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PROVIDENCE, R.I. (AP) — A nurse practitioner has pleaded guilty to fraudulently billing commercial health insurers and Medicare nearly $4.4 million for services that he never provided to patients as he had claimed, federal prosecutors said Thursday.

Alexander A. Istomin, 56, routinely submitted fraudulent claims for in-person patient services that he falsely claimed to have performed at offices in Rhode Island, New York and Florida, U.S. Attorney Zachary Cunha said in a statement.

In some cases, the patients that Istomin claimed he met with in person were in another country.

He also used patient names and other information to get prescriptions filled, which he would keep and then distribute to people other than those in whose names the prescriptions were filled, prosecutors said.

He also waived copayments for some Medicare patients, which is prohibited, and in return the patients would not report the fraudulent billing, prosecutors said.

Istomin pleaded guilty on Wednesday in federal court in Providence to 11 counts, including health care fraud and aggravated identity theft.

According to a plea agreement, he must also forfeit all the money he received from the scheme. Sentencing is scheduled for Jan. 26.