Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Armed Forces Pacific for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Armed Forces Pacific only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Armed Forces Pacific (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Doris Nieves (NPI 1083753529)

Field	Value
Entity Type	Individual
Organization	Doris Nieves
Address	Bdaach/549th Hc Usag Humphreys Bldg. #3030
City	Apo
State	AP (Armed Forces Pacific)
ZIP	96271
Taxonomy	Physical Therapist
NPI Enumerated	February 5, 2007

Payer Source	Total Paid
Medicare	$4.2K
Medicaid	$0

Key Findings

This provider’s Medicare footprint is very small in absolute terms: total Medicare revenue is $4.2K and there is no Medicaid billing on file, making this effectively a single‑payer Medicare practice at the claims level. The NPI was enumerated 2007-02-05 (~19 years ago), indicating long-tenured registration despite low current Medicare billing volume.

Revenue concentration is high within a narrow set of physical‑therapy services: the precomputed top 3 codes by revenue account for 80.4% of the provider’s total Medicare revenue, led by 97110, 97112, and 97140. Those three codes collectively dominate the Medicare receipts, which suggests most billings flow from a small set of routine PT interventions.

The mix of top codes (97110 34.6% of Medicare revenue, 97112 23.8%, 97140 21.9%) indicates a service-line focused on hands‑on and exercise‑based rehabilitation—therapeutic exercise, neuromuscular reeducation, and manual therapy. This pattern is consistent with outpatient physical therapy or clinic-based sessions emphasizing direct therapeutic contact and function‑oriented treatment rather than high‑intensity procedures or durable medical equipment.

Claim counts and average payments further illustrate limited scale: 97110 shows 72 claims with $20 avg paid/claim and $1.4K revenue; 97112 shows 38 claims with $26 avg paid/claim and $988 revenue; 97140 shows 48 claims with $19 avg paid/claim and $912 revenue; 97530 shows 24 claims with $34 avg paid/claim and $816 revenue. These per‑claim payment levels and total dollars indicate small episode volumes and modest per‑code revenue contribution relative to national program dollars.

Competitive standing against national Medicare peers is modest to low across the primary CPTs: 97110 ranks #75206 of 79999 (6th percentile; typical, unremarkable volume for this code), 97112 ranks #59899 of 61940 (3th percentile; typical, unremarkable volume for this code), 97140 ranks #61071 of 65133 (6th percentile; typical, unremarkable volume for this code), and 97530 ranks #61911 of 62717 (1th percentile; typical, unremarkable volume for this code). Those placements in single‑digit percentiles indicate the provider is a modest participant nationally rather than a dominant or high‑volume provider for these services.

From a payer or network perspective, the combination of minimal Medicare revenue ($4.2K), absence of Medicaid billing, and heavy reliance on three procedure codes suggests limited contracting leverage and a narrow service profile. The data support treating this entity as a small, focused PT billing source—potentially useful for localized capacity but unlikely to materially affect utilization patterns or rates at scale.

Across the top billings there are no flagged statistical high outliers: each listed code is described with the plain‑English label "typical, unremarkable volume". In other words, the provider’s activity levels for these CPTs align with typical low‑volume peers rather than showing anomalous spikes or unusually high utilization patterns.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	70	$20	$1.4K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	40	$30	$990
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	50	$20	$910
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	20	$30	$820

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes. Note: this provider's state, "AP," is a US military postal designation for Armed Forces stationed in the Asia-Pacific region — not a traditional US state; the State panel below benchmarks against other providers coded under the same designation.

View: State1 / 2

Claims Volume vs. Armed Forces Pacific Distribution

Doris Nieves — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Armed Forces Pacific

Full comparison — all codes billed, vs. state median

4 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97110	4	10	140	$20	$4.6K
97530	4	10	130	$30	$3.8K
97112	3	10	100	$20	$2.7K
97140	4	10	110	$20	$1.8K

Nearby Providers

Other providers in the same ZIP code as Doris Nieves, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Joon Park	AP (Armed Forces Pacific)	Dentist	$0	$623.9K
Seong Cho-ju	AP (Armed Forces Pacific)	Clinical Social Worker	$0	$195K
Dennis Chung	AP (Armed Forces Pacific)	General Practice Dentistry	$0	$51.7K
Hannah Choi	AP (Armed Forces Pacific)	Family Medicine Physician	$7.6K	$38.6K
Sang-wahn Koo	AP (Armed Forces Pacific)	Psychiatry Physician	$6.9K	$0
Timothy Gocke	AP (Armed Forces Pacific)	Internal Medicine Physician	$3.2K	$0
Il-gyu Cho	AP (Armed Forces Pacific)	Child & Adolescent Psychiatry Physician	$2.8K	$0
Steve Huynh	AP (Armed Forces Pacific)	Optometrist	$0	$1.8K
Hyun Shim	AP (Armed Forces Pacific)	Clinical Social Worker	$1K	$0

Doris Nieves — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References