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NPI 1134162977 · Lowell, MA · Land Ambulance
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Pridestar Ems Inc is a land ambulance provider located in Lowell, Massachusetts. This profile covers 7 Medicare and 12 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 | Pridestar Ems Inc |
| Address | 229 Stedman St |
| City | Lowell |
| State | MA |
| ZIP | 01851 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | June 13, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $18.1M |
| Medicare | $4.6M |
PRIDESTAR EMS INC operates as a land ambulance provider with its top Medicare and Medicaid revenue driven overwhelmingly by transport services. The provider’s leading Medicare codes are A0429 (BLS emergency), A0427 (ALS 1 emergency), and A0428 (BLS non‑emergency), and Medicaid revenue is similarly concentrated in A0429, A0428 and mileage/A0425, which indicates the core business is emergency and non‑emergency patient transport rather than ancillary clinical services. The service mix is consistent with a high‑volume regional ambulance operator.
Revenue concentration is very high on both payers. For Medicare, the precomputed top‑3 codes account for 87.7% of the provider’s total Medicare revenue, meaning A0429, A0427 and A0428 together drive nearly all Medicare receipts and create dependence on a narrow set of transport services. For Medicaid, the top‑3 codes account for 83.1% of Medicaid revenue, so a similar concentration exists on the state side as well.
Medicaid dominates this provider’s payer mix by scale: total Medicaid revenue is $18.1M versus total Medicare revenue of $4.6M, indicating the operation is effectively Medicaid‑heavy. This suggests reimbursement exposure and business sensitivity are greater to state Medicaid policies and rates than to Medicare fee‑schedules.
PRIDESTAR shows extreme national prominence on the Medicare BLS emergency code A0429, where it ranks #35 of 7808 providers nationally (100th percentile; extreme outlier). That single code accounts for $2.4M of Medicare revenue and 52.1% of the provider’s Medicare receipts, marking the organization as a substantial national outlier specifically for BLS emergency transports. Other Medicare codes such as A0427 and A0428 are high‑volume but described as typical/unremarkable by their percentiles.
On the Medicaid side the provider is a major in‑state player for core transport codes. A0429 ranks #7 of 242 in‑state (98th percentile; notably above typical state volume) and A0425 (ground mileage) ranks #8 of 295 in‑state (98th percentile; notably above typical state volume), showing PRIDESTAR books both a very large share of emergency BLS transports and substantial mileage billing within Massachusetts. Several other Medicaid codes (A0428, A0427, A0130) register as high or typical state volume but do not approach the top‑code dominance seen for A0429 and A0425.
Operational footprint is suggested by large mileage and claim volumes reported: the provider reported 66.6K Medicare claims for A0425 (ground mileage) and 92.6K Medicaid claims for A0425, indicating sustained high mileage billing across both payers. High mileage claims alongside dominant A0429 volumes are consistent with a broad service area or frequent long‑distance transfers, which has implications for staffing, vehicle fleet, and reimbursement risk tied to per‑mile rates.
Competitive posture is mixed: the provider is a standout for a few transport codes but otherwise a conventional participant. Nationally, beyond the exceptional A0429 showing, codes like A0427 and A0428 are ranked in high percentiles but characterized as typical or unremarkable volume for their peer sets, while in‑state the provider is clearly among the leaders for A0429 and A0425 but less dominant on codes such as A0428 and A0130. This pattern points to concentrated competitive strength in core BLS emergency and mileage billing rather than broad dominance across all EMS code lines.
PRIDESTAR’s NPI has been enumerated since 2006-06-13 (~20 years), indicating long tenure in the market. That longevity, combined with the concentrated high volumes on core transport codes, supports characterization of the entity as an established regional ambulance operator with entrenched referral and dispatch activity tied to Medicaid and selected Medicare transports.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 6,480 | $370 | $2.4M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1,980 | $420 | $822K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 3,470 | $230 | $802K |
| A0425 | Ground mileage, per statute mile | 66,580 | $10 | $466.1K |
| A0434 | Specialty care transport (sct) | 60 | $750 | $42.6K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 120 | $280 | $33.5K |
| A0433 | Advanced life support, level 2 (als 2) | 40 | $600 | $21K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 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.
12 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 49,310 | $200 | $9.9M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 38,340 | $80 | $3.1M |
| A0425 | Ground mileage, per statute mile | 92,590 | $20 | $2M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 8,500 | $200 | $1.7M |
| A0130 | Non-emergency transportation: wheelchair van | 26,810 | $30 | $857.8K |
| S0215 | Non-emergency transportation; mileage, per mile | 20,800 | $10 | $291.3K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 670 | $160 | $104.5K |
| A0434 | Specialty care transport (sct) | 290 | $340 | $100.5K |
| S0209 | Wheelchair van, mileage, per mile | 1,330 | $20 | $23.9K |
| A0380 | Bls mileage (per mile) | 1,330 | $10 | $11.9K |
Showing 1–10 of 12
How this provider's Medicaid billing volume and revenue compare to other Massachusetts providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Massachusetts median
12 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 9 | 60 | 9,300 | $90 | $2.1M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 7 | 240 | 980 | $180 | $1.2M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 17 | 220 | 1,290 | $180 | $740.6K |
| A0130 | Non-emergency transportation: wheelchair van | 14 | 80 | 5,670 | $30 | $449K |
| A0434 | Specialty care transport (sct) | 14 | 30 | 210 | $390 | $404.6K |
| A0425 | Ground mileage, per statute mile | 8 | 300 | 2,300 | $20 | $267.6K |
| S0215 | Non-emergency transportation; mileage, per mile | 26 | 100 | 8,500 | $10 | $253.8K |
| A0999 | Unlisted ambulance service | 12 | 20 | 690 | $30 | $155.8K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 17 | 40 | 510 | $140 | $137K |
| S0209 | Wheelchair van, mileage, per mile | 17 | 40 | 750 | $20 | $41K |
Showing 1–10 of 12
Other providers in the same ZIP code as Pridestar Ems Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Commonwealth Of Massachusetts | MA | Case Management Agency | $0 | $306.3M |
| Better Life At Home LLC. | MA | Home Health Agency | $0 | $31.6M |
| Essy Nursing Services Inc | MA | Home Health Agency | $0 | $23M |
| Trinity Ems, Inc. | MA | Land Ambulance | $0 | $13.6M |
| Dental Dreams, LLC | MA | General Practice Dentistry | $0 | $11.3M |
| Active Ma, Inc. | MA | Adult Day Care Clinic/Center | $0 | $9.5M |
| Elm Tree Clinic, LLC | MA | Internal Medicine Physician | $0 | $8.3M |
| Northeast Endoscopy Center, LLC | MA | Endoscopy Clinic/Center | $922.4K | $209.6K |
| Cvs Pharmacy Inc | MA | Pharmacy | $283.2K | $0 |
| Paul Burke | MA | Vascular Surgery Physician | $218.6K | $0 |
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