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NPI 1194797993 · Shelton, CT · Clinical Medical Laboratory
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Ameripath New York LLC is a clinical medical laboratory provider located in Shelton, Connecticut. This profile covers 25 Medicare and 10 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 | Ameripath New York LLC |
| Address | 1 Greenwich Pl |
| City | Shelton |
| State | CT |
| ZIP | 06484 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | February 6, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $7.7M |
| Medicare | $2.9M |
Payer mix and scale: AMERIPATH NEW YORK LLC reports $2.9M in total Medicare revenue and $7.7M in total Medicaid revenue, indicating Medicaid is the larger payer relationship by dollars. This makes the entity effectively more Medicaid-driven in revenue scale while maintaining a meaningful Medicare business line.
High revenue concentration across a few codes: The provider’s Medicare revenue is heavily concentrated, with the top 3 Medicare codes accounting for 79.6% of total Medicare revenue, and its Medicaid revenue concentration is even more extreme, with the top 3 Medicaid codes accounting for 96.2% of total Medicaid revenue. That pattern indicates most of this entity’s billing dollars are tied to a very small set of procedure types for each payer.
Clinical service mix and operational profile: The Medicare code mix is weighted toward flow cytometry and surgical pathology—notably 88185 (54.7K claims, $1.1M revenue, 39.1% of Medicare revenue), 88305 (18.2K claims, $1M revenue, 34.6% of Medicare revenue), and 88189 (2.5K claims, $171.2K revenue, 5.8% of Medicare revenue). These volumes and code types are consistent with a centralized clinical medical laboratory offering high-throughput immunophenotyping and pathology interpretation rather than a general diagnostic lab.
Medicare competitive standing: The provider is a national high-volume outlier on key Medicare codes—88185 ranks #6 of 618 providers nationally (99th percentile; extreme outlier), 88305 ranks #96 of 14580 providers nationally (99th percentile; extreme outlier), and 88189 ranks #8 of 1717 providers nationally (100th percentile; extreme outlier). Those rankings indicate AMERIPATH NEW YORK operates at scale nationally for flow cytometry and certain pathology interpretation services.
Medicaid competitive standing in-state: On Medicaid the provider is a dominant in-state participant for surgical pathology and special stains—88305 is 42.8K claims and $4.9M revenue (63.9% of Medicaid revenue) and ranks #5 of 86 providers in-state (95th percentile), while 88312 (11K claims, $1.6M, 20.5% of Medicaid revenue) ranks #2 of 45 in-state (98th percentile; notably above typical state volume) and 88313 (11.7K claims, $911.6K, 11.8% of Medicaid revenue) ranks #4 of 40 in-state (92nd percentile; notably above typical state volume). These positions imply strong state-level referral relationships for histology and special stain services.
Operational concentration implications: With single codes representing large shares (for example 88305 represents 63.9% of Medicaid revenue and 34.6% of Medicare revenue, and 88185 represents 39.1% of Medicare revenue), the provider’s revenue is sensitive to changes in reimbursement, referral patterns, or utilization for a very small set of services. That concentration suggests any payer policy, contract shifts, or clinical guideline changes affecting these codes would have outsized financial and operational impacts.
Tenure and stability signal: The NPI was enumerated on 2006-02-06 (~20 years ago), indicating long-standing operation in the market. Combined with the high volumes and top-code rankings, this tenure supports a picture of an established laboratory with sustained referral and billing activity.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
25 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 88185 | The lab analyst performs the technical component of a flow cytometry procedure using cell surface, cytoplasmic, or nuclear markers to characterize cells and aid clinicians in diagnosing patients with… | 54,720 | $20 | $1.1M |
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 18,160 | $60 | $1M |
| 88189 | The clinician, typically a pathologist, interprets flow cytometry results of 16 or more markers. | 2,520 | $70 | $171.2K |
| 88184 | The lab analyst performs the technical component of a flow cytometry procedure using a cell surface, cytoplasmic, or nuclear marker to characterize cells and aid clinicians in diagnosing patients… | 2,360 | $60 | $148.5K |
| 88341 | The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified… | 1,400 | $70 | $95.1K |
| 88342 | The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,… | 1,010 | $80 | $75.5K |
| 88275 | The analyst performs a molecular cytogenetic test using interphase in situ hybridization and analyzes 100 to 300 cells. Interphase refers to a period of time when a cell is not dividing and… | 1,060 | $50 | $53.2K |
| 88313 | The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,… | 710 | $60 | $44.6K |
| 88271 | The analyst performs a molecular cytogenetic test using a DNA probe method, such as FISH, fluorescence in situ hybridization, to test cells for genetic abnormalities. | 2,070 | $20 | $43.4K |
| 88237 | The lab analyst performs a procedure to grow a culture of cells from bone marrow or blood in a neoplastic disorder. | 240 | $140 | $33.7K |
Showing 1–10 of 25
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 25 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
25 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 88185 | 1 | 10 | 32,650 | $20 | $642.3K |
| 88275 | 3 | 10 | 1,910 | $50 | $106.1K |
| 81450 | 2 | 10 | 130 | $740 | $96K |
| 88271 | 3 | 10 | 4,250 | $20 | $82.1K |
| 88184 | 1 | 10 | 1,290 | $60 | $81.1K |
| 88237 | 4 | 10 | 460 | $140 | $64K |
| 88264 | 3 | 10 | 460 | $140 | $55.3K |
| 88305 | 2 | 200 | 410 | $40 | $44.6K |
| 81206 | 3 | 10 | 120 | $160 | $37.3K |
| 81279 | 2 | 10 | 140 | $180 | $26.1K |
Showing 1–10 of 25
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.
10 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 42,840 | $120 | $4.9M |
| 88312 | The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets… | 10,980 | $140 | $1.6M |
| 88313 | The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,… | 11,690 | $80 | $911.6K |
| 88342 | The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,… | 3,530 | $50 | $166K |
| 88185 | The lab analyst performs the technical component of a flow cytometry procedure using cell surface, cytoplasmic, or nuclear markers to characterize cells and aid clinicians in diagnosing patients with… | 500 | $130 | $63.5K |
| 88341 | The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified… | 600 | $70 | $44.5K |
| 88189 | The clinician, typically a pathologist, interprets flow cytometry results of 16 or more markers. | 470 | $20 | $7.5K |
| 88184 | The lab analyst performs the technical component of a flow cytometry procedure using a cell surface, cytoplasmic, or nuclear marker to characterize cells and aid clinicians in diagnosing patients… | 510 | $10 | $6.1K |
| 82657 | The lab analyst measures the enzyme activity found from within the cells, which can be from a variety of locations including tissue. He uses a nonradioactive substrate for the test. Use this code… | 180 | $10 | $1.2K |
| 88112 | Selective cellular enhancement for cytopathology, such as the method of using a liquid–based slide preparation, uses a liquid–based medium to collect samples and preserve cells which can aid in… | 10 | $90 | $1.1K |
How this provider's Medicaid billing volume and revenue compare to other Connecticut providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Connecticut median
10 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 5 | 90 | 3,980 | $40 | $424.8K |
| 88184 | The lab analyst performs the technical component of a flow cytometry procedure using a cell surface, cytoplasmic, or nuclear marker to characterize cells and aid clinicians in diagnosing patients… | 7 | 10 | 650 | $80 | $188.6K |
| 88185 | The lab analyst performs the technical component of a flow cytometry procedure using cell surface, cytoplasmic, or nuclear markers to characterize cells and aid clinicians in diagnosing patients with… | 7 | 10 | 630 | $60 | $132.7K |
| 88313 | The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,… | 4 | 40 | 1,210 | $30 | $99.6K |
| 88342 | The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,… | 20 | 50 | 1,720 | $30 | $88.3K |
| 88312 | The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets… | 2 | 50 | 470 | $40 | $86.6K |
| 88189 | The clinician, typically a pathologist, interprets flow cytometry results of 16 or more markers. | 5 | 10 | 170 | $30 | $47.5K |
| 82657 | The lab analyst measures the enzyme activity found from within the cells, which can be from a variety of locations including tissue. He uses a nonradioactive substrate for the test. Use this code… | 2 | 10 | 180 | $20 | $46.2K |
| 88112 | Selective cellular enhancement for cytopathology, such as the method of using a liquid–based slide preparation, uses a liquid–based medium to collect samples and preserve cells which can aid in… | 28 | 30 | 440 | $20 | $29.6K |
| 88341 | The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified… | 16 | 40 | 500 | $20 | $23.7K |
Other providers in the same ZIP code as Ameripath New York LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Pediatric Services Of America, LLC | CT | Home Health Agency | $0 | $92.9M |
| Adult Day Care Of America, Inc. | CT | In Home Supportive Care Agency | $0 | $35.1M |
| Dianon Systems, Inc | CT | Clinical Medical Laboratory | $4.9M | $8.5M |
| Option Care Enterprises, Inc | CT | Home Infusion Therapy Pharmacy | $0 | $13.3M |
| Esoterix Genetic Laboratories, LLC | CT | Clinical Medical Laboratory | $2.2M | $3.2M |
| Enzo Clinical Labs, Inc. | CT | Clinical Medical Laboratory | $0 | $3.8M |
| Bridgeport Radiological Associates LLC | CT | Diagnostic Radiology Physician | $0 | $2.9M |
| Shelton Pediatrics | CT | Pediatrics Physician | $0 | $2.7M |
| Echo Hose Hook And Ladder Ambulance Corps., Inc. | CT | Land Ambulance | $568.5K | $1.7M |
| Shelton Dental Group LLC | CT | Dentist | $0 | $2.1M |
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