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NPI 1063525152 · Bronx, NY · Anesthesiology Physician
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Montefiore Medical Center is a anesthesiology physician provider located in Bronx, New York. This profile covers 4 Medicare and 710 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Montefiore Medical Center |
| Address | 111 E 210th St |
| City | Bronx |
| State | NY |
| ZIP | 10467 |
| Taxonomy | Anesthesiology Physician |
| NPI Enumerated | August 16, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $398.4M |
| Medicare | $1.4M |
MONTEFIORE MEDICAL CENTER’s Medicaid footprint dwarfs its Medicare receipts, reporting $398.4M in lifetime Medicaid revenue versus $1.4M from Medicare, indicating the organization operates predominantly in the Medicaid space rather than as a Medicare-focused billing entity. The presence of both payers is notable, but the scale difference implies strategic emphasis on Medicaid-covered services and populations.
Medicare revenue is highly concentrated: the top 3 Medicare codes account for 97.5% of the provider’s Medicare revenue, driven primarily by opioid treatment program services such as G2067, G2078, and G2074. This concentration suggests the provider’s Medicare activity is narrowly focused on medication-assisted treatment (methadone dispensing and associated counseling/assessment) rather than broad anesthesiology procedure billing.
On Medicare G2067—Medication assisted treatment weekly bundle—MONTEFIORE reports $1.2M in revenue from 4.2K claims and ranks #22 of 830 providers nationally (97th percentile), which the data flags as notably above typical national volume. That national standing indicates the medical center is a major national participant for Medicare-covered opioid treatment program services relative to peers.
For Medicaid, revenue is less concentrated across a mix of core E/M, ED, inpatient, and procedural codes: the top 3 Medicaid codes account for 51.4% of Medicaid revenue, with 99214 ($61.5M), 99213 ($59.9M), and 99284 ($24.7M) together driving a large share. This code mix signals a high-volume outpatient and emergency care operation, consistent with a large academic medical center providing routine and acute evaluation/management at scale.
Competitive standing in Medicaid is exceptionally strong across many E/M and hospital-based services: multiple top Medicaid codes are labeled as "extreme outlier" in-state (100th percentile), including 99214, 99213, 99284, 99204 and others, and several hospital/inpatient and imaging codes rank #1 or in the top few statewide. These rankings indicate MONTEFIORE is a dominant in-state provider for both ambulatory and acute care services compared with New York peers.
The provider also reports high-volume, high-value anesthesia and procedural Medicaid codes that align with its Anesthesiology Physician taxonomy—most notably 01967 (neuraxial anesthesia for planned vaginal delivery) with $10.4M revenue and a #2 in-state rank (98th percentile). This corroborates substantive peripartum anesthetic services within its Medicaid case mix alongside broad hospital and ED activity.
Several pediatric, preventive, imaging, and pathology codes (for example 99392, 99393, 77067, 88305) are extreme outliers in-state, indicating substantial breadth of services beyond anesthesia—primary care preventive visits, imaging/screening, and pathology throughput are all unusually large relative to New York peers. This breadth is consistent with a large, integrated health system serving diverse patient needs under Medicaid.
Tenure data show the provider’s NPI was enumerated on 2006-08-16 (~20 years ago), signaling long-standing billing activity; coupled with the extreme-volume Medicaid profile and specialized Medicare OTP billing, this suggests an established operation specializing in high-volume outpatient, ED, inpatient, and substance use disorder services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 4,240 | $270 | $1.2M |
| G2078 | Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure | 3,530 | $40 | $137.6K |
| G2074 | Medication assisted treatment, weekly bundle not including the drug, including substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services… | 340 | $220 | $73.9K |
| G2077 | Periodic assessment; assessing periodically by an otp practitioner and includes a review of moud dosing, treatment response, other substance use disorder treatment needs, responses and… | 260 | $140 | $35.1K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
710 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 586,030 | $110 | $61.5M |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 788,430 | $80 | $59.9M |
| 99284 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making. | 197,490 | $130 | $24.7M |
| 99204 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider… | 104,760 | $150 | $15.8M |
| 99283 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making. | 154,300 | $70 | $11.1M |
| 99285 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making. | 63,570 | $170 | $10.9M |
| 01967 | The provider performs neuraxial anesthesia services for a patient undergoing a planned vaginal delivery. | 6,400 | $1,630 | $10.4M |
| 99203 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider… | 99,230 | $110 | $10.4M |
| 99215 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the… | 64,570 | $130 | $8.5M |
| 99233 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 72,140 | $100 | $7.1M |
Showing 1–10 of 710
How this provider's Medicaid billing volume and revenue compare to other New York providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New York median
710 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 83 | 90 | 5,000 | $210 | $4.5M |
| H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | 107 | 120 | 61,480 | $30 | $4.4M |
| 96150 | N/A | 13 | 20 | 220 | $710 | $3M |
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by… | 56 | 100 | 1,490 | $70 | $1.3M |
| 96361 | The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration. | 195 | 210 | 2,850 | $180 | $1.1M |
| 90832 | In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere… | 151 | 1,510 | 1,010 | $110 | $1.1M |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 149 | 180 | 3,200 | $90 | $1M |
| 90937 | Hemodialysis is a procedure that involves drawing blood via an intraarterial or intravenous catheter, then sieving it through a semipermeable membrane to remove the impurities and finally transfusing… | 65 | 80 | 3,680 | $40 | $919.1K |
| 90834 | In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere… | 779 | 2,200 | 1,010 | $130 | $892.2K |
| 01967 | The provider performs neuraxial anesthesia services for a patient undergoing a planned vaginal delivery. | 2 | 50 | 200 | $710 | $882.9K |
Showing 1–10 of 710
Other providers in the same ZIP code as Montefiore Medical Center, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Port Morris Home Care Agency, LLC | NY | Home Health Agency | $0 | $95.8M |
| Jsp Life Agency Inc. | NY | Home Health Agency | $0 | $94M |
| Bronx Jewish Community Council -home Attendant Services Inc | NY | Home Health Agency | $0 | $39.2M |
| Bronx Community Home Care, Inc. | NY | In Home Supportive Care Agency | $0 | $26.5M |
| Bronx Sc LLC | NY | Ambulatory Surgical Clinic/Center | $396.7K | $2.4M |
| Mahmood Kazmi | NY | Psychiatry Physician | $540.6K | $760.6K |
| Menachem Gold | NY | Diagnostic Radiology Physician | $207.7K | $852.7K |
| Aleksandr Morim | NY | Diagnostic Radiology Physician | $801.3K | $62.8K |
| Venise Cameron | NY | Family Medicine Physician | $593.3K | $0 |
| Elona Dhrami | NY | Ophthalmology Physician | $213.2K | $332.2K |
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