Providers

PATRICK CONAN TAPIA, MD

NPI 1942462502, individual, Birmingham, AL, Psychiatry & Neurology, Psychiatry

4
Evidence tier
structure or single-organization volume
  • Hours beyond a day in 1 month under one organization, which can be supervisory billing.
  • Records needed.
  • Medicaid dollars per patient on code 99232 ($683 per patient-month) sit in the top 5% of every provider billing that code.
score 55 of 100, rank 7745, $1.5M 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
Jun 2020More hours than a day holds at a conservative unit price14.644.729.840.672199223 99233$59K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NamePATRICK CONAN TAPIA, MD
TypeIndividual, sole proprietor
StatusActive
NPI issuedJune 25, 2008, last updated May 21, 2025
Practice location100 CENTURY PARK S STE 102, Birmingham, AL 35226-3922, 205-381-4838
Specialties
Psychiatry & Neurology, Psychiatry (2084P0800X, primary, license 29809 AL)

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
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes$1.1M62%$683$96 (top 5% from $249)100th percentile
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes$361K20%$523$67 (top 5% from $174)100th percentile
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes$191K11%$299$81 (top 5% from $170)99th percentile
99239Hospital discharge day management, more than 30 minutes$74K4%$163$49 (top 5% from $101)100th percentile
99245Medicaid service code$39K2%$293$153 (top 5% from $281)96th percentile
99244Medicaid service code$8K0%$256$128 (top 5% from $223)too few months to rank
99214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$5K0%$63$60 (top 5% from $133)53rd percentile
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes$7550%$18$37 (top 5% from $103)too few months to rank

In this area

19 providers in Jefferson County, AL carry an indicator in the public record, with $17.7M at stake between them. The most common is more hours than a day holds, on 18 of them, followed by paid after a public list action on 1. 1 is tier 1: documented action, then payment.

tierproviderat stakewhy
1CARE COMPLETE MEDICAL CLINIC(CCMC)LLC
Birmingham, AL, ranked 313
$6K
  • Listed on the Medicare revocation list since August 14, 2018.
  • Medicaid still paid claims in 9 later months, $6,105 in total.
4WALDEMAR CARLO
Birmingham, AL, ranked 7796
$1.2M
  • Hours beyond a day in 1 month, but with up to 134 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • and 1 more
4SONYA PRITCHARD
Birmingham, AL, ranked 7800
$1.2M
  • Hours beyond a day in 6 months under one organization, which can be supervisory billing.
  • Records needed.
  • and 1 more
4LINDY WINTER
Birmingham, AL, ranked 7822
$1.1M
  • Hours beyond a day in 3 months, but with up to 117 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • and 1 more
4JOSEPH PHILIPS
Birmingham, AL, ranked 7901
$673K
  • Hours beyond a day in 1 month, but with up to 116 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • and 1 more
4JEGEN KANDASAMY
Birmingham, AL, ranked 7937
$505K
  • Hours beyond a day in 1 month, but with up to 116 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • and 1 more
4CHARITHARTH LAL
Birmingham, AL, ranked 7945
$485K
  • Hours beyond a day in 1 month, but with up to 113 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • and 1 more
4JESSE MARTINEZ
Birmingham, AL, ranked 8012
$243K
  • Hours beyond a day in 1 month, but with up to 149 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • and 1 more
All 19 in AL

Recent enforcement in AL

All releases

Department 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.

Ask this case

Answers come only from the evidence tables, and every sentence cites the record it used.