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NPI 1578709440 · Mayaguez, PR · Neurology Physician
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Luis Natali is a neurology physician provider located in Mayaguez, Puerto Rico. This profile covers 11 Medicare and 1 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Luis Natali |
| Address | 75 Norte Calle Ramon E. Betances |
| City | Mayaguez |
| State | PR |
| ZIP | 00680 |
| Taxonomy | Neurology Physician |
| NPI Enumerated | December 26, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $245K |
| Medicaid | $2K |
This provider is effectively Medicare-dominant: lifetime Medicare revenue is $245K compared with only $2K in Medicaid revenue, so nearly all billed dollars flow from Medicare rather than Medicaid. The Medicaid footprint is minimal in scale and does not meaningfully contribute to the practice’s revenue base.
Medicare revenue is highly concentrated in a small set of procedures: the precomputed top‑3 Medicare codes (95886, 95912, 99215) account for 68.8% of this provider’s Medicare revenue, with 95886 alone generating $72.7K (29.7% of Medicare revenue). This concentration indicates the practice depends on a handful of high-revenue services for the majority of its Medicare income.
The code mix indicates a specialist neurology practice with a strong electrodiagnostic services line: 95886 (909 claims, $80 avg paid/claim, $72.7K revenue) and 95912 (244 claims, $198 avg paid/claim, $48.3K revenue) are dominant, and 95910 also appears on the list, supporting a workflow focused on EMG/nerve conduction studies alongside office-based E/M visits. High volumes of diagnostic neurophysiology tests plus substantive E/M (for example, 99215: 362 claims, $131 avg paid/claim, $47.4K revenue) point to a clinic model that runs an electrodiagnostic lab integrated with ambulatory neurology care.
Competitive standing for electrodiagnostic services is notably strong: 95886 ranks #47 of 6525 providers nationally (99th percentile; extreme outlier) and 95912 ranks #16 of 1477 providers nationally (99th percentile; extreme outlier). For high-complexity office visits, 99215 ranks #4006 of 145531 providers nationally (97th percentile; notably above typical national volume), so the provider is an above‑average national performer on both procedure and high-level E/M metrics.
By contrast, the Medicaid picture is sparse and localized: the provider’s entire Medicaid revenue is from 99213 (27 claims, $74 avg paid/claim, $2K revenue), which is 100.0% of Medicaid revenue and ranks #2758 of 3229 in-state (13th percentile). That rank places the provider in the lower tier of in-state Medicaid activity for basic established-patient office visits, underscoring a very limited Medicaid participation.
The provider has long tenure in the NPI registry (enumerated 2008-12-26, ~18 years ago), which combined with concentrated high-volume procedure billing suggests an established specialty practice that has operated at scale in its chosen service lines for many years. This longevity supports the interpretation that current billing patterns reflect stable clinical focus rather than a transient reporting artifact.
There is some diversification beyond outpatient procedures: inpatient/observation initial visits (99223: 116 claims, $140 avg paid/claim, $16.2K revenue) and high-level new-patient office visits (99205: 81 claims, $169 avg paid/claim, $13.7K revenue) appear on the Medicare list, indicating the provider also manages consults and hospital-based care. Those secondary E/M contributions are meaningful but materially smaller than the top electrodiagnostic revenue drivers.
Because a large share of Medicare revenue is driven by a few high-volume procedure codes, the practice is sensitive to changes in utilization or reimbursement for electrodiagnostic testing; conversely, the provider’s national outlier status on 95886 and 95912 indicates potential local market dominance for those services, which could be an asset for referral capture but also concentrates operational and payer risk.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
11 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 95886 | The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more… | 910 | $80 | $72.7K |
| 95912 | In this procedure, the provider performs eleven or twelve nerve conduction studies, a diagnostic test to evaluate function, especially the electrical conduction ability of the motor and sensory… | 240 | $200 | $48.3K |
| 99215 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the… | 360 | $130 | $47.4K |
| 95910 | In this procedure, the provider performs seven or eight nerve conduction studies, a diagnostic test to evaluate the function, especially the electrical conduction ability of the motor and sensory… | 210 | $150 | $30.7K |
| 99223 | The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 120 | $140 | $16.2K |
| 99205 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider… | 80 | $170 | $13.7K |
| 99233 | The 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… | 70 | $100 | $6.9K |
| 95819 | Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. In this procedure the provider performs the EEG… | 100 | $50 | $4.5K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 40 | $50 | $1.9K |
| 99204 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider… | 20 | $110 | $1.6K |
Showing 1–10 of 11
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 30 | $70 | $2K |
How this provider's Medicaid billing volume and revenue compare to other Puerto Rico providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Puerto Rico median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 2,758 | 3,230 | 330 | $10 | $42.4K |
Other providers in the same ZIP code as Luis Natali, ranked by combined Medicare and Medicaid revenue.
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