Providers

CHIMA O CHIONUMA, MD

NPI 1669437687, individual, Liverpool, NY, Pediatrics

5
Evidence tier
informational
  • Medicaid dollars per patient on code 99213 ($140 per patient-month) sit in the top 5% of every provider billing that code.
score 35 of 100, rank 9921, $3.0M at stake

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameCHIMA O CHIONUMA, MD
TypeIndividual, sole proprietor
StatusActive
NPI issuedApril 20, 2006, last updated July 8, 2007
Practice location7711 OSWEGO ROAD, Liverpool, NY 13090, 315-622-3155
Specialties
Pediatrics (208000000X, primary, license 1901291 NY)

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$2.9M44%$140$44 (top 5% from $110)97th percentile
99214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$967K15%$134$60 (top 5% from $133)95th percentile
99212Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more$561K9%$145$28 (top 5% from $147)95th percentile
99393Medicaid service code$505K8%$120$78 (top 5% from $121)95th percentile
99394Medicaid service code$372K6%$123$83 (top 5% from $128)94th percentile
90460Administration of first vaccine or toxoid component with counseling (18 years or younger)$350K5%$38$26 (top 5% from $54)75th percentile
99392Medicaid service code$306K5%$108$78 (top 5% from $124)90th percentile
99391Medicaid service code$194K3%$108$76 (top 5% from $126)90th percentile

In this area

6 providers in Onondaga County, NY carry an indicator in the public record, with $3.1M at stake between them. The most common is part of a provider network, on 3 of them, followed by more hours than a day holds on 3.

tierproviderat stakewhy
34800 BEAR ROAD OPERATING COMPANY LLC
Liverpool, NY, ranked 2428
$0
  • Part of provider network D1-00132, ranked 132 nationally.
3CPRNC, LLC
Syracuse, NY, ranked 5645
$0
  • Part of provider network D1-00091, ranked 91 nationally.
3VDRNC LLC
Syracuse, NY, ranked 6732
$0
  • Part of provider network D1-00091, ranked 91 nationally.
4FRANKIE QUARLES
Syracuse, NY, ranked 7654
$2.3M
  • Hours beyond a day in 2 months, but with up to 1809 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • and 1 more
5BILL HINES
Syracuse, NY, ranked 10168
$748K
  • Medicaid dollars per patient on code 99213 ($709 per patient-month) sit in the top 5% of every provider billing that code.
5ELIZABETH WILLIAMS
Syracuse, NY, ranked 11591
$125K

Recent enforcement in NY

All releases

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

DOJIndictedAug 20, 2026
Four Members Of The “War Room” Charged In Connection With $12 Million Medicaid Fraud Scheme
Members of a Bronx-based racketeering organization known as the "War Room" fabricated ride data for methadone clinic transportation using a GPS spoofing application, paid Medicaid patients kickbacks in cash and drugs for their enrollment information, provided the fake data to transportation companies that submitted over $12 million in claims to Medicaid, and laundered the proceeds.
DOJIndictedAug 20, 2026
Four Members of the “War Room” Charged in Connection with $12M Medicaid Fraud Scheme
Four members of a Bronx racketeering organization known as the "War Room" fabricated medical transportation ride data using a ride-tracking app and GPS spoofing, paid Medicaid patients at methadone clinics kickbacks in cash and drugs for their enrollment information, provided the fake data to transportation companies that submitted over $12 million in Medicaid claims, and laundered the proceeds.
DOJCivil settlementAug 17, 2026
Safire nursing homes agree to pay $9 million to resolve fraudulent Medicare and Medicaid billing allegations
The United States alleged that Safire submitted false claims to Medicare and Medicaid for skilled rehabilitative therapy services that were not reasonable or necessary, not supported by medical records, not documented as provided, or not provided at all, including by scheduling therapy based on insurer reimbursement policies, pressuring therapists and residents, and manufacturing or altering therapy referrals and medical records.
DOJSentencedJul 21, 2026
Owner of Long Island Ambulette Services Company Sentenced to Prison for Multimillion Dollar Healthcare Fraud Scheme
Arshad and co-conspirators paid kickbacks to Medicaid beneficiaries to order transportation through his companies and billed Medicaid over $19 million for medical transportation rides that were not provided, including for individuals who were deceased, hospitalized or incarcerated, and inflated reimbursements with false pickup addresses and distant treatment centers.
DOJIndictedJul 2, 2026
Two Defendants Charged with Multi-Million Dollar Health Care Fraud Scheme
The defendants, who owned and operated Tri-Hamlet Taxi Inc., allegedly paid kickbacks to Medicaid beneficiaries and submitted more than $35 million in claims to Medicaid for ambulette trips that were not provided or whose costs were inflated by using false pickup or drop-off addresses.

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.