EDGAR J EVANGELISTA, MD

NPI 1669693081, individual, Las Vegas, NV, 2084D0003X

Evidence tier

structure or single-organization volume

Hours beyond a day in 14 months, but with up to 517 patients a month across 4 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
Records needed.

score 51 of 100, rank 8570, $2.9M at stake

Hours billed per day

Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.

month	what was found	hours per day, lower bound	hours per day, at price	hours per day, conservative	per working day	patients	billing organizations	codes	paid
Jul 2018	More hours than a day holds, even counting one unit per claim line	37.9	38.4	25.6	36.0	261	2	90876 99214	$144K
Aug 2018	More hours than a day holds, even counting one unit per claim line	58.7	59.7	39.8	53.6	297	2	90876 99204 99213 99214	$225K
Sep 2018	More hours than a day holds, even counting one unit per claim line	82.8	66.8	44.5	66.8	497	3	90837 90876 99213 99214 H0004	$248K
Oct 2018	More hours than a day holds, even counting one unit per claim line	78.2	73.4	48.9	66.0	517	3	90837 90876 99213 99214 H0004	$304K
Nov 2018	More hours than a day holds, even counting one unit per claim line	65.2	73.2	48.8	66.6	500	2	90837 90876 99204 99213 99214 H0004	$280K
Dec 2018	More hours than a day holds, even counting one unit per claim line	62.6	69.4	46.3	68.3	512	2	90837 90876 99213 99214 H0004	$273K
Jan 2019	More hours than a day holds, even counting one unit per claim line	59.4	63.1	42.0	56.7	257	2	90876 99213 99214	$226K
Feb 2019	More hours than a day holds, even counting one unit per claim line	65.9	62.6	41.7	58.4	285	2	90837 90876 99213 H0004	$205K
Mar 2019	More hours than a day holds, even counting one unit per claim line	71.5	65.0	43.3	63.9	470	2	90837 90876 99203 99213 H0004	$254K
Apr 2019	More hours than a day holds, even counting one unit per claim line	57.7	58.3	38.9	53.0	407	2	90837 90876 99213 99214 H0004	$217K
May 2019	More hours than a day holds, even counting one unit per claim line	53.8	52.7	35.1	47.4	420	2	90837 90876 99213 99214 H0004	$202K
Jun 2019	More hours than a day holds, even counting one unit per claim line	36.8	37.8	25.2	37.8	201	2	90876 99213 99214	$131K
Jul 2019	More hours than a day holds, even counting one unit per claim line	43.9	24.7	16.4	22.2	247	2	90876 99213 99214	$89K
Aug 2019	More hours than a day holds, even counting one unit per claim line	32.1	15.1	10.1	14.2	363	4	90876 99213 99214	$55K

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	EDGAR J EVANGELISTA, MD
Type	Individual
Status	Active
NPI issued	May 2, 2007, last updated May 22, 2024
Practice location	2110 E FLAMINGO RD STE 201, Las Vegas, NV 89119-5192, 702-800-7831
Mailing address	1452 W HORIZON RIDGE PKWY # 566, Henderson, NV 89012-4422
Specialties	Psychiatry & Neurology, Diagnostic Neuroimaging (2084D0003X, license 12377 NV) Psychiatry & Neurology, Neurology (2084N0400X, license 12377 NV) (2084N0600X, primary, license 12377 NV)

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
90876	Psychophysiological therapy with biofeedback 45 min	$2.6M	79%	$772	$392 (top 5% from $816)	92nd percentile
H0004	Behavioral health counseling and therapy per 15 minhistory of abuse	$292K	9%	$340	$174 (top 5% from $559)	85th percentile
Q3014	Telehealth originating site facility fee	$109K	3%	$82	$21 (top 5% from $84)	95th percentile
90837	Psychotherapy, 1 hourhistory of abuse	$74K	2%	$114	$191 (top 5% from $442)	17th percentile
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	$59K	2%	$42	$44 (top 5% from $110)	47th percentile
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	$56K	2%	$62	$60 (top 5% from $133)	52nd percentile
95812	Measurement of brain wave activity (eeg), 41-60 minutes	$51K	2%	$237	$69 (top 5% from $513)	77th percentile
93306	Ultrasound of heart with color-depicted blood flow, rate, direction and valve function	$8K	0%	$119	$52 (top 5% from $244)	too few months to rank

Medicare Part B 2024, largest codes

code	what it is	services	beneficiaries	paid	submitted per service	allowed per service	charge to allowed	usual for this code
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	306	143	$20K	$300	$89	3.4x	2.2x (90th percentile 3.8x)
95886	Needle measurement of electrical activity in arm or leg muscles, complete study	106	41	$8K	$750	$94	8.0x	3.0x (90th percentile 6.3x)
99204	New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	63	63	$8K	$500	$161	3.1x	2.4x (90th percentile 3.9x)
95819	Measurement of brain wave activity (eeg), awake and asleep	22	22	$8K	$1K	$445	2.9x	2.8x (90th percentile 9.2x)
95887	Needle measurement of electrical activity in trunk or head muscles	53	41	$3K	$346	$81	4.3x	3.6x (90th percentile 9.1x)
95812	Measurement of brain wave activity (eeg), 41-60 minutes	12	12	$3K	$975	$343	2.8x	3.3x (90th percentile 10.9x)
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	34	31	$3K	$350	$125	2.8x	2.3x (90th percentile 3.8x)
95913	Nerve conduction, 13 or more studies	13	13	$3K	$1K	$278	3.6x	3.1x (90th percentile 6.6x)

A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.

In this area

338 providers in Clark County, NV carry an indicator in the public record, with $273.4M at stake between them. The most common is part of a provider network, on 167 of them, followed by more hours than a day holds on 151. 17 are tier 1: documented action, then payment.

tier	provider	at stake	why
1	TIMOTHY WILSON Las Vegas, NV, ranked 113	$192K	Listed on the Medicare revocation list since January 26, 2023. Medicaid still paid claims in 21 later months, $191,872 in total.
1	DEVONTE' CHRISTOPHER North Las Vegas, NV, ranked 175	$59K	Listed on the AZ Medicaid exclusion list since September 1, 2024. Medicaid still paid claims in 1 later month, $59,101 in total.
1	MANE SHAH Las Vegas, NV, ranked 205	$40K	Listed on the Medicare revocation list since August 16, 2018. Medicaid still paid claims in 15 later months, $40,126 in total.
1	JOHN MARIUS TOLENTINO Las Vegas, NV, ranked 254	$16K	Listed on the CA Medicaid exclusion list since December 2, 2022. Medicaid still paid claims in 5 later months, $16,415 in total.
1	DAVID ADAMS Las Vegas, NV, ranked 345	$3K	Listed on the CA Medicaid exclusion list since October 2, 2018. Medicaid still paid claims in 2 later months, $3,216 in total.
1	VICTOR BRUCE Las Vegas, NV, ranked 361	$2K	Listed on the OIG exclusion list and the NY Medicaid exclusion list and the SAM.gov exclusion list (OPM) since December 20, 2015. Medicaid still paid claims in 2 later months, $2,266 in total.
1	AMARA MEDICAL CENTER LLC Las Vegas, NV, ranked 457	$9	Listed on the Medicare revocation list since June 20, 2024. Medicaid still paid claims in 2 later months, $9 in total.
1	RODNESHIA CARTER North Las Vegas, NV, ranked 479	$0	Adjudicated (sentenced) per a state attorney general release dated December 9, 2024. No Medicaid payments in the last 12 observed months.

All 338 in NV

Recent enforcement in NV

All releases

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

DOJIndictedSep 24, 2025

Reno Doctor Arrested And Indicted For Health Care Fraud

An OB-GYN allegedly submitted false claims to Medicaid and private health plans for gynecologic tests and surgical procedures that were not medically necessary and falsified patients' medical records.

DOJPleaded guiltyJul 16, 2025

Nevada Nurse Practitioner Pleads Guilty To Fraudulent Medicare Wound Care Billing

A nurse practitioner admitted conspiring to fraudulently bill Medicare approximately $14,333,550 for amniotic wound allografts that were medically unnecessary and were procured through illegal kickbacks and bribes.

DOJChargedJun 30, 2025

U.S. Attorney's Office Participates In Record-Setting National Health Care Fraud Takedown

Two Las Vegas nurses were charged by information with conspiracy to defraud the United States and to pay and receive kickbacks for applying medically unnecessary amniotic wound allografts to Medicare beneficiaries and receiving kickbacks, with wound care companies billing Medicare over $94 million and approximately $14.3 million respectively.

DOJSentencedMay 1, 2024

Las Vegas Woman Sentenced To Prison For $1 Million Medicaid Fraud Scheme

Binford failed to disclose her criminal history to enroll her company Shepherd's Heart Services as a Nevada Medicaid provider and then submitted false bills for counseling services and training not rendered.

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.

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