Providers
All 30 in CT
THEODORA FRASER MCPHERSON, PA
NPI 1992192827, individual, New Haven, CT, Physician Assistant
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 2 months, but with up to 726 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 99213 ($163 per patient-month) sit in the top 5% of every provider billing that code.
score 55 of 100, rank 7966, $397K 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.
| month | what was found | hours per day, lower bound | hours per day, at price | hours per day, conservative | per working day | patients | billing organizations | codes | paid |
|---|---|---|---|---|---|---|---|---|---|
| Apr 2018 | More hours than a day holds, even counting one unit per claim line | 25.3 | 16.6 | 11.1 | 15.8 | 697 | 1 | 99203 99214 | $55K |
| May 2018 | More hours than a day holds, even counting one unit per claim line | 26.5 | 17.1 | 11.4 | 15.4 | 726 | 1 | 99214 | $59K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | THEODORA FRASER MCPHERSON, PA |
| Type | Individual |
| Status | Active |
| NPI issued | April 17, 2015, last updated July 1, 2026 |
| Practice location | 151 CLIFTON ST, New Haven, CT 06513-3319, 203-469-3816 |
| Specialties | Physician Assistant (363A00000X, primary, license 3310 CT) |
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 | $720K | 46% | $95 | $60 (top 5% from $133) | 82nd percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $362K | 23% | $163 | $44 (top 5% from $110) | 98th percentile | |
| 95165 | Professional service for preparation and provision of 1 or more antigens | $119K | 8% | $394 | $187 (top 5% from $1K) | 83rd percentile | |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $88K | 6% | $147 | $95 (top 5% from $171) | 88th percentile | |
| 99402 | Preventive counseling individual 30 min | $55K | 4% | $65 | $36 (top 5% from $131) | 73rd percentile | |
| 80307 | Testing for presence of drug, by chemistry analyzers | $45K | 3% | $37 | $45 (top 5% from $110) | 40th percentile | |
| 95004 | Test for allergy using allergenic extract | $37K | 2% | $189 | $136 (top 5% from $315) | 72nd percentile | |
| 96127 | Assessment of emotional or behavioral problems | $35K | 2% | $20 | $4.12 (top 5% from $19) | 95th percentile |
In this area
30 providers in New Haven, CT carry an indicator in the public record, with $17.4M at stake between them. The most common is part of a provider network, on 12 of them, followed by more hours than a day holds on 11. 4 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | KATRIN MOSKOWITZ Waterbury, CT, ranked 169 | $63K |
|
| 1 | ANATOLY BRAYLOVSKY Wallingford, CT, ranked 488 | $0 |
|
| 1 | FAMILY PRACTICE OF GREATER NEW HAVEN, LLC Wallingford, CT, ranked 514 | $0 |
|
| 1 | LP COUNSELING SERVICES, LLC North Haven, CT, ranked 673 | $0 |
|
| 3 | TOTALITY HOME HEALTH CARE AGENCY, LLC Milford, CT, ranked 779 | $2.3M |
|
| 3 | WHITNEY MANOR OPERATING COMPANY LLC Hamden, CT, ranked 1451 | $35K |
|
| 3 | ADVANCED CENTER FOR NURSING & REHABILITATION LLC New Haven, CT, ranked 1471 | $27K |
|
| 3 | NEW HAVEN CENTER FOR NURSING & REHABILITATION, LLC New Haven, CT, ranked 1479 | $24K |
|
Recent enforcement in CT
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJCivil settlementJun 23, 2026
Connecticut Lab and its Owner Pay Over $145K to Settle Allegations of Medicaid Enrollment Fraud
Coastal Diagnostics and its owner made material misrepresentations in a Connecticut Medicaid Provider Enrollment Application by denying any relationship to another enrolled provider, Genco Lab, and then submitted claims for laboratory services.
DOJPleaded guiltyJun 23, 2026
Middletown Man Pleads Guilty to Operating Unlawful Money Transmitting Business
Habib registered a company and opened a bank account through which fraudulent claims were submitted to Medicare Advantage plans for durable medical equipment, including orthotics and braces, that beneficiaries did not request, consent to, or receive, and he wired proceeds to Pakistan without a money transmitting license.
DOJComplaint filedMay 22, 2026
APRN Charged with Defrauding Connecticut’s Medicaid Program
An APRN was charged with submitting fraudulent Medicaid claims for medication management services that were not provided, including for patients who had stopped seeing her or who were hospitalized, incarcerated, or deceased.
DOJSentencedApr 30, 2026
Cheshire Nurse Who Illegally Distributed Controlled Substances is Sentenced
An Advanced Practice Registered Nurse enrolled as a Medicare and Medicaid provider unlawfully distributed amphetamines and benzodiazepines to individuals without legitimate medical need, charging $200 cash for office visits, and Medicaid paid $287.58 for prescriptions written for an undercover agent.
DOJSentencedFeb 10, 2026
Bloomfield Man Sentenced to Federal Prison for Health Care Fraud
Tyson and Epps submitted fraudulent Medicaid claims for psychotherapy counseling sessions that were not provided, billed under Tyson's provider number for services purportedly provided by the suspended Epps, and Tyson provided fraudulent patient records during a Medicaid audit.
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.