Providers

PAUL TOBIN, MD

NPI 1295816106, individual, Chapel Hill, NC, Pediatrics

1
Evidence tier
documented action, then payment
  • Listed on the Medicare revocation list since January 6, 2023.
  • Medicaid still paid claims in 6 later months, $67,978 in total.
score 95 of 100, rank 166, $68K at stake

Public list actions

Medicare revocation effective January 6, 2023, barred from re-enrolling until January 5, 2028
424.535(a)(9) failure to report and 424.535(a)(12) other program termination (medicaid), Practitioner - Internal Medicine, NC

Paid after the action

Months in which Medicaid paid claims for this provider after a public action that should have triggered a screening check. This is a record of payments, not a determination that they were improper.

listidentity checkaction datewindow closedmonths paid afterfirstlastpaid after12 months before
Medicare revocation list
424.535(a)(9) failure to report and 424.535(a)(12) other program termination (medicaid)
Exact NPI, name verifiedJan 6, 2023Jan 5, 20286Jul 2024Dec 2024$68K$61K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NamePAUL TOBIN, MD
TypeIndividual
StatusActive
NPI issuedOctober 18, 2006, last updated April 30, 2025
Practice location6013 FARRINGTON RD STE 101, Chapel Hill, NC 27517-8173, 984-974-7010
Mailing address2000 PERIMETER PARK DR STE 200, Morrisville, NC 27560-8442
Specialties
Internal Medicine (207R00000X, license 36129 NC)
Pediatrics (208000000X, primary, license 0000-36129 NC)

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
codewhat it ispaidshareper patient-monthtypicalrank among providers
T1015Medicaid service code$122K69%$185$182 (top 5% from $488)51st percentile
99214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$25K14%$62$60 (top 5% from $133)52nd percentile
99213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$20K11%$59$44 (top 5% from $110)70th percentile
99392Medicaid service code$3K2%$268$78 (top 5% from $124)too few months to rank
99393Medicaid service code$2K1%$149$78 (top 5% from $121)too few months to rank
90460Administration of first vaccine or toxoid component with counseling (18 years or younger)$2K1%$27$26 (top 5% from $54)too few months to rank
U00022019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc$1K1%$69$40 (top 5% from $69)too few months to rank
87635Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen$6670%$48$44 (top 5% from $70)too few months to rank

In this area

2 providers in Chatham County, NC carry an indicator in the public record, with $840K at stake between them. The most common is paid after a public list action, on 2 of them.

tierproviderat stakewhy
5CHATHAM HOSPITAL INC
Siler City, NC, ranked 11162
$607K
5CHATHAM HOSPITAL, INC.
Siler City, NC, ranked 11431
$233K

Recent enforcement in NC

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJSentencedAug 27, 2026
Charlotte Woman Sentenced for Defrauding the North Carolina Medicaid Program
Jackson and her company submitted over $1.9 million in claims to NC Medicaid for urine drug testing and psychotherapy services that were never performed or already paid, using Medicaid recipients' personal information, and she spent the proceeds.
DOJPleaded guiltyJul 9, 2026
Guilford County Woman Pleads Guilty to Health Care Fraud in Connection with Million Dollar Urine Drug Testing Scheme
Singleton owned and operated Joelle's Center of Hope, which submitted approximately $1,735,865 in claims to North Carolina Medicaid for urine drug tests that were not performed, listing a nurse practitioner and a doctor as ordering providers who never ordered the tests.
DOJPleaded guiltyJun 24, 2026
Raleigh Man Pleads Guilty to Receiving More than $60 Million in Fraudulent Claims from Paying Kickbacks for Patient Referrals
Price owned and operated Golden Star Labs, which paid collectors on a per-specimen basis to supply bogus respiratory test samples obtained through identity theft, and billed Medi-Cal and Medicare more than $96 million in false claims, receiving more than $60 million, and he also filed a false federal income tax return.
DOJChargedJun 24, 2026
McLeansville Woman Charged With Health Care Fraud, Part of National Health Care Fraud Takedown
White, the owner of Reginald Center of Turn Around, billed North Carolina Medicaid for thousands of fictitious drug tests resulting in a loss of $2.8 million.
DOJIndictedJun 24, 2026
Felon Indicted in Multimillion Dollar Healthcare Kickback and False Documents Conspiracy
Ayyad is alleged to have solicited and received kickbacks from clinical laboratories in exchange for generating referrals, paid kickbacks to independent contractor sales reps, created dozens of sham invoices and contracts to conceal the payments, and caused the submission of fraudulent claims for laboratory testing to Medicare, HRSA, TRICARE, and other payers through labs and entities he owned and controlled.

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.

Ask this case

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