Providers

BENJAMIN F. SANFORD, M.D.

NPI 1629042304, individual, Starkville, MS, Internal Medicine

1
Evidence tier
documented action, then payment
  • Listed on the Medicare revocation list since January 26, 2021.
  • Medicaid still paid claims in 3 later months, $5,278 in total.
score 94 of 100, rank 320, $5K at stake

Public list actions

Medicare revocation effective January 26, 2021, barred from re-enrolling until January 26, 2031
424.535(a)(9) failure to report and 424.535(a)(3) felonies, Practitioner - Internal Medicine, MS
OIG exclusion August 18, 2022 under section 1128a1
Physician (MD, DO), Rheumatology, Starkville, MS

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.

listidentity checkaction datewindow closedmonths paid afterfirstlastpaid after12 months before
Medicare revocation list
424.535(a)(9) failure to report and 424.535(a)(3) felonies
Exact NPI, name verifiedJan 26, 2021Jan 26, 20313Feb 2021Apr 2021$5K$8K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameBENJAMIN F. SANFORD, M.D.
TypeIndividual
StatusActive
NPI issuedFebruary 17, 2006, last updated April 22, 2009
Practice location107 BRANDON RD, Starkville, MS 39759-2521, 662-324-1291
Specialties
Internal Medicine (207R00000X, primary, license 8043 MS)

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
99213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$24K36%$20$44 (top 5% from $110)16th percentile
99283Emergency department visit with low level of medical decision making$8K11%$49$60 (top 5% from $193)37th percentile
36415Insertion of needle into vein for collection of blood sample$5K7%$4.00$1.97 (top 5% from $12)82nd percentile
94681Test to measure exhaled air and carbon dioxide for evaluation of lung function$4K6%$12too few months to rank
94375Test to measure rate of airflow$4K6%$11$22 (top 5% from $69)22nd percentile
94200Test to measure largest amount of air breathed in an out$3K5%$10.00$8.36 (top 5% from $35)59th percentile
99284Emergency department visit with moderate level of medical decision making$3K5%$74$86 (top 5% from $224)too few months to rank
94726Test to determine lung volumes using sensors$3K4%$13$14 (top 5% from $75)47th percentile

In this area

2 providers in Oktibbeha County, MS carry an indicator in the public record, with $491K at stake between them. The most common is more hours than a day holds, on 2 of them.

tierproviderat stakewhy
4CATHERINE FANDEL
Starkville, MS, ranked 9371
$283K
  • Hours beyond a day in 6 months under one organization, which can be supervisory billing.
  • Records needed.
4KAREN ROBERSON
Starkville, MS, ranked 9462
$207K
  • Hours beyond a day in 3 months under one organization, which can be supervisory billing.
  • Records needed.

Recent enforcement in MS

All releases

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

DOJSentencedJun 30, 2026
Madison Man Sentenced to 30 Months in Federal Prison for Role in Medicare Kickback Conspiracy
Smith, a marketer for diagnostic laboratories, solicited and received kickbacks from laboratories in exchange for referrals of specimens and orders for molecular diagnostic testing of toenails and paid kickbacks to providers to induce those referrals, resulting in over $1.4 million in claims to Medicare.
DOJSentencedJun 29, 2026
Two Corinth Pharmacists Sentenced for Conspiracy to Commit Healthcare Fraud
Two pharmacists billed Medicare and Medicaid for the same single prescription drug product numerous times, including diabetic insulin pens, asthma inhalers and psychotropic medications.
DOJSentencedMay 8, 2026
Former NFL Player Sentenced to Over 16 Years in Prison for $197M Medicare Fraud
French worked with overseas call centers to obtain patient information, paid kickbacks to sham telemedicine companies for signed doctors' orders for orthotic braces, sold the orders to marketers and supply companies, and billed Medicare and CHAMPVA through eight DME companies he owned using straw owners.
DOJPleaded guiltyNov 20, 2025
Mississippi Businessman Pleads Guilty to $19M Health Care Fraud Conspiracy
Gibbs paid kickbacks for fraudulent doctors' orders and used them to bill Medicare over $19 million for medically unnecessary orthotic braces through seven durable medical equipment supply companies he owned or controlled, sometimes through straw owners.
DOJCivil settlementAug 22, 2025
MISSISSIPPI MEDICAID RECIPIENTS AGREE TO PAY OVER $170,000 TO RESOLVE FALSE CLAIMS ACT ALLEGATIONS OF HEALTH CARE BENEFITS FRAUD
Former Medicaid recipients allegedly falsified their income on Mississippi Medicaid applications and renewals to create eligibility for health care benefits for their dependents.

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.

Ask this case

Answers come only from the evidence tables, and every sentence cites the record it used.