Providers
All 11 in DC
DIVYA PANA SHENOY, M.D.
NPI 1215322797, individual, Washington, DC, Family Medicine
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 29 months, but with up to 1213 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 99214 ($135 per patient-month) sit in the top 5% of every provider billing that code.
score 56 of 100, rank 7477, $4.5M at stake
Hours billed per day
Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.
| month | what was found | hours per day, lower bound | hours per day, at price | hours per day, conservative | per working day | patients | billing organizations | codes | paid |
|---|---|---|---|---|---|---|---|---|---|
| Jan 2019 | More hours than a day holds at a conservative unit price | 6.1 | 52.5 | 35.0 | 47.2 | 542 | 1 | 99202 99203 99204 99211 99212 99213 99214 | $92K |
| Feb 2019 | More hours than a day holds at a conservative unit price | 10.2 | 85.4 | 56.9 | 79.7 | 815 | 1 | 99202 99203 99211 99212 99213 99214 | $142K |
| Mar 2019 | More hours than a day holds at a conservative unit price | 10.4 | 86.7 | 57.8 | 85.3 | 880 | 1 | 99202 99203 99211 99212 99213 99214 | $159K |
| Apr 2019 | More hours than a day holds at a conservative unit price | 9.9 | 82.9 | 55.3 | 75.4 | 805 | 1 | 99202 99203 99211 99212 99213 99214 | $145K |
| May 2019 | More hours than a day holds at a conservative unit price | 14.5 | 121.6 | 81.1 | 109.3 | 1213 | 1 | 99201 99202 99203 99212 99213 99214 | $214K |
| Jun 2019 | More hours than a day holds at a conservative unit price | 14.5 | 122.1 | 81.4 | 122.1 | 1173 | 1 | 99201 99202 99203 99204 99212 99213 99214 | $203K |
| Jul 2020 | More hours than a day holds at a conservative unit price | 6.4 | 73.4 | 48.9 | 66.0 | 715 | 1 | 99201 99202 99203 99211 99212 99213 99214 | $99K |
| Aug 2020 | More hours than a day holds at a conservative unit price | 7.0 | 76.8 | 51.2 | 75.5 | 761 | 1 | 99202 99203 99211 99212 99213 99214 | $105K |
| Sep 2020 | More hours than a day holds at a conservative unit price | 9.5 | 100.5 | 67.0 | 91.3 | 873 | 1 | 99202 99203 99211 99212 99213 99214 | $132K |
| Oct 2020 | More hours than a day holds at a conservative unit price | 7.5 | 74.4 | 49.6 | 69.9 | 686 | 1 | 99202 99203 99211 99212 99213 99214 | $108K |
| Nov 2020 | More hours than a day holds at a conservative unit price | 5.7 | 56.5 | 37.7 | 53.8 | 499 | 1 | 99202 99203 99211 99212 99213 99214 | $79K |
| Dec 2020 | More hours than a day holds at a conservative unit price | 5.2 | 52.7 | 35.1 | 47.3 | 460 | 1 | 99202 99203 99211 99212 99213 99214 | $75K |
| Jan 2021 | More hours than a day holds at a conservative unit price | 6.7 | 50.7 | 33.8 | 49.9 | 499 | 1 | 99202 99203 99204 99212 99213 99214 | $89K |
| Feb 2021 | More hours than a day holds at a conservative unit price | 7.9 | 56.6 | 37.7 | 52.8 | 493 | 1 | 99203 99204 99212 99213 99214 | $93K |
| Mar 2021 | More hours than a day holds at a conservative unit price | 8.0 | 54.6 | 36.4 | 49.0 | 529 | 1 | 99202 99203 99204 99212 99213 99214 | $108K |
| Apr 2021 | More hours than a day holds at a conservative unit price | 12.6 | 83.4 | 55.6 | 75.8 | 825 | 1 | 99202 99203 99204 99212 99213 99214 | $155K |
| May 2021 | More hours than a day holds at a conservative unit price | 9.8 | 69.2 | 46.1 | 68.1 | 742 | 1 | 99202 99203 99204 99212 99213 99214 | $124K |
| Jun 2021 | More hours than a day holds at a conservative unit price | 11.9 | 82.3 | 54.8 | 74.8 | 865 | 1 | 99202 99203 99204 99212 99213 99214 | $145K |
| Jul 2021 | More hours than a day holds at a conservative unit price | 13.7 | 94.7 | 63.1 | 89.0 | 965 | 1 | 99202 99203 99204 99212 99213 99214 | $183K |
| Aug 2021 | More hours than a day holds at a conservative unit price | 12.2 | 78.3 | 52.2 | 73.6 | 757 | 1 | 99202 99203 99204 99212 99213 99214 | $162K |
| Sep 2021 | More hours than a day holds at a conservative unit price | 12.2 | 77.5 | 51.7 | 70.5 | 736 | 1 | 99202 99203 99204 99211 99212 99213 99214 | $159K |
| Oct 2021 | More hours than a day holds at a conservative unit price | 13.9 | 89.2 | 59.5 | 87.8 | 901 | 1 | 99202 99203 99204 99211 99212 99213 99214 | $189K |
| Nov 2021 | More hours than a day holds at a conservative unit price | 13.0 | 81.1 | 54.1 | 73.7 | 804 | 1 | 99203 99204 99211 99212 99213 99214 | $167K |
| Dec 2021 | More hours than a day holds at a conservative unit price | 10.1 | 62.9 | 42.0 | 56.5 | 662 | 1 | 99203 99204 99211 99212 99213 99214 | $130K |
| Jan 2022 | More hours than a day holds at a conservative unit price | 12.2 | 70.9 | 47.3 | 69.8 | 807 | 1 | 99202 99203 99204 99211 99212 99213 99214 | $155K |
| Feb 2022 | More hours than a day holds at a conservative unit price | 12.6 | 77.3 | 51.5 | 72.1 | 725 | 1 | 99202 99203 99204 99211 99212 99213 99214 | $149K |
| Mar 2022 | More hours than a day holds at a conservative unit price | 12.1 | 81.9 | 54.6 | 73.6 | 803 | 1 | 99202 99203 99204 99211 99212 99213 99214 | $165K |
| Apr 2022 | More hours than a day holds at a conservative unit price | 14.3 | 100.2 | 66.8 | 95.5 | 969 | 1 | 99202 99203 99204 99211 99212 99213 99214 | $194K |
| Aug 2022 | More hours than a day holds at a conservative unit price | 10.4 | 69.0 | 46.0 | 62.0 | 737 | 1 | 99202 99203 99204 99211 99212 99213 99214 | $140K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | DIVYA PANA SHENOY, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | April 1, 2015, last updated March 14, 2025 |
| Practice location | 1225 4TH ST NE, Washington, DC 20002-3431, 202-347-8500 |
| Specialties | Family Medicine (207Q00000X, license D0095907 MD) Family Medicine (207Q00000X, license 0101277413 VA) Family Medicine (207Q00000X, primary, license MD210002783 DC) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $2.4M | 14% | $135 | $60 (top 5% from $133) | 95th percentile | |
| J7307 | Medicaid service code | $2.0M | 12% | $849 | $827 (top 5% from $1K) | 55th percentile | |
| 87491 | Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique | $1.8M | 11% | $45 | $27 (top 5% from $50) | 93rd percentile | |
| 87591 | Detection test by nucleic acid for neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique | $1.7M | 10% | $44 | $26 (top 5% from $46) | 94th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $1.4M | 8% | $75 | $44 (top 5% from $110) | 85th percentile | |
| S4993 | Medicaid service code | $1.4M | 8% | $184 | $77 (top 5% from $195) | 93rd percentile | |
| J7304 | Medicaid service code | $591K | 4% | $1K | $726 (top 5% from $1K) | 72nd percentile | |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $578K | 3% | $289 | $95 (top 5% from $171) | 100th percentile |
In this area
11 providers in District of Columbia County, DC carry an indicator in the public record, with $3.6M at stake between them. The most common is part of a provider network, on 4 of them, followed by more hours than a day holds on 4. 2 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | STEVEN PRICE Washington, DC, ranked 592 | $0 |
|
| 1 | HOLY HEALTH CARE SERVICES LLC Washington, DC, ranked 625 | $0 |
|
| 3 | GOSHEN HEALTHCARE & MANAGEMENT SERVICES Washington, DC, ranked 1045 | $0 |
|
| 3 | CAPITAL HOSPICE Washington, DC, ranked 1153 | $485K |
|
| 3 | MEDSTAR HEALTH VISITING NURSE ASSOCIATION, INC. Washington, DC, ranked 1418 | $52K |
|
| 3 | AFFINITY CARE OF DC LLC Washington, DC, ranked 2126 | $0 |
|
| 3 | CARROLL MANOR Washington, DC, ranked 4777 | $0 |
|
| 4 | CELESTE CROTTY Washington, DC, ranked 7324 | $1.0M |
|
Recent enforcement in DC
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJPleaded guiltyAug 27, 2026
Behavioral Health Worker Pleads Guilty to Billing D.C. Medicaid for Therapy Sessions That Never Happened
Nassor, a Community Support Worker at a D.C. Medicaid behavioral health provider, conspired with company employees and other community support workers to bill D.C. Medicaid for mental health telehealth services that were never provided or were inflated, including documenting over 701 hours of telehealth across six patients when call records showed roughly 172 minutes.
DOJSentencedAug 4, 2026
WMATA Train Operator Sentenced in Four-Year Scheme to Defraud AFLAC Insurance of More Than $360,000
Shropshire prepared and submitted fraudulent disability and health care claims to AFLAC for herself and WMATA coworkers claiming injuries they never suffered, fabricating medical records and forging doctors' signatures, and received kickbacks of about 20 percent of each payout.
DOJConvictedMar 4, 2026
D.C. Dentist and Hygienist Found Guilty in Scheme to Defraud D.C. Medicaid of $4 Million
Price and Moore submitted repeated D.C. Medicaid claims for clinical crown lengthening procedures and space maintainers that were not actually performed, causing more than $4 million to be paid out.
DOJPleaded guiltyJan 23, 2026
WMATA Train Operators Plead Guilty in Health Care Fraud Scheme
Two WMATA train operators admitted conspiring to submit fraudulent health care and short-term disability claims to AFLAC using forged medical notes and physician signatures, with kickbacks paid from claim payments.
DOJPleaded guiltyDec 11, 2025
Former Community Support Worker Pleads Guilty to Defrauding District of Columbia Medicaid Program
Jalloh submitted encounter notes for community support services she did not provide and overbilled for services she allegedly provided to District Medicaid beneficiaries, causing the District's Medicaid program to pay over $234,500.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.