Providers

JEFFREY M GALLUPS, M.D.

NPI 1851471866, individual, Alpharetta, GA, Specialist

1
Evidence tier
documented action, then payment
  • Listed on the Medicare revocation list since October 21, 2021.
  • Medicaid still paid claims in 3 later months, $61,386 in total.
  • Adjudicated (sentenced) per a Department of Justice release dated July 12, 2024.
score 95 of 100, rank 172, $61K at stake

Public list actions

Medicare revocation effective October 21, 2021, barred from re-enrolling until October 21, 2031
424.535(a)(9) failure to report and 424.535(a)(3) felonies, Practitioner - Otolaryngology, GA
OIG exclusion July 20, 2023 under section 1128a3
Physician (MD, DO), Otorhinolaryngology, Fort Lauderdale, FL

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.

listidentity checkaction datewindow closedmonths paid afterfirstlastpaid after12 months before
Medicare revocation list
424.535(a)(9) failure to report and 424.535(a)(3) felonies
Exact NPI, name verifiedOct 21, 2021Oct 21, 20313Nov 2021Jan 2022$61K$468K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameJEFFREY M GALLUPS, M.D.
TypeIndividual
StatusActive
NPI issuedOctober 16, 2006, last updated December 16, 2016
Practice location925 N POINT PKWY, Alpharetta, GA 30005-5210, 678-206-2589
Mailing address2365 OLD MILTON PKWY STE 300, Alpharetta, GA 30009-2140
Specialties
Specialist (174400000X, primary, license 033774 GA)

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
95165Professional service for preparation and provision of 1 or more antigens$590K100%$758$187 (top 5% from $1K)92nd percentile

In this area

11 providers in Fulton County, GA carry an indicator in the public record, with $15.3M at stake between them. The most common is more hours than a day holds, on 5 of them, followed by part of a provider network on 3. 2 are tier 1: documented action, then payment.

tierproviderat stakewhy
1RAJASHAKHER REDDY
Alpharetta, GA, ranked 151
$96K
  • Listed on the NY Medicaid exclusion list since September 6, 2011.
  • Medicaid still paid claims in 31 later months, $95,663 in total.
1ANAND LALAJI
Atlanta, GA, ranked 245
$19K
  • Listed on a Department of Justice release and the KY Medicaid exclusion list since November 16, 2023.
  • Medicaid still paid claims in 12 later months, $19,383 in total.
2SIGRID ELSTON
Atlanta, GA, ranked 686
$14.1M
  • Billed more hands-on hours than a day holds in 9 months, peaking at 31.4 hours per day across 3 billing organizations.
  • Medicaid dollars per patient on code 97153 ($11668 per patient-month) sit in the top 5% of every provider billing that code.
  • and 1 more
3CREATIVE HOSPICE CARE INC
Roswell, GA, ranked 2511
$0
  • Part of provider network D1-00051, ranked 51 nationally.
3AFFINITY CARE OF GEORGIA LLC
Atlanta, GA, ranked 3336
$0
  • Part of provider network D1-00113, ranked 113 nationally.
3RUTLEDGE MEDICAL ASSOCIATES LLC
East Point, GA, ranked 5925
$0
  • Charged (charged) per a Department of Justice release dated June 24, 2026, not adjudicated.
3ENNOBLE HOSPICE GA LLC
Sandy Springs, GA, ranked 7024
$0
  • Part of provider network D1-00103, ranked 103 nationally.
4PANCHAJANYA PAUL
Atlanta, GA, ranked 7929
$532K
  • Hours beyond a day in 1 month under one organization, which can be supervisory billing.
  • Records needed.
  • and 1 more
All 11 in GA

Recent enforcement in GA

All releases

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

DOJIndictedAug 24, 2026
Southern District of Georgia federal indictments include murder, drug- and firearm-related charges and healthcare fraud
Perry Patalano was indicted for Healthcare Fraud, Theft of Government Money, Property or Records, and Aggravated Identity Theft.
DOJChargedJun 24, 2026
Two Georgia Men Charged in National Health Care Fraud Takedown
Rutledge billed Georgia Medicaid for thousands of wound care, cyst removal, psychotherapy, and allergy testing services that were never performed, and Releford obtained nursing jobs by lying about his qualifications and stealing a licensed practical nurse's identity, causing providers to bill Medicare and Medicaid for services he could not legally perform.
DOJSentencedMay 4, 2026
Two Sentenced to Prison for $522M Genetic Testing Fraud and Illegal Kickback Scheme Targeting Medicare and Medicaid
Two men who controlled four laboratories paid kickbacks and bribes to marketers to obtain DNA samples and fraudulent requisition forms from medical providers, resulting in approximately $522 million in false claims for medically unnecessary genetic tests.
DOJPleaded guiltyApr 14, 2026
Behavioral therapist pleads guilty to health care fraud for submitting inflated insurance reimbursement claims
From June 2020 through May 2023, Stallings submitted false and fraudulent billing claims to TRICARE for individual and group therapy services that were not provided or were not provided as presented, and also obtained COVID-19 Economic Injury Disaster Loan funds that she spent on personal purposes.
DOJSentencedDec 2, 2025
Georgia Man Sentenced for $24M Kickback and Medicare Fraud Conspiracy
Moore instructed a network of recruiters to induce Medicare beneficiaries to accept medically unnecessary genetic tests, received approximately $4.3 million in kickbacks for referring beneficiary information, DNA specimens and doctors' orders, and concealed the payments with sham invoices.

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.

Ask this case

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