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    OpenPayerNPI Medicare & MedicaidAnthony Baldoni
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    Anthony Baldoni — Billing Profile & Reimbursement Data

    NPI 1134508112 · Roanoke, VA · Gastroenterology Physician

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    Anthony Baldoni is a gastroenterology physician provider located in Roanoke, Virginia. This profile covers 14 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationAnthony Baldoni
    Address3 Riverside Cir
    CityRoanoke
    StateVA
    ZIP24016
    TaxonomyGastroenterology Physician
    NPI EnumeratedMay 25, 2015

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$70.7K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    14 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    45385The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…130$190$24.8K
    43239The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.100$70$7.3K
    99222The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…70$100$7K
    99232The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…80$60$4.7K
    99223The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…30$130$3.9K
    99214The 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…60$70$3.8K
    45390The provider performs flexible colonoscopy along with excision of mucous membrane tissue using an endoscope.10$260$3.6K
    43235The provider inserts an endoscope through the mouth and down into the esophagus, stomach, and duodenum for diagnostic purposes; the provider may collect specimens by brushing or washing.40$80$2.9K
    45380The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…40$70$2.6K
    99204The 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…30$90$2.5K

    Showing 1–10 of 14

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    14 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    453859940070$260$24.7K
    992149,24612,890140$80$21K
    4538026040060$160$12.9K
    992322,2434,46080$60$11K
    9921310,03012,44090$60$10K
    45390254020$370$9.7K
    4323910439070$110$9.3K
    992232,1073,66040$130$9.2K
    G012115519020$250$7.2K
    992044,2096,85040$110$5.9K

    Showing 1–10 of 14

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Anthony Baldoni, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Carilion Medical CenterVAGeneral Acute Care Hospital$0$124.7M
    Carilion Medical CenterVAMulti-Specialty Clinic/Center$0$73.4M
    Carilion Healthcare CorporationVAMulti-Specialty Clinic/Center$0$26.1M
    Carilion Franklin Memorial HospitalVAGeneral Acute Care Hospital$0$18.4M
    Carilion Medical CenterVAEmergency Medicine Physician$0$18.1M
    Carilion Rockbridge Community HospitalVACritical Access Hospital$0$11.8M
    Llewellyn LeeTXVascular & Interventional Radiology Physician$834.2K$0
    William JonesVAUrology Physician$468.4K$0
    John MarshVAFamily Medicine Physician$457.4K$5.1K
    Rahul SharmaAZInterventional Cardiology Physician$392.9K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Blue Ridge Behavioral HealthcareVAMental Health Clinic/Center (Including Community Mental Health Center)$0$75.7M
    Mainstream Mental Health ServicesVACommunity/Behavioral Health Agency$0$32.9M
    Ehs Support Services, LLCVACommunity/Behavioral Health Agency$0$28.4M
    Anderson & Associates, LLCVASubstance Abuse Rehabilitation Facility$0$17.9M
    Hall Community Services IncVAMental Health Counselor$0$16.6M
    Vistar Eye Center, IncVASpecialist$0$11.4M
    Professional Therapies Of Roanoke, Inc.VARehabilitation Clinic/Center$0$10.5M
    It's About Time, IncVADevelopmentally Disabled Services Day Training Agency$0$9.4M
    Roanoke Resource LLCVACommunity/Behavioral Health Agency$0$8.3M
    Carilion Medical CenterVAHome Health Agency$0$7.3M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    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.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Virginia Distribution
    Anthony Baldoni — 0 of 14 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Virginia