Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidShanice Figueroa
    Ask Trek AI about this page

    Shanice Figueroa — Billing Profile & Reimbursement Data

    NPI 1821556770 · Atlanta, GA · Nurse Practitioner

    Customize your policy alerts

    Sign up for Shanice Figueroa — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Shanice Figueroa is a nurse practitioner provider located in Atlanta, Georgia. 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.

    Table of contents

    Progress1 / 9

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationShanice Figueroa
    Address2045 Peachtree Rd Ne Ste 410
    CityAtlanta
    StateGA
    ZIP30309
    TaxonomyNurse Practitioner
    NPI EnumeratedMarch 11, 2019

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

    Payer SourceTotal Paid
    Medicare$2.8M
    Medicaid$0

    Key Findings

    This provider is effectively a Medicare-only biller: lifetime Medicare revenue is $2.8M and there is no Medicaid billing on file, so payer mix is overwhelmingly single-payer Medicare rather than a mixed Medicare/Medicaid practice. Analysts should treat Medicaid-related comparisons as inapplicable for this NPI given the absence of any Medicaid claims.

    Revenue is extremely concentrated in a single Medicare product: Q4236 accounts for $2.7M and 97.0% of total Medicare revenue, and the platform’s precomputation shows the top 3 Medicare codes together account for 99.1% of this provider's total Medicare revenue. That concentration indicates the practice’s financial profile is dominated by one billing item rather than a diversified set of E/M or procedural services.

    The code mix points to a wound-care / skin-replacement focus with adjunct home-based evaluation: the dominant Q4236 (Carepatch, per square centimeter) together with 15271 and 15272 (skin substitutes/grafting) and debridement codes like 11042 and 11000 imply primary business activity around wound dressings, grafting and debridement. The presence of home visit codes 99348 and 99342 also suggests some services are delivered in patients’ residences, aligning with a clinic or mobile wound-care model rather than a general primary care panel.

    Competitive standing on the largest revenue driver is modest rather than dominant: Q4236 revenue ranks #22 of 79 providers nationally (73th percentile) and is characterized as typical, unremarkable volume for this code, so although Q4236 generates most revenue for this NPI, the provider is not an extreme outlier in national Q4236 billing. Secondary codes 11042 and 99348 similarly carry labels of typical, unremarkable volume despite their high national percentiles, indicating participation at levels consistent with many peers.

    Secondary Medicare codes generate only fractional revenue but clarify service mix: 11042 brings $38.6K (1.4% of Medicare revenue) and 99348 brings $19.2K (0.7% of Medicare revenue), which supports the interpretation that procedural wound care and some home-based E/M care are offered but do not materially change the overall revenue picture. These smaller revenue lines are nationally ranked in ranges characterized as typical, unremarkable volume for each code.

    Tenure is recent-to-mid career: the NPI was enumerated on 2019-03-11 (~7 years ago), so this billing pattern has developed over a relatively short professional window and may reflect a focused, possibly newer practice model built around Q4236-related services. Analysts should consider whether the heavy reliance on one product/code reflects intentional specialization or a transient billing composition.

    The provider shows additional wound-care coding beyond the top revenue driver—codes such as 15271 ($18.5K), 15272 ($1.7K), and debridement codes 11042/11000 appear on file—supporting that the operation offers both advanced dressing/supplement products and surgical debridement services. These supporting codes remain small contributors to total Medicare revenue but corroborate the clinical emphasis on wound management rather than broad multispecialty services.

    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
    Q4236Carepatch, per square centimeter (add-on, list separately in addition to primary procedure)2,830$970$2.7M
    11042The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.440$90$38.6K
    99348The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30…380$50$19.2K
    15271The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the patient’s trunk, arms, and/or legs up to an area of 100 cm2. This code covers up to the first 25 cm2.180$100$18.5K
    99342The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a low level of medical decision making or the provider spends at least 30…60$50$3.1K
    93922Noninvasive physiologic studies of upper or lower extremity arteries, single level, bilateral50$50$2.4K
    15272At the same session that the provider uses a skin substitute, such as an allograft or xenograft, to cover the wounds on the patient’s trunk, arms, and/or legs up to an area of 100 scm2, the provider…110$20$1.7K
    11000The provider uses surgical instruments to debride the dead tissue in skin for up to 10 percent of the body surface.20$20$550
    11721The provider surgically debrides (debulks or removes) 6 or more abnormal, diseased, or infected nails.10$20$210

    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
    Q42362102,830$940$2M
    11721310310240$30$10.6K
    1527164050$100$9K
    110421024070$70$8.3K
    99348516050$50$4.1K
    1100061040$30$3K
    9392210626040$40$2.8K
    9934283020$50$2.7K
    1527211050$20$980

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Richard ParkCAInternal Medicine Physician$31.7M$0
    Nyrie AustinNJFamily Nurse Practitioner$15.9M$8.8K
    Patrick BlackCAPhysical Therapist$14M$0
    Owen EllingtonTXHematology & Oncology Physician$11.5M$0
    Joseph PalumboWVEmergency Medicine Physician$7.9M$44.3K
    Shelita JonesTXFamily Nurse Practitioner$6.7M$0
    Kellie KingTXFamily Nurse Practitioner$5.3M$0
    Jamie Kate AdocCAFamily Nurse Practitioner$4.7M$0
    Raymond WawrowskiOHPhysician Assistant$4.7M$0
    Thuy VoCAFamily Nurse Practitioner$4.4M$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Obstetrix Medical Group Of Atlanta, LLCGAMaternal & Fetal Medicine Physician$0$10M
    Dentistry For Children Of Georgia LLCGAPediatric Dentistry$0$7.9M
    Kristin BourgGAPhysician Assistant$1.8M$0
    Janice McalisterGANurse Practitioner$1.6M$0
    Michelle JuneauGADermatology Physician$951K$0
    William WilsonGARheumatology Physician$865.7K$0
    David D'heurleGAOphthalmology Physician$672.5K$0
    Georgia West Imaging, PCGADiagnostic Radiology Physician$0$616.2K
    Peachtree Orthopaedic Surgery Center At Piedmont LLCGAOrthopaedic Surgery Physician$605.7K$0
    Piedmont Hospital, IncGAGeneral Acute Care Hospital$0$542.7K

    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. Georgia Distribution
    Shanice Figueroa — 3 of 9 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Georgia