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    OpenPayerNPI Medicare & MedicaidMuhammad Shibli
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    Muhammad Shibli — Billing Profile & Reimbursement Data

    NPI 1376656413 · Washington, DC · Pulmonary Disease Physician

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    Muhammad Shibli is a pulmonary disease physician provider located in Washington, District of Columbia. This profile covers 9 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationMuhammad Shibli
    Address1150 Varnum St Ne
    CityWashington
    StateDC
    ZIP20017
    TaxonomyPulmonary Disease Physician
    NPI EnumeratedAugust 15, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$320.3K
    Medicaid$0

    Key Findings

    This provider’s Medicare footprint is the dominant and effectively sole payer presence: lifetime Medicare revenue is $320.3K while Medicaid revenue is none (no Medicaid billing on file), so the practice operates as a Medicare-focused billing profile with no recorded Medicaid activity. Analysts should treat this entity as single-payer (Medicare) for payer-mix and utilization comparisons.

    Revenue is highly concentrated in a very small set of services: the precomputed top three codes by revenue account for 83.7% of this provider’s total Medicare revenue. Those top three codes are 99291 ($122.1K revenue, 38.1%), 99309 ($116.7K revenue, 36.5%), and 99308 ($29.2K revenue, 9.1%), which together drive the overwhelming majority of reported Medicare dollars.

    The code mix indicates a dual operational focus on high-acuity critical care and nursing-facility longitudinal management: 99291 is a critical care service, while 99309 and 99308 are subsequent nursing facility E/M visits. This pattern suggests the provider spends substantial time in acute critical-care encounters and in ongoing nursing-facility management rather than primarily performing routine outpatient office visits.

    99291 is an outlier in national comparison, with this provider reporting 667 claims generating $122.1K and ranking #251 of 71290 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code). That ranking signals an unusually high critical-care volume relative to peers and positions this provider as a major national outlier specifically for critical care billing.

    By contrast, 99309 (1.3K claims, $116.7K) ranks #2177 of 28092 providers nationally (92th percentile; typical, unremarkable volume) and 99308 (449 claims, $29.2K) ranks #6544 of 25763 providers nationally (75th percentile; typical, unremarkable volume). These percentile placements indicate the nursing-facility E/M work is above median but characterized in the data as typical in distribution, so the provider’s nursing-facility activity is notable but not an extreme statistical outlier.

    A small set of additional hospital and procedure codes contribute materially but modestly to revenue: 99233 ($25.3K, 7.9%), 99310 ($17.3K, 5.4%), and procedure codes such as 36556 ($2K, 0.6%) and 31500 ($1.8K, 0.6%). The presence of central line placement, intubation, and inpatient follow-up codes supports the interpretation that the provider performs bedside invasive procedures and inpatient care in addition to nursing-facility management.

    The revenue concentration into a few codes (83.7% from the top three) creates a business profile heavily dependent on critical-care and nursing-facility reimbursement streams; any shifts in utilization, reimbursement policy, or payer mix for those specific services would disproportionately affect this provider’s Medicare revenue. For contracting and utilization review purposes, monitoring volumes and documentation for 99291, 99309, and 99308 should therefore be a priority.

    The provider has a long-standing NPI enrollment (NPI enumerated 2006-08-15 (~20 years ago)) and reports lifetime Medicare revenue of $320.3K over that tenure. The longevity of enrollment combined with modest lifetime Medicare dollars suggests a sustained but relatively small-scale Medicare billing operation concentrated in a narrow set of high-impact codes.

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    9 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99291Critical care services include the treatment of vital organ failure  or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…670$180$122.1K
    99309The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…1,260$90$116.7K
    99308The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…450$70$29.2K
    99233The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…250$100$25.3K
    99310The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…130$130$17.3K
    99232The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…70$70$4.8K
    36556The provider inserts a central venous access catheter in the neck, chest, or groin to draw blood or administer medication or nutrients to a patient 5 years of age or older.30$70$2K
    31500The provider inserts a flexible tube into the trachea (windpipe) typically via the mouth in an emergency situation to maintain an open airway in a patient with a compromised airway.20$120$1.8K
    36620In this procedure, the provider inserts a catheter percutaneously (through the skin) into an artery and uses this catheter for the purpose of sampling, transfusion, or continuous real–time blood…20$40$910

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    9 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    99309860270$80$45.5K
    993081460250$60$22.9K
    993101530120$110$20.2K
    9923316465090$100$17.6K
    99291141050$180$14.8K
    9923230664070$70$10K
    3150031010$110$1.6K
    3655632020$70$1.4K
    36620378020$40$1.1K

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Muhammad Shibli, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Providence Health Services IncDCFamily Medicine Physician$0$13.4M
    Providence HospitalDCGeneral Acute Care Hospital$0$12.2M
    St Agnes Healthcare IncMDInternal Medicine Physician$0$11.5M
    M Medical Group, Inc.MDCritical Care Medicine (Internal Medicine) Physician$0$11.3M
    Usacs Integrated Acute Care Services Of Maryland, LLCMDInternal Medicine Physician$0$7.7M
    Seton Medical Group, IncMDInternal Medicine Physician$0$5.9M
    St. Agnes Healthcare, Inc.MDGeneral Acute Care Hospital$0$5.4M
    Naveed ShahRIPulmonary Disease Physician$1.4M$0
    Nasser Nasseri-aslMDSpecialist$1.2M$0
    St. Agnes Healthcare, Inc.MDClinical Medical Laboratory$147.4K$890.8K

    Nearby Providers

    Other providers in the same ZIP code as Muhammad Shibli, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    My Own Place, Inc.DCIntellectual and/or Developmental Disabilities Residential Treatment Facility$0$48.7M
    Anchor Mental Health AssociationDCMental Health Clinic/Center (Including Community Mental Health Center)$0$22M
    Hsc Home Care, LLCDCHome Health Agency$0$14.7M
    American Health Care Services IncDCIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility$0$5.3M
    Hospital For Sick ChildrenDCSpecial Hospital$0$4.7M
    United Cerebral Palsy Of Washington & No. Virginia, Inc.DCDevelopmentally Disabled Services Day Training Agency$0$4.4M
    Gerald Family CareDCFamily Medicine Physician$0$3.2M
    Cheryl LeeDCDentist$0$2.5M
    Providence Opticians Designer Eyewear IncDCEyewear Supplier$0$2.1M
    On With Life Therapies, IncDCHome Health Agency$0$1.8M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. District of Columbia Distribution
    Muhammad Shibli — 1 of 9 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — District of Columbia