Providers

SAMUEL WERZBERGER, M.D.

NPI 1801278395, individual, Monroe, NY, Pediatrics

4
Evidence tier
structure or single-organization volume
  • Hours beyond a day in 2 months, but with up to 1856 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
score 51 of 100, rank 9038, $852K 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.

monthwhat was foundhours per day, lower boundhours per day, at pricehours per day, conservativeper working daypatientsbilling organizationscodespaid
Jan 2019More hours than a day holds, even counting one unit per claim line24.325.216.822.61849199202 99203 99204 99212 99213 99214$114K
Feb 2019More hours than a day holds, even counting one unit per claim line28.429.819.927.81856199202 99203 99204 99212 99213 99214$117K
Dec 2021More hours than a day holds, even counting one unit per claim line32.741.727.837.42042199203 99204 99211 99212 99213 99214$155K
Jan 2022More hours than a day holds, even counting one unit per claim line27.038.425.637.81699199203 99211 99212 99213 99214$136K
Feb 2022More hours than a day holds, even counting one unit per claim line24.133.222.131.01413199203 99212 99213 99214$107K
Nov 2022More hours than a day holds, even counting one unit per claim line24.636.524.333.11533199203 99211 99212 99213 99214$127K
Dec 2022More hours than a day holds, even counting one unit per claim line30.944.129.441.51911199203 99212 99213 99214$157K
Jan 2023More hours than a day holds, even counting one unit per claim line27.040.326.937.91758199203 99211 99212 99213 99214$143K
Feb 2023More hours than a day holds, even counting one unit per claim line29.844.930.041.91778199203 99212 99213 99214$144K
Mar 2023More hours than a day holds, even counting one unit per claim line27.141.227.537.01787199203 99212 99213 99214 99441$147K
May 2023More hours than a day holds, even counting one unit per claim line30.137.625.133.81693199203 99212 99213 99214 99441$135K
Jun 2023More hours than a day holds, even counting one unit per claim line28.040.026.736.41735199203 99212 99213 99214 99441$139K
Jul 2023More hours than a day holds, even counting one unit per claim line32.742.828.542.11913199203 99212 99213 99214 99441$153K
Aug 2023More hours than a day holds, even counting one unit per claim line30.039.226.135.21764199203 99212 99213 99214 99441$139K
Sep 2023More hours than a day holds, even counting one unit per claim line25.635.924.034.21599199203 99212 99213 99214 99441$124K
Oct 2023More hours than a day holds, even counting one unit per claim line25.634.923.232.71610199203 99212 99213 99214 99441$125K
Nov 2023More hours than a day holds, even counting one unit per claim line38.956.337.551.22320199203 99212 99213 99214 99441$194K
Dec 2023More hours than a day holds, even counting one unit per claim line34.451.534.350.72205199203 99204 99212 99213 99214 99441$183K
Jan 2024More hours than a day holds, even counting one unit per claim line43.257.438.351.62516199203 99204 99212 99213 99214$204K
Feb 2024More hours than a day holds, even counting one unit per claim line37.845.030.041.51953199203 99204 99212 99213 99214$150K
Mar 2024More hours than a day holds, even counting one unit per claim line35.842.428.341.71962199203 99204 99212 99213 99214$151K
Apr 2024More hours than a day holds, even counting one unit per claim line26.336.724.533.31647199203 99212 99213 99214$127K
May 2024More hours than a day holds, even counting one unit per claim line26.841.827.937.51835199203 99212 99213 99214$151K
Jul 2024More hours than a day holds at a conservative unit price22.836.424.232.71600199212 99213 99214 99441$131K
Sep 2024More hours than a day holds, even counting one unit per claim line28.338.325.536.41622199203 99212 99213 99214 99441$133K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameSAMUEL WERZBERGER, M.D.
TypeIndividual
StatusActive
NPI issuedJune 22, 2015, last updated June 22, 2015
Practice location22 VAN BUREN DR, SUITE 102, Monroe, NY 10950-6018, 845-783-2222
Specialties
Pediatrics (208000000X, primary, license 280539 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$5.3M44%$75$44 (top 5% from $110)86th percentile
99214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$1.2M10%$91$60 (top 5% from $133)79th percentile
99203New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more$767K6%$74$67 (top 5% from $121)60th percentile
99392Medicaid service code$635K5%$80$78 (top 5% from $124)54th percentile
99391Medicaid service code$505K4%$73$76 (top 5% from $126)46th percentile
90460Administration of first vaccine or toxoid component with counseling (18 years or younger)$364K3%$24$26 (top 5% from $54)46th percentile
87880Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)$360K3%$11$12 (top 5% from $18)43rd percentile
99204New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more$267K2%$104$95 (top 5% from $171)59th percentile
Medicare Part B 2024, largest codes
codewhat it isservicesbeneficiariespaidsubmitted per serviceallowed per servicecharge to allowedusual for this code
99203New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more1817$1K$350$1173.0x2.4x (90th percentile 3.9x)
99213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more3025$1K$250$962.6x2.2x (90th percentile 3.8x)
99214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more1212$831$316$1342.4x2.3x (90th percentile 3.8x)
87804Detection test by immunoassay with direct visual observation for influenza virus2814$454$78$164.8x2.5x (90th percentile 3.9x)
87426Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus1212$415$160$354.6x2.8x (90th percentile 4.4x)
87880Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)1211$194$75$164.6x2.6x (90th percentile 4.1x)

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

14 providers in Orange County, NY carry an indicator in the public record, with $12.6M at stake between them. The most common is more hours than a day holds, on 10 of them, followed by paid after a public list action on 4. 1 is tier 1: documented action, then payment.

tierproviderat stakewhy
1PAUL FELDMAN
Newburgh, NY, ranked 23
$25K
  • Listed on the Medicare revocation list since January 24, 2024.
  • Medicaid still paid claims in 3 later months, $25,159 in total.
  • and 1 more
4TANISHA CASTELLANOS
Goshen, NY, ranked 7303
$2.5M
  • Hours beyond a day in 9 months, but with up to 734 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • and 2 more
4LAZAR KHAIMOV
Monroe, NY, ranked 7526
$3.4M
  • Hours beyond a day in 1 month, but with up to 1246 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • and 1 more
4TZVI FARKAS
Monroe, NY, ranked 8048
$157K
  • Hours beyond a day in 5 months, but with up to 2975 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • and 1 more
4YITZCHOK SCHLAFRIG
Monroe, NY, ranked 9014
$921K
  • Hours beyond a day in 3 months, but with up to 177 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
4SAMUEL WEISER
Monroe, NY, ranked 9193
$536K
  • Hours beyond a day in 2 months under one organization, which can be supervisory billing.
  • Records needed.
4OSA GUOBADIA
Middletown, NY, ranked 9692
$27K
  • Hours beyond a day in 1 month, but with up to 199 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
5ERROL YOUNG
Warwick, NY, ranked 10206
$641K
  • Medicaid dollars per patient on code 97140 ($154 per patient-month) sit in the top 5% of every provider billing that code.
All 14 in NY

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

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