Providers

SHELBY ELIZABETH DIPILLA, BCBA

NPI 1821331919, individual, Dothan, AL, Behavior Analyst

4
Evidence tier
structure or single-organization volume
  • Hours beyond a day in 4 months under one organization, which can be supervisory billing.
  • Records needed.
  • 81% of Medicaid dollars are on codes with a history of abuse.
score 53 of 100, rank 8111, $3.0M 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.

monthwhat was foundhours per day, lower boundhours per day, at pricehours per day, conservativeper working daypatientsbilling organizationscodespaid
Jul 2024More hours than a day holds at a conservative unit price33.160.140.133.4326197153 97155 97156$253K
Aug 2024More hours than a day holds at a conservative unit price35.566.444.337.2344197153 97155 97156$282K
Sep 2024More hours than a day holds at a conservative unit price33.168.545.739.8326197153 97155 97156$280K
Oct 2024More hours than a day holds at a conservative unit price31.562.141.433.3319197153 97155 97156$263K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameSHELBY ELIZABETH DIPILLA, BCBA
TypeIndividual, sole proprietor
StatusActive
NPI issuedMarch 27, 2013, last updated March 26, 2018
Practice location2543 ROSS CLARK CIR, Dothan, AL 36301-4925, 334-699-4007
Mailing address25 COURTYARD WAY, Enterprise, AL 36330-5054
Specialties
Developmental Therapist (222Q00000X)
Behavior Analyst (103K00000X, primary, license 1-17-29817 AL)

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
97153Adaptive behavior treatment by protocol by technicianhistory of abuse$4.8M71%$1K$2K (top 5% from $6K)44th percentile
97156Family adaptive behavior treatment guidance$1.0M15%$510$210 (top 5% from $547)93rd percentile
97155Adaptive behavior treatment with protocol modification by QHPhistory of abuse$675K10%$268$512 (top 5% from $1K)18th percentile
97151Behavior identification assessment by professional, each 15 minutes$251K4%$248$389 (top 5% from $1K)28th percentile

In this area

3 providers in Houston County, AL carry an indicator in the public record, with $2.5M at stake between them. The most common is more hours than a day holds, on 3 of them.

tierproviderat stakewhy
4DAVID GHOSTLEY
Dothan, AL, ranked 9097
$713K
  • Hours beyond a day in 11 months, but with up to 671 patients a month across 3 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
5JOHN STRUNK
Dothan, AL, ranked 10891
$1.5M
5WILLIAM WATSON
Dothan, AL, ranked 11408
$255K

Recent enforcement in AL

All releases

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

DOJCivil settlementJun 23, 2026
Alabama Provider Pays $300,000 to Resolve False Claims as Part of 2026 National Health Care Fraud Takedown
A Phenix City-based provider billed Alabama Medicaid for Basic Living Skills services for at-risk children that were not actually rendered.
DOJSentencedApr 2, 2026
Former Medicaid Provider Sentenced to Federal Prison for Health Care Fraud and Aggravated Identity Theft
Pulliam, a child and family therapist enrolled as an Alabama Medicaid provider, submitted claims for counseling services that were never provided using beneficiaries' identifying information without consent.
DOJCivil judgmentMar 19, 2026
Mississippi Man Ordered to Pay $31 Million for Role in Healthcare Kickback Scheme
Crites and others referred patients, primarily TRICARE beneficiaries, to Cloverland Pharmacy in exchange for kickbacks paid by the pharmacy for each referral.
DOJCivil settlementFeb 21, 2025
Saad Healthcare Agrees to Pay $3M to Settle False Claims Act Allegations That It Billed Medicare for Ineligible Hospice Patients
Saad submitted, or caused the submission of, false claims to Medicare between 2013 and 2020 for 21 hospice patients who were not terminally ill and thus ineligible for the Medicare hospice benefit.
DOJCivil settlementFeb 21, 2025
Saad Healthcare Agrees to Pay $3M to Settle False Claims Act Allegations That It Billed Medicare for Ineligible Hospice Patients
Saad Healthcare submitted, or caused the submission of, false claims to Medicare between 2013 and 2020 for 21 hospice patients who were not terminally ill and were ineligible for the Medicare hospice benefit.

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.

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