Providers

MARK M SHIH, M.D.

NPI 1851366801, individual, Portland, OR, Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine

4
Evidence tier
structure or single-organization volume
  • Hours beyond a day in 1 month, but with up to 446 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
score 51 of 100, rank 8780, $1.8M 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 2018More hours than a day holds, even counting one unit per claim line30.841.727.839.1258192507 92523 92609 97110 97166 97530 97802 99214$135K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameMARK M SHIH, M.D.
TypeIndividual
StatusActive
NPI issuedFebruary 22, 2006, last updated January 10, 2023
Practice location3181 SW SAM JACKSON PARK RD, Portland, OR 97239-3011, 503-346-0640
Specialties
Pediatrics (208000000X, license MD21938 OR)
Physical Medicine & Rehabilitation (208100000X, license MD21938 OR)
Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (2081P0010X, primary, license MD21938 OR)

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
97530Therapy procedure using functional activities$1.6M49%$173$124 (top 5% from $387)63rd percentile
92507Treatment of speech, language, voice, communication, and/or hearing processing disorder$932K28%$120$190 (top 5% from $477)26th percentile
92523Evaluation of speech sound production with evaluation of language comprehension and expression$248K7%$179$137 (top 5% from $251)83rd percentile
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes$151K4%$104$76 (top 5% from $314)65th percentile
92609Therapy service for use of speech-generating device with programming$82K2%$142$181 (top 5% from $466)35th percentile
97166Evaluation for occupational therapy, typically 45 minutes$73K2%$83$53 (top 5% from $238)77th percentile
97161Evaluation for physical therapy, typically 20 minutes$69K2%$77$51 (top 5% from $132)82nd percentile
97802Therapy procedure for nutrition management, each 15 minutes$55K2%$69$3.93 (top 5% from $105)89th percentile

In this area

14 providers in Multnomah County, OR carry an indicator in the public record, with $2.8M at stake between them. The most common is part of a provider network, on 7 of them, followed by more hours than a day holds on 6. 1 is tier 1: documented action, then payment.

tierproviderat stakewhy
1JENNIFER JABLIN
Portland, OR, ranked 102
$264K
  • Listed on the CA Medicaid exclusion list since March 3, 2023.
  • Medicaid still paid claims in 18 later months, $264,374 in total.
3WESTERN HEALTH RESOURCES
Portland, OR, ranked 1454
$34K
  • Part of provider network D1-00071, ranked 71 nationally.
3TRADITIONS HOSPICE OF PORTLAND, LLC
Portland, OR, ranked 1489
$22K
  • Part of provider network D1-00051, ranked 51 nationally.
3WEST HILLS CONVALESCENT CENTER LIMITED PARTNERSHIP
Portland, OR, ranked 2938
$0
  • Part of provider network D1-00097, ranked 97 nationally.
3WARM SPRINGS HOME HEALTH CARE INC
Portland, OR, ranked 3840
$0
  • Part of provider network D1-00067, ranked 67 nationally.
3WESTERN HEALTH RESOURCES
Portland, OR, ranked 4477
$0
  • Part of provider network D1-00071, ranked 71 nationally.
3PINNACLE HOSPICE CARE INC
Portland, OR, ranked 4577
$0
  • Part of provider network D1-00067, ranked 67 nationally.
3ROSE CITY HOME HEALTH CARE INC
Portland, OR, ranked 6121
$0
  • Part of provider network D1-00066, ranked 66 nationally.
All 14 in OR

Recent enforcement in OR

All releases

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

DOJChargedJun 23, 2026
Two Charged in the District of Oregon as Part of the National Health Care Fraud Takedown
Two defendants were charged with health care fraud for submitting claims for genetic testing that was never provided to Medicare Advantage plans and for sleep tests billed as conducted in office when they were done at home or not at all.
DOJComplaint filedMar 24, 2026
Pakistani National Residing in Southern California Charged with Fraudulently Billing Medicare Plans
The owner of Oregon Clinical Laboratory allegedly participated in a scheme to fraudulently bill Medicare Advantage insurance plans for laboratory testing services never performed, submitting more than $46 million in claims.
DOJIndictedJan 26, 2026
Oregon Mother and Daughter Facing New Charges Related to Forced Labor and Health Care Fraud
A superseding indictment alleges the owners of an adult foster care home coerced the labor of three victims for little or no pay while requesting and receiving Medicaid and ODHS "exceptional payments" for additional paid employee hours, lying about the victims' residence in the home, and falsifying a disability claim so one defendant could be paid hourly as a Homecare Worker.
DOJIndictedJan 26, 2026
Oregon Mother and Daughter Facing New Charges Related to Forced Labor and Health Care Fraud
A superseding indictment alleges the owners of an adult foster care home coerced the labor of three victims for little or no pay while requesting and receiving Medicaid and Oregon Department of Human Services "exceptional payments" for additional employee hours, lying about the victims' residence in the home, and falsifying a disability claim so one defendant could be paid hourly as a Homecare Worker.
DOJCivil settlementJul 1, 2025
U.S. Attorney’s Office Participates in National Health Care Fraud Takedown Resulting in $2 Million Civil Settlement
Riverpark allegedly billed Medicare and Oregon Medicaid for grossly substandard nursing home services when staffing levels did not meet minimum staffing requirements, resulting in residents experiencing increased instances and severity of preventable urinary tract infections, pressure sores, and falls.

Referral packet

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