Providers
All 9 in WA
PAUL BRIAN MEANS, NP
NPI 1851626303, individual, Spokane, WA, Nurse Practitioner, Psych/Mental Health
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 26 months, but with up to 1282 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 99336 ($105 per patient-month) sit in the top 5% of every provider billing that code.
score 55 of 100, rank 7640, $2.3M 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 2018 | More hours than a day holds at a conservative unit price | 22.6 | 43.9 | 29.3 | 39.4 | 787 | 1 | 90833 90838 99204 99214 99335 99336 | $58K |
| Feb 2018 | More hours than a day holds at a conservative unit price | 20.8 | 39.2 | 26.1 | 36.6 | 651 | 1 | 90833 90838 99204 99214 99335 99336 | $48K |
| Apr 2018 | More hours than a day holds at a conservative unit price | 21.3 | 39.0 | 26.0 | 37.1 | 730 | 1 | 90833 99204 99214 99335 99336 | $53K |
| May 2018 | More hours than a day holds at a conservative unit price | 22.2 | 41.3 | 27.5 | 37.1 | 782 | 1 | 90833 99204 99214 99335 99336 | $58K |
| Jan 2019 | More hours than a day holds at a conservative unit price | 23.0 | 39.1 | 26.0 | 35.1 | 804 | 1 | 90833 99204 99214 99327 99336 | $55K |
| Feb 2019 | More hours than a day holds, even counting one unit per claim line | 25.7 | 44.7 | 29.8 | 41.7 | 857 | 1 | 90833 99214 99327 99336 | $56K |
| Mar 2019 | More hours than a day holds, even counting one unit per claim line | 25.8 | 43.0 | 28.6 | 42.3 | 968 | 1 | 90833 99214 99327 99336 | $60K |
| Apr 2019 | More hours than a day holds, even counting one unit per claim line | 25.6 | 42.0 | 28.0 | 38.2 | 897 | 1 | 90833 99327 99336 | $55K |
| May 2019 | More hours than a day holds, even counting one unit per claim line | 29.4 | 49.3 | 32.9 | 44.3 | 1034 | 1 | 90833 99214 99327 99336 | $66K |
| Jun 2019 | More hours than a day holds, even counting one unit per claim line | 27.9 | 45.1 | 30.1 | 45.1 | 900 | 1 | 90833 99214 99327 99336 | $58K |
| Jul 2019 | More hours than a day holds, even counting one unit per claim line | 28.4 | 45.4 | 30.2 | 40.8 | 925 | 1 | 90833 99214 99327 99336 | $61K |
| Aug 2019 | More hours than a day holds, even counting one unit per claim line | 27.5 | 47.0 | 31.3 | 44.1 | 855 | 1 | 90833 99204 99214 99327 99336 | $65K |
| Sep 2019 | More hours than a day holds, even counting one unit per claim line | 33.1 | 55.3 | 36.9 | 52.7 | 1078 | 1 | 90833 99214 99327 99336 | $72K |
| Oct 2019 | More hours than a day holds, even counting one unit per claim line | 42.0 | 77.2 | 51.5 | 69.4 | 1152 | 1 | 90833 99204 99214 99327 99336 | $100K |
| Nov 2019 | More hours than a day holds, even counting one unit per claim line | 41.2 | 77.7 | 51.8 | 74.0 | 1048 | 1 | 90833 99204 99214 99327 99336 | $96K |
| Dec 2019 | More hours than a day holds, even counting one unit per claim line | 44.9 | 91.3 | 60.9 | 85.8 | 1082 | 1 | 90833 99214 99327 99336 | $112K |
| Jan 2020 | More hours than a day holds, even counting one unit per claim line | 49.6 | 92.9 | 61.9 | 83.5 | 1222 | 1 | 90833 99204 99214 99327 99336 | $129K |
| Feb 2020 | More hours than a day holds, even counting one unit per claim line | 54.4 | 102.5 | 68.3 | 99.1 | 1282 | 1 | 90833 99204 99214 99327 99336 | $131K |
| Mar 2020 | More hours than a day holds, even counting one unit per claim line | 38.4 | 72.9 | 48.6 | 68.5 | 1069 | 1 | 90833 99205 99214 99327 99336 | $103K |
| Apr 2020 | More hours than a day holds, even counting one unit per claim line | 35.1 | 72.0 | 48.0 | 65.5 | 887 | 1 | 90833 99205 99214 99327 99336 | $98K |
| May 2020 | More hours than a day holds, even counting one unit per claim line | 30.7 | 60.7 | 40.5 | 59.8 | 885 | 1 | 90833 99214 99327 99336 | $80K |
| Jun 2020 | More hours than a day holds, even counting one unit per claim line | 27.7 | 49.7 | 33.1 | 45.2 | 828 | 1 | 90833 99214 99327 99336 | $64K |
| Jul 2020 | More hours than a day holds, even counting one unit per claim line | 34.1 | 60.1 | 40.0 | 54.0 | 1110 | 1 | 90833 99214 99327 99336 | $83K |
| Aug 2020 | More hours than a day holds, even counting one unit per claim line | 33.1 | 56.8 | 37.9 | 55.9 | 1073 | 1 | 90833 99214 99327 99336 | $78K |
| Sep 2020 | More hours than a day holds, even counting one unit per claim line | 31.0 | 51.8 | 34.6 | 47.1 | 893 | 1 | 90833 99214 99327 99336 | $69K |
| Oct 2020 | More hours than a day holds, even counting one unit per claim line | 33.7 | 57.7 | 38.5 | 54.2 | 913 | 1 | 90833 99214 99327 99336 | $80K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | PAUL BRIAN MEANS, NP |
| Type | Individual |
| Status | Active |
| NPI issued | October 15, 2009, last updated July 31, 2015 |
| Practice location | 3704 N NEVADA ST, Spokane, WA 99207-2968, 509-228-3646 |
| Mailing address | 4301 S HELENA ST, Spokane, WA 99203-4310 |
| Specialties | Nurse Practitioner, Family (363LF0000X, license AP60097094 WA) Nurse Practitioner, Psych/Mental Health (363LP0808X, primary, license AP60097094 WA) |
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 | |
|---|---|---|---|---|---|---|---|
| 99336 | Domiciliary/rest home visit established level 3 (retired 2023) | $1.1M | 41% | $105 | $28 (top 5% from $90) | 97th percentile | |
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | $897K | 34% | $58 | $49 (top 5% from $109) | 63rd percentile | |
| 99327 | Domiciliary/rest home visit new patient level 4 (retired 2023) | $296K | 11% | $76 | $92 (top 5% from $147) | 33rd percentile | |
| 99328 | Domiciliary/rest home visit new patient level 5 (retired 2023) | $195K | 7% | $95 | too few months to rank | ||
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $121K | 5% | $119 | $60 (top 5% from $133) | 92nd percentile | |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $39K | 1% | $94 | $95 (top 5% from $171) | 49th percentile | |
| 99335 | Domiciliary/rest home visit established level 2 (retired 2023) | $13K | 0% | $44 | $19 (top 5% from $69) | 89th percentile | |
| 99326 | Domiciliary/rest home visit new patient level 3 (retired 2023) | $5K | 0% | $53 | $40 (top 5% from $114) | 59th percentile |
In this area
9 providers in Spokane County, WA carry an indicator in the public record, with $16.4M at stake between them. The most common is more hours than a day holds, on 6 of them, followed by part of a provider network on 3.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | SPOKANE UNITED METHODIST HOMES Spokane, WA, ranked 2645 | $0 |
|
| 3 | AVALON CARE CENTER - SPOKANE LLC Spokane, WA, ranked 3670 | $0 |
|
| 3 | EDEN HOME HEALTH OF SPOKANE COUNTY, LLC Spokane Valley, WA, ranked 5198 | $0 |
|
| 4 | JULIE CHRISTIANSEN Deer Park, WA, ranked 7787 | $1.3M |
|
| 5 | NICOLE MANWILLER Spokane Valley, WA, ranked 10018 | $1.6M |
|
| 5 | MATTHEW KILGORE Spokane, WA, ranked 10240 | $544K |
|
| 5 | JAMES MATTHEWS Spokane, WA, ranked 10448 | $11.8M |
|
| 5 | NORA LAUGHLIN Spokane, WA, ranked 10573 | $990K |
|
Recent enforcement in WA
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJSentencedMar 27, 2026
Local Physician Sentenced to 1 Year Imprisonment, a $60,000 fine, and Restitution of $349,272.79 for Adulterating and Misbranding Medical Devices with the Intent to Defraud
Haeger purchased over 500 used and recalled CPAP and BiPAP devices, had the sound abatement foam removed outside clean room conditions, provided the devices to Washington State Medicaid patients through his sleep clinic, and billed Medicaid representing them as new devices in good working order.
DOJCivil settlementJan 12, 2026
DOJ and Seattle-based FidaLab, LLC settle allegations it inflated bills to government health care programs
FidaLab billed Medicare for a series of urinary tract infection tests under multiple billing codes instead of a single code after its request to bill the tests as a panel was denied.
DOJPleaded guiltyDec 18, 2025
Local Physician Pleads Guilty to Adulterating and Misbranding Medical Devices with the Intent to Defraud
Physician purchased over 500 used and recalled CPAP and BiPAP devices, had the sound abatement foam removed outside of clean room conditions, provided the devices to Washington State Medicaid patients, and had staff bill Medicaid representing them as new devices in good working order.
DOJCivil settlementDec 10, 2025
Spokane Physician Pays $120,000 to Resolve Allegations He Prescribed Controlled Substances Without Legitimate Medical Purpose
Between 2017 and 2025 a licensed physician issued over 1,400 prescriptions for controlled substances to thirteen identified patients that lacked legitimate medical purposes or were outside the usual course of professional practice, failing to address red flags of substance abuse.
DOJSentencedDec 2, 2025
Indian national sentenced to prison for Medicare fraud scheme that stole more than $1 million in taxpayer funds
Asif conspired with others to bill Medicare for COVID-19 tests and other respiratory illness tests that had not been ordered or performed through American Labworks LLC.
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.