Clinic
Puerto Rican Organization to Motivate Enlighten and Serve Addicts, INC
Puerto Rican Organization to Motivate Enlighten and Serve Addicts, INC was paid $23.48M by Medicaid between Jan 2019 and Dec 2024, across 24 billing codes. Its largest line is H0020, Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) — 75% of everything it billed.
33Billing provider infoPUERTO RICAN ORGANIZATION TO MOTIVATE ENLIGHTEN AND SERVE ADDICTS, INC
BRONX, NY 10457
BRONX, NY 10457
33aNPI1407034614assigned 02/11/2008
33bProvider typeSubstance Use Disorder Rehabilitation Clinic/Center
28Total paid$23.48M
24GClaims658,052
24DCodes billed24
24AFirst – last monthJan 2019 – Dec 2024
Compared with peers
Next to other Substance Use Disorder Rehabilitation Clinic/Center providers in New York
Rank by total paid#5 of 64
Median peer was paid$2.18M
This provider vs. median11×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official GATELL, VICKY controls 14+ related entities in our dataset. Read more
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2019 | 45,090 | $1.56M | |
| 2020 | 148,851 | $4.46M | |
| 2021 | 158,400 | $5.05M | |
| 2022 | 127,109 | $5.16M | |
| 2023 | 120,044 | $5.01M | |
| 2024incomplete | 58,558 | $2.24M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | 75% | 597,252 | 28,157 | $17.58M |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 11% | 18,852 | 13,028 | $2.57M |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 5.7% | 12,656 | 9,193 | $1.33M |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.8% | 4,980 | 3,682 | $649K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1.7% | 3,172 | 2,658 | $403K |
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatment program) | <1% | 4,999 | 1,620 | $182K |
| H0005 | Alcohol and/or drug services; group counseling by a clinician | <1% | 3,249 | 966 | $172K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | <1% | 3,446 | 2,828 | $164K |
| G2078 | Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure | <1% | 4,560 | 1,437 | $102K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 890 | 884 | $98K |
| H0038 | Self-help/peer services, per 15 minutes | <1% | 2,651 | 1,842 | $84K |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | <1% | 412 | 408 | $66K |
12 more codes
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 212 | $29K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 135 | $17K |
| 99386 | <1% | 113 | $11K | |
| 99407 | <1% | 241 | $9K | |
| H0049 | Alcohol and/or drug screening | <1% | 96 | $5K |
| H0001 | Alcohol and/or drug assessment | <1% | 14 | $2K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 12 | $1K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 60 | $1K |
| 99205 | Prolong outpt/office vis | <1% | 12 | $1K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 14 | $1K |
| 99199 | Unlisted special service, procedure or report | <1% | 12 | $573.81 |
| 99406 | <1% | 12 | $544.32 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialGATELL, VICKY (CHIEF FINANCIAL OFFICER)
| Provider | Location | Paid |
|---|---|---|
| Puerto Rican Organization to Motivate Enlighten and Serve Addicts INC | Bronx, NY | $64.21M |
| Puerto Rican Organization to Motivate Enlighten and Serve Addicts INC | Bronx, NY | $38.03M |
| Puerto Rican Organization to Motivate Enlighten and Serve Addicts, INC | Bronx, NY | $36.30M |
| Bronx Addiction Services Integrated Concepts System INC | Bronx, NY | $19.91M |
| LA Casa De Salud INC. | Bronx, NY | $8.58M |
| Greenhope Services for Women, INC. | New York, NY | $5.52M |
| LA Casa De Salud, INC | Bronx, NY | $5.24M |
| LA Casa De Salud, INC | Bronx, NY | $4.49M |
| Puerto Rican Organization to Motivate Enlighten and Serve Addicts, INC | Dunkirk, NY | $3.87M |
| Community Association of Progressive Dominicans, INC | New York, NY | $3.66M |
| El Regreso, INC. | Brooklyn, NY | $3.34M |
| Queens Village Committee for Mental Health for J-Cap, INC | Jamaica, NY | $816K |
| Puerto Rican Organization to Motivate, Enlighten and Serve Addicts, in | Bronx, NY | $255K |
| Puerto Rican Organization to Motivate Enlighten and Serve Addicts INC | New York, NY | $81K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.