Providers
CELIA R ZUNIGA, Nurse Practictioner
NPI 1689862682, individual, Rio Grande City, TX, Nurse Practitioner, Family
1
Evidence tier
documented action, then payment
- Listed on the Medicare revocation list since February 26, 2014.
- Medicaid still paid claims in 5 later months, $18,657 in total.
score 94 of 100, rank 249, $19K at stake
Public list actions
Medicare revocation effective February 26, 2014, barred from re-enrolling until August 10, 2032
424.535(a)(4) false or misleading information and 424.535(a)(3) felonies, Practitioner - Nurse Practitioner, TX
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)(4) false or misleading information and 424.535(a)(3) felonies | Exact NPI, name verified | Feb 26, 2014 | Aug 10, 2032 | 5 | Feb 2022 | Jun 2022 | $19K | $0 |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | CELIA R ZUNIGA, Nurse Practictioner |
| Type | Individual |
| Status | Active |
| NPI issued | October 4, 2007, last updated November 3, 2021 |
| Practice location | 2790 PHARMACY RD STE B, Rio Grande City, TX 78582-6547, 956-487-7561 |
| Specialties | Nurse Practitioner, Family (363LF0000X, license 654527 TX) Nurse Practitioner, Family (363LF0000X, primary, license AP115760 TX) |
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 | $15K | 79% | $120 | $182 (top 5% from $488) | too few months to rank | |
| 80050 | Medicaid service code | $2K | 10% | $60 | $34 (top 5% from $146) | too few months to rank | |
| 82306 | Vitamin d-3 level | $1K | 6% | $39 | $20 (top 5% from $40) | too few months to rank | |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | $500 | 3% | $17 | $9.74 (top 5% from $20) | too few months to rank | |
| 84439 | Thyroxine (thyroid chemical), free | $375 | 2% | $12 | $7.30 (top 5% from $20) | too few months to rank | |
| 96161 | Administration and interpretation of caregiver-focused health risk assessment | $0 | 0% | $0.00 | $3.04 (top 5% from $18) | too few months to rank |
In this area
5 providers in Starr County, TX carry an indicator in the public record, with $4.5M at stake between them. The most common is more hours than a day holds, on 5 of them.
| tier | provider | at stake | why |
|---|---|---|---|
| 4 | DARIA BABINEAUX Rio Grande City, TX, ranked 8798 | $1.7M |
|
| 4 | ARTEMIO GARCIA Rio Grande City, TX, ranked 9393 | $269K |
|
| 5 | MARIO RODRIGUEZ Rio Grande City, TX, ranked 10059 | $1.3M |
|
| 5 | MARIA VALDEZ Roma, TX, ranked 10944 | $1.2M | |
| 5 | YVETTE BELTRAN DBA LOS GIRASOLES ADULT DAY Rio Grande City, TX, ranked 11838 | $28K |
Recent enforcement in TX
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJCivil settlementAug 26, 2026
Dallas medical clinic to pay $7.5 million to resolve COVID-19 testing overbilling allegations
Aymancare billed the federal government's HRSA Uninsured Program for separate evaluation and management services in addition to COVID-19 specimen collection and testing at pop-up testing sites when no such separate services were performed.
DOJConvictedAug 12, 2026
Scammer pharmacist guilty in $20 million healthcare kickback scheme
Thomas paid over $2 million in kickbacks to the owner of a Houston clinic in exchange for referrals of DOL-OWCP insured patients prescribed high-reimbursement compounded medications, which his pharmacy then billed to DOL-OWCP, receiving more than $20 million in reimbursements.
DOJIndictedJun 24, 2026
U.S. Attorney Announces Major Health Care Fraud Cases in Western District of Texas
Charles is alleged to have received illegal kickbacks for referring patients to San Antonio area hospice companies, causing over $9 million in Medicare claims, while Dr. Duncan settled allegations of billing Medicare and TRICARE for an unapproved amniotic-based product and Trevor's Place settled allegations of submitting inflated TRICARE claims for services not provided.
DOJIndictedJun 23, 2026
Nine charged in SDTX as part of national health care fraud takedown
Nine defendants were indicted in the Southern District of Texas for operating pill mill clinics and a pharmacy that unlawfully distributed controlled substances, billing Medicaid $16 million for mental health services for minors that did not occur, and billing Medicare and TRICARE approximately $906 million for medically unnecessary amniotic wound allografts procured through kickbacks.
DOJChargedJun 23, 2026
Northern District of Texas Charges 13 Health Care Fraudsters for Loss Over $360 Million
Thirteen defendants in the Northern District of Texas were charged in seven cases involving more than $365 million in fraudulent billing to federally-funded programs and other insurers, including laboratory and genetic testing claims procured through kickbacks, transcranial magnetic stimulation treatments billed to TRICARE, medically unnecessary EEG testing, and hospice services never provided.
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.