JOSEPH JOHN LEROY, LCSW

NPI 1760612204, individual, Tacoma, WA, Social Worker

Evidence tier

structure or single-organization volume

Hours beyond a day in 2 months, but with up to 430 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
Records needed.
77% of Medicaid dollars are on codes with a history of abuse.

score 53 of 100, rank 8216, $640K 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
Feb 2021	More hours than a day holds, even counting one unit per claim line	27.2	28.9	19.3	27.0	397	1	90791 90832 90834 90837 90847	$73K
Mar 2021	More hours than a day holds, even counting one unit per claim line	26.9	29.4	19.6	26.4	430	1	90791 90832 90834 90837 90847	$82K

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	JOSEPH JOHN LEROY, LCSW
Type	Individual
Status	Active
NPI issued	July 17, 2009, last updated March 12, 2013
Practice location	6424 N 9TH ST, Tacoma, WA 98406-2091, 253-565-4484
Mailing address	10210 MINTERWOOD DRIVE KP N, Gig Harbor, WA 98329-5091
Specialties	Social Worker (104100000X, primary)

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
90837	Psychotherapy, 1 hourhistory of abuse	$616K	77%	$224	$191 (top 5% from $442)	63rd percentile
90834	Psychotherapy, 45 minutes	$91K	11%	$110	$101 (top 5% from $318)	55th percentile
90847	Family psychotherapy with patient, 50 minutes	$36K	5%	$156	$130 (top 5% from $458)	63rd percentile
90791	Psychiatric diagnostic evaluation	$28K	4%	$98	$105 (top 5% from $228)	43rd percentile
90832	Psychotherapy, 30 minutes	$25K	3%	$62	$59 (top 5% from $239)	54th percentile

In this area

7 providers in Pierce County, WA carry an indicator in the public record, with $867K at stake between them. The most common is part of a provider network, on 6 of them, followed by more hours than a day holds on 1.

tier	provider	at stake	why
3	MULTICARE HEALTH SYSTEM Tacoma, WA, ranked 814	$121K	Part of provider network D1-00104, ranked 104 nationally. Medicaid dollars per patient on code Q5001 ($3334 per patient-month) sit in the top 5% of every provider billing that code.
3	WILDWOOD HEALTHCARE, INC. Puyallup, WA, ranked 834	$21K	Part of provider network D1-00104, ranked 104 nationally. Medicaid dollars per patient on code 94799 ($3440 per patient-month) sit in the top 5% of every provider billing that code.
3	MULTICARE HEALTH SYSTEM Tacoma, WA, ranked 1332	$125K	Part of provider network D1-00104, ranked 104 nationally.
3	HIGHLAND WELLNESSCARE, LLC Tacoma, WA, ranked 1647	$2K	Part of provider network D1-00009, ranked 9 nationally.
3	PNW HOSPICE, LLC Tacoma, WA, ranked 4705	$0	Part of provider network D1-00104, ranked 104 nationally.
3	AVALON HEALTHCARE - TACOMA, LLC Tacoma, WA, ranked 5729	$0	Part of provider network D1-00104, ranked 104 nationally.
5	KATHRYN BROWN Tacoma, WA, ranked 11165	$598K

Recent enforcement in WA

All releases

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

DOJSentencedMar 27, 2026

Local Physician Sentenced to 1 Year Imprisonment, a $60,000 fine, and Restitution of $349,272.79 for Adulterating and Misbranding Medical Devices with the Intent to Defraud

Haeger purchased over 500 used and recalled CPAP and BiPAP devices, had the sound abatement foam removed outside clean room conditions, provided the devices to Washington State Medicaid patients through his sleep clinic, and billed Medicaid representing them as new devices in good working order.

DOJCivil settlementJan 12, 2026

DOJ and Seattle-based FidaLab, LLC settle allegations it inflated bills to government health care programs

FidaLab billed Medicare for a series of urinary tract infection tests under multiple billing codes instead of a single code after its request to bill the tests as a panel was denied.

DOJPleaded guiltyDec 18, 2025

Local Physician Pleads Guilty to Adulterating and Misbranding Medical Devices with the Intent to Defraud

Physician purchased over 500 used and recalled CPAP and BiPAP devices, had the sound abatement foam removed outside of clean room conditions, provided the devices to Washington State Medicaid patients, and had staff bill Medicaid representing them as new devices in good working order.

DOJCivil settlementDec 10, 2025

Spokane Physician Pays $120,000 to Resolve Allegations He Prescribed Controlled Substances Without Legitimate Medical Purpose

Between 2017 and 2025 a licensed physician issued over 1,400 prescriptions for controlled substances to thirteen identified patients that lacked legitimate medical purposes or were outside the usual course of professional practice, failing to address red flags of substance abuse.

DOJSentencedDec 2, 2025

Indian national sentenced to prison for Medicare fraud scheme that stole more than $1 million in taxpayer funds

Asif conspired with others to bill Medicare for COVID-19 tests and other respiratory illness tests that had not been ordered or performed through American Labworks LLC.

Referral packet

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