Providers
All 12 in MD
JOSE MARIO ORTEGA, M.D.
NPI 1952376634, individual, Kensington, MD, Pediatrics
5
Evidence tier
informational
score 32 of 100, rank 10731, $3.3M at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | JOSE MARIO ORTEGA, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | February 17, 2006, last updated February 17, 2016 |
| Practice location | 10901 CONNECTICUT AVE, STE. 100, Kensington, MD 20895-1645, 240-290-1041 |
| Specialties | Pediatrics (208000000X, primary, license D54919 MD) |
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 | |
|---|---|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $3.3M | 30% | $91 | $44 (top 5% from $110) | 92nd percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $1.0M | 9% | $131 | $60 (top 5% from $133) | 95th percentile | |
| 0241U | Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected | $856K | 8% | $146 | $113 (top 5% from $189) | 77th percentile | |
| 99393 | Medicaid service code | $603K | 5% | $100 | $78 (top 5% from $121) | 83rd percentile | |
| 99394 | Medicaid service code | $560K | 5% | $110 | $83 (top 5% from $128) | 85th percentile | |
| 99392 | Medicaid service code | $556K | 5% | $101 | $78 (top 5% from $124) | 83rd percentile | |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $524K | 5% | $60 | $28 (top 5% from $147) | 85th percentile | |
| 0240U | Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid-19), influenza a, and influenza b) in upper respiratory specimen, each reported as detected or not detected | $470K | 4% | $147 | $132 (top 5% from $205) | 66th percentile |
In this area
12 providers in Montgomery County, MD carry an indicator in the public record, with $11.8M at stake between them. The most common is more hours than a day holds, on 7 of them, followed by named in an enforcement record on 3. 3 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | ELIA TORRES Takoma Park, MD, ranked 25 | $14K |
|
| 1 | RICHARD O AKOTO MD PA Takoma Park, MD, ranked 510 | $0 |
|
| 1 | RICHARD AKOTO Takoma Park, MD, ranked 516 | $0 |
|
| 3 | ADVENTIST HOME HEALTH SERVICES INC Silver Spring, MD, ranked 1439 | $42K |
|
| 3 | SILVER SPRING HEALTH, LLC Silver Spring, MD, ranked 2862 | $0 |
|
| 3 | JEWISH SOCIAL SERVICE AGENCY Rockville, MD, ranked 4017 | $0 |
|
| 4 | NORMAN BALOG Silver Spring, MD, ranked 8407 | $5.1M |
|
| 4 | MANBIR TAKHAR Germantown, MD, ranked 8860 | $1.4M |
|
Recent enforcement in MD
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJCivil settlementMar 20, 2026
Health Care Management Corporation Agrees to Pay $4 Million to Resolve False Claims Act Allegations
CVR knowingly submitted claims to Medicare, Medicaid, and TRICARE for sclerotherapy, radiofrequency ablation, and endovenous laser ablation procedures to treat chronic venous insufficiency that were not clinically indicated and were medically unnecessary between January 1, 2010, and December 31, 2016.
DOJCivil settlementNov 20, 2025
Diagnostic Laboratory Agrees to Pay More Than $1 Million to Settle Alleged False Claims Act Violations
GTI agreed to pay $1.635 million to resolve allegations that it submitted Medicare claims for respiratory pathogen panels that were medically unnecessary or obtained through kickbacks paid under a marketing services agreement with an infection prevention company for laboratory test referrals from long-term care facilities.
DOJSentencedNov 13, 2025
Baltimore County Woman Sentenced for Impersonating Nurses and Aggravated Identity Theft
Amponsah used stolen nursing licenses and false educational and professional histories to obtain employment as a purported licensed nurse at no less than 40 facilities in Maryland that billed health care benefit programs including Medicare and Medicaid for services she provided, earning more than $145,000 in wages.
DOJPleaded guiltyAug 14, 2025
Baltimore County Woman Admits to Impersonating Nurses, Pleads Guilty to Aggravated Identity Theft
Amponsah used stolen nursing licenses and false educational and professional histories to obtain employment as a purported licensed nurse at no less than 40 facilities in Maryland, which billed health care benefit programs including Medicare and Medicaid for services she provided.
DOJCivil judgmentAug 11, 2025
United States Obtains More Than $1.4 Million Judgment Against Family Medical Practitioner for Fraudulent Billing
Akoto billed Medicare for auricular stimulation (P-Stim) devices using a code for a surgically implanted neurostimulator device, which Medicare does not reimburse as acupuncture.
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.