Providers
TOMMIE MATTHEW ROBINSON, M.D.
NPI 1790929222, individual, Owens Cross Roads, AL, Family Medicine
1
Evidence tier
adjudicated in a public enforcement record
- Adjudicated (charged, pleaded guilty, sentenced) per a Department of Justice release dated August 18, 2025.
- Medicaid paid $33,068 in the last 12 observed months.
score 95 of 100, rank 217, $33K at stake
Public list actions
Medicare revocation effective October 1, 2025, barred from re-enrolling until October 1, 2035
424.535(a)(9) failure to report and 424.535(a)(3) felonies, Practitioner - Family Practice, AL
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | TOMMIE MATTHEW ROBINSON, M.D. |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | April 28, 2009, last updated October 4, 2019 |
| Practice location | 3217 COVE LAKE RD SE, Owens Cross Roads, AL 35763, 256-203-4006 |
| Mailing address | 6275 UNIVERSITY DR NW STE 37-506, Huntsville, AL 35806-1776 |
| Specialties | Family Medicine (207Q00000X, primary, license MD.30885 AL) Student in an Organized Health Care Education/Training Program (390200000X) |
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 | $431K | 56% | $99 | $60 (top 5% from $133) | 84th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $100K | 13% | $62 | $44 (top 5% from $110) | 74th percentile | |
| 99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or morehistory of abuse | $37K | 5% | $121 | $88 (top 5% from $210) | 72nd percentile | |
| 99393 | Medicaid service code | $35K | 5% | $69 | $78 (top 5% from $121) | 40th percentile | |
| 99392 | Medicaid service code | $21K | 3% | $69 | $78 (top 5% from $124) | 38th percentile | |
| 99394 | Medicaid service code | $20K | 3% | $69 | $83 (top 5% from $128) | 38th percentile | |
| 99391 | Medicaid service code | $16K | 2% | $70 | $76 (top 5% from $126) | 40th percentile | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $10K | 1% | $89 | $67 (top 5% from $121) | 77th percentile |
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 |
|---|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 134 | 114 | $11K | $287 | $114 | 2.5x | 2.3x (90th percentile 3.8x) |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | 21 | 21 | $2K | $255 | $151 | 1.7x | 2.4x (90th percentile 3.9x) |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 20 | 20 | $1K | $62 | $50 | 1.2x | 2.4x (90th percentile 3.7x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 24 | 24 | $782 | $143 | $82 | 1.7x | 2.2x (90th percentile 3.8x) |
| 96372 | Injection of drug or substance under skin or into muscle | 72 | 61 | $624 | $38 | $12 | 3.0x | 3.6x (90th percentile 6.4x) |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 34 | 17 | $551 | $36 | $16 | 2.2x | 2.5x (90th percentile 3.9x) |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | 14 | 14 | $487 | $180 | $100 | 1.8x | 2.4x (90th percentile 3.9x) |
| J0702 | Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg | 37 | 36 | $190 | $15 | $7 | 2.2x | 2.4x (90th percentile 5.0x) |
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
2 providers in Madison County, AL carry an indicator in the public record, with $440K at stake between them. The most common is named in an enforcement record, on 1 of them, followed by more hours than a day holds on 1. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | FRANCENE GAYLE Huntsville, AL, ranked 672 | $0 |
|
| 4 | VENKATA DEVABHAKTUNI Huntsville, AL, ranked 9246 | $440K |
|
Recent enforcement in AL
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJCivil settlementJun 23, 2026
Alabama Provider Pays $300,000 to Resolve False Claims as Part of 2026 National Health Care Fraud Takedown
A Phenix City-based provider billed Alabama Medicaid for Basic Living Skills services for at-risk children that were not actually rendered.
DOJSentencedApr 2, 2026
Former Medicaid Provider Sentenced to Federal Prison for Health Care Fraud and Aggravated Identity Theft
Pulliam, a child and family therapist enrolled as an Alabama Medicaid provider, submitted claims for counseling services that were never provided using beneficiaries' identifying information without consent.
DOJCivil judgmentMar 19, 2026
Mississippi Man Ordered to Pay $31 Million for Role in Healthcare Kickback Scheme
Crites and others referred patients, primarily TRICARE beneficiaries, to Cloverland Pharmacy in exchange for kickbacks paid by the pharmacy for each referral.
DOJCivil settlementFeb 21, 2025
Saad Healthcare Agrees to Pay $3M to Settle False Claims Act Allegations That It Billed Medicare for Ineligible Hospice Patients
Saad submitted, or caused the submission of, false claims to Medicare between 2013 and 2020 for 21 hospice patients who were not terminally ill and thus ineligible for the Medicare hospice benefit.
DOJCivil settlementFeb 21, 2025
Saad Healthcare Agrees to Pay $3M to Settle False Claims Act Allegations That It Billed Medicare for Ineligible Hospice Patients
Saad Healthcare submitted, or caused the submission of, false claims to Medicare between 2013 and 2020 for 21 hospice patients who were not terminally ill and were ineligible for the Medicare hospice benefit.
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.