Providers
All 256 in FL
ALAN SWARTZ, MD
NPI 1649252677, individual, Miami, FL, Pediatrics
1
Evidence tier
documented action, then payment
- Listed on the Medicare revocation list since January 11, 2021.
- Medicaid still paid claims in 1 later month, $452 in total.
score 93 of 100, rank 419, $452 at stake
Public list actions
Medicare revocation effective January 11, 2021, barred from re-enrolling until January 11, 2031
424.535(a)(9) failure to report and 424.535(a)(3) felonies and 424.535(a)(2) provider or supplier conduct (exclusion), Order And Referring Only - Pediatric Medicine, FL
OIG exclusion August 18, 2022 under section 1128a4
Physician (MD, DO), Pediatrics, Sunny Isles Beach, FL
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 |
|---|---|---|---|---|---|---|---|---|
| Medicare revocation list 424.535(a)(9) failure to report and 424.535(a)(3) felonies and 424.535(a)(2) provider or supplier conduct (exclusion) | Exact NPI, name verified | Jan 11, 2021 | Jan 11, 2031 | 1 | Mar 2021 | Mar 2021 | $452 | $24K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | ALAN SWARTZ, MD |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | November 16, 2005, last updated June 21, 2011 |
| Practice location | 13550 N KENDALL DR, #160, Miami, FL 33186-1514, 305-385-7304 |
| Specialties | Pediatrics (208000000X, primary, license ME35970 FL) |
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 | |
|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $41K | 73% | $48 | $60 (top 5% from $133) | 34th percentile | |
| 96116 | Exam of neurobehavioral status, first hour | $8K | 14% | $47 | $59 (top 5% from $351) | 45th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $3K | 6% | $20 | $44 (top 5% from $110) | 16th percentile | |
| 99402 | Preventive counseling individual 30 min | $2K | 4% | $11 | $36 (top 5% from $131) | 17th percentile | |
| 90460 | Administration of first vaccine or toxoid component with counseling (18 years or younger) | $2K | 4% | $6.38 | $26 (top 5% from $54) | 16th percentile | |
| 90686 | Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage | $130 | 0% | $11 | $2.30 (top 5% from $20) | too few months to rank | |
| 99401 | Preventive counseling individual 15 min | $116 | 0% | $9.68 | $16 (top 5% from $46) | too few months to rank | |
| 99403 | Preventive counseling individual 45 min | $53 | 0% | $0.14 | $70 (top 5% from $161) | 11th percentile |
In this area
256 providers in Miami-Dade County, FL carry an indicator in the public record, with $454.5M at stake between them. The most common is more hours than a day holds, on 203 of them, followed by part of a provider network on 44. 5 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | ROSALVA ZEGARRA Hialeah, FL, ranked 424 | $302 |
|
| 1 | LARKIN BEHAVIOR HEALTH INC Hialeah Gardens, FL, ranked 501 | $0 |
|
| 1 | ABRH CARE INC Miami, FL, ranked 507 | $0 |
|
| 1 | DAVILA MEDICAL CENTER INC Miami, FL, ranked 649 | $0 |
|
| 1 | NEW BEHAVIOR HEALTH DIRECTION INC Miami, FL, ranked 683 | $0 |
|
| 2 | MARIA MACHADO Miami, FL, ranked 691 | $4.0M |
|
| 2 | MASSIEL MERLO-GOMEZ Miami, FL, ranked 740 | $387K |
|
| 3 | PRIMARY MEDICAL STAFFING, INC. Miami Lakes, FL, ranked 756 | $17.5M |
|
Recent enforcement in FL
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJPleaded guiltyAug 14, 2026
Ocala Mental Health Counselor Pleads Guilty to Aggravated Identity Theft and Wire Fraud
Forsythe used the names and insurance policy information of 22 individuals without their consent to bill two health insurance companies for counseling services she had not provided.
DOJConvictedAug 12, 2026
Cuban National Convicted of Unlawfully Obtaining US Citizenship After Concealing Healthcare Fraud Scheme
Rodriguez concealed on her naturalization application her participation in a seven-year healthcare fraud conspiracy that resulted in approximately $4.6 million in fraudulent healthcare claims.
DOJCivil settlementAug 3, 2026
Medicare Advantage Provider Complete Health to Pay $14,100,000 to Settle False Claims Act Suit
Complete Health caused the submission of diagnosis codes within HCC 55 and HCC 59 that were not clinically valid, not supported by medical records, and/or not considered in the beneficiary's care, increasing Medicare Advantage risk-adjusted payments from which it received a percentage.
DOJCivil settlementJul 31, 2026
Two Additional Ophthalmology Practices Agree to Pay $2.3M to Resolve Allegations of Fraudulent Claims to Medicare and Medicaid for Cranial Ultrasounds
Two ophthalmology practices billed Medicare and Medicaid for medically unnecessary trans-cranial doppler ultrasounds premised on false diagnoses, with one practice receiving remuneration from a third-party testing company to refer patients for the tests.
DOJCivil settlementJul 31, 2026
Two Additional Ophthalmology Practices Agree to Pay $2.3M to Resolve Allegations of Fraudulent Claims to Medicare and Medicaid for Cranial Ultrasounds
Two ophthalmology practices billed Medicare and Medicaid for medically unnecessary trans-cranial doppler ultrasounds premised on false diagnoses and, as to Floral Park Ophthalmology, resulting from remuneration paid by a third-party testing company to induce referrals.
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.