 (top 5% from $108) | 93rd percentile | |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $87K | 3% | $34 | $28 (top 5% from $147) | 62nd percentile | |
| 76813 | Medicaid service code | $74K | 2% | $125 | $79 (top 5% from $137) | 89th percentile | |
| 76805 | Ultrasound scan of pregnant uterus (14 weeks or more), single or first fetus | $61K | 2% | $102 | $82 (top 5% from $153) | 69th percentile | |
| 76801 | Ultrasound scan of pregnant uterus (less than 14 weeks), single or first fetus | $49K | 2% | $85 | $63 (top 5% from $142) | 69th percentile |
In this area
38 providers in Stanislaus County, CA carry an indicator in the public record, with $35.0M at stake between them. The most common is more hours than a day holds, on 23 of them, followed by part of a provider network on 14. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | JEROME ROBSON Modesto, CA, ranked 298 | $8K |
|
| 3 | SUTTER VISITING NURSE ASSOCIATION AND HOSPICE Salida, CA, ranked 782 | $1.8M |
|
| 3 | COVENANT HOME SERVICES Turlock, CA, ranked 1260 | $246K |
|
| 3 | GLOBAL HEALTH CARE SERVICES LLC Modesto, CA, ranked 1361 | $94K |
|
| 3 | VISTA DEL SOL POSTACUTE CARE Ceres, CA, ranked 1952 | $0 |
|
| 3 | COVENANT HOME SERVICES Turlock, CA, ranked 2873 | $0 |
|
| 3 | TRACY RIDGE HEALTHCARE, INC. Turlock, CA, ranked 3808 | $0 |
|
| 3 | AVALON CARE CENTER-NEWMAN LLC Newman, CA, ranked 3839 | $0 |
|
Recent enforcement in CA
All releasesDepartment 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
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.