Loading...
NPI 1124454566 · Dunmore, PA · Ambulance
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Pennsylvania Ambulance LLC is a ambulance provider located in Dunmore, Pennsylvania. This profile covers 6 Medicare and 7 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 | Pennsylvania Ambulance LLC |
| Address | 1000 Dunham Dr |
| City | Dunmore |
| State | PA |
| ZIP | 18512 |
| Taxonomy | Ambulance |
| NPI Enumerated | September 17, 2013 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $9.3M |
| Medicare | $2.9M |
PENNSYLVANIA AMBULANCE LLC operates at a materially different scale across payers: reported Medicare revenue is $2.9M while Medicaid revenue is $9.3M, indicating that Medicaid is the larger revenue source by a substantial margin. The provider’s NPI was enumerated 2013-09-17 (~13 years ago), so this is an established operation with more than a decade of billing history across these programs.
Medicare revenue is highly concentrated in a small set of transport codes: the top 3 Medicare codes by revenue account for 88.6% of the provider’s total Medicare revenue. Specifically, A0427 represents 55.0% of Medicare revenue, A0429 22.4%, and A0425 11.2%, which together signal dependence on emergency ALS and BLS transports plus ground mileage as the core Medicare business lines.
Medicaid revenue shows an even tighter concentration in the same core service lines: the top 3 Medicaid codes by revenue account for 90.1% of the provider’s total Medicaid revenue. On the Medicaid side, A0427 is 47.6% of revenue, A0429 is 36.6%, and A0428 is 5.9%, highlighting that emergency ALS and BLS transports dominate Medicaid billing for this provider as well.
The code mix (A0427, A0429, A0425 and A0428) describes a primarily ambulance transport operator with a heavy emergency caseload and substantial advanced life support capability. A0427 (advanced life support, emergency transport) is the single largest driver across both payers, and A0429 (basic life support, emergency transport) is the secondary driver; A0425 (ground mileage) and A0428 (BLS non-emergency) make up the remainder of the concentrated revenue stream, implying operations centered on point-to-point emergency response and patient transport.
On Medicare measures the provider is a national high-volume participant for its principal emergency transport codes: A0427 ranks #161 of 6841 providers nationally and A0429 ranks #186 of 7808 providers nationally (both flagged as 98th percentile and described as notably above typical national volume for those codes). By contrast, mileage A0425 is ranked #437 of 8934 providers nationally (95th percentile) and is characterized as typical/unremarkable, indicating that the provider’s national standing is driven more by emergency transport volume than by mileage billing alone.
Within Pennsylvania Medicaid comparisons the provider is a top in-state performer for key emergency codes: A0427 ranks #7 of 285 providers in-state (98th percentile; described as notably above typical state volume). A0429 also ranks #7 of 385 providers in-state (98th percentile) but is described in the file as typical/unremarkable in-state; together these signals indicate a strong regional presence for emergency transport services even if some code labels are internally inconsistent.
There are notable statistical outliers in the Medicaid profile beyond the primary ALS/BLS emergency codes. A0432 (paramedic intercept, rural area) appears with 2.1K claims and $392.5K revenue and is ranked #2 of 44 providers in-state (98th percentile; described as notably above typical state volume), suggesting the provider has unusually high involvement in paramedic intercept services relative to peers in Pennsylvania.
Concentration risk is apparent: with top-3 code shares of 88.6% (Medicare) and 90.1% (Medicaid), the provider’s revenue depends heavily on a narrow set of ambulance transport services. This concentrated mix, combined with the long tenure since NPI enumeration on 2013-09-17 (~13 years ago), points to an established, service-line-focused operation where changes in ambulance reimbursement or utilization for those few codes would have outsized impact on overall revenue.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 4,190 | $380 | $1.6M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 2,040 | $320 | $645.1K |
| A0425 | Ground mileage, per statute mile | 46,190 | $10 | $323.3K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 1,260 | $200 | $250.7K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 220 | $240 | $52.1K |
| A0433 | Advanced life support, level 2 (als 2) | 50 | $550 | $26.3K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 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.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 14,540 | $300 | $4.4M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 12,740 | $270 | $3.4M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 3,160 | $170 | $543.3K |
| A0425 | Ground mileage, per statute mile | 10,570 | $40 | $444.1K |
| A0432 | Paramedic intercept (pi), rural area, transport furnished by a volunteer ambulance company which is prohibited by state law from billing third party payers | 2,090 | $190 | $392.5K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 250 | $320 | $80K |
| A0433 | Advanced life support, level 2 (als 2) | 10 | $340 | $4K |
How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Pennsylvania median
7 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 7 | 290 | 710 | $300 | $631.5K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 7 | 390 | 510 | $250 | $557.8K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 28 | 160 | 460 | $150 | $316.4K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 24 | 60 | 120 | $270 | $160.6K |
| A0433 | Advanced life support, level 2 (als 2) | 6 | 10 | 40 | $360 | $115.7K |
| A0432 | Paramedic intercept (pi), rural area, transport furnished by a volunteer ambulance company which is prohibited by state law from billing third party payers | 2 | 40 | 100 | $150 | $76.2K |
| A0425 | Ground mileage, per statute mile | 21 | 440 | 400 | $30 | $76K |
Other providers in the same ZIP code as Pennsylvania Ambulance LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Traditional Home Health And Hospice LLC | PA | Home Health Agency | $0 | $20.8M |
| Padmaja Bojanapally | PA | Hematology & Oncology Physician | $2M | $0 |
| Carl Barsigian | PA | Hematology & Oncology Physician | $1.4M | $0 |
| Christopher Peters | PA | Radiation Oncology Physician | $1.2M | $0 |
| Thomas Churilla | PA | Radiation Oncology Physician | $1M | $0 |
| Kishori Veerabhadrappa | PA | Hematology & Oncology Physician | $996.1K | $1 |
| Lisa Thomas | PA | Hematology & Oncology Physician | $922.4K | $0 |
| Meghan Haggerty | PA | Radiation Oncology Physician | $793.3K | $0 |
| Kristin Liptock | PA | Hematology & Oncology Physician | $739.1K | $0 |
| Vithalbhai Dhaduk | PA | Neurology Physician | $519.3K | $1.5K |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.