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NPI 1194952929 · Providence, RI · Gastroenterology Physician
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Jason Ferreira is a gastroenterology physician provider located in Providence, Rhode Island. This profile covers 22 Medicare and 5 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 | Individual |
| Organization | Jason Ferreira |
| Address | 148 W River St Ste 3 |
| City | Providence |
| State | RI |
| ZIP | 02904 |
| Taxonomy | Gastroenterology Physician |
| NPI Enumerated | June 19, 2009 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $261.5K |
| Medicaid | $246.5K |
Payer mix is roughly balanced between Medicare and Medicaid: lifetime Medicare revenue is $261.5K and lifetime Medicaid revenue is $246.5K, so neither payer dominates this provider’s revenue base and the practice appears to rely on a near-parity of public payers. This dual-payer footprint implies operational workflows that must serve both fee-for-service Medicare infusion claims and higher-volume Medicaid procedural throughput.
Medicare revenue is highly concentrated in biologic and infusion drug codes: the top three Medicare codes by revenue (J3380, J1745, J1439) account for 69.6% of the provider’s total Medicare revenue. In particular J3380 accounts for $112.2K (42.9% of Medicare revenue) and J1745 accounts for $49.7K (19.0%), indicating that management and administration of infused biologics are the primary drivers of Medicare billing.
By contrast, Medicaid revenue is extremely concentrated in endoscopy and related outpatient services: the top three Medicaid codes (43239, 45380, 99214) account for 97.7% of this provider’s total Medicaid revenue. Code 43239 alone generates $119.8K (48.7%) and 45380 generates $99.3K (40.4%), showing Medicaid revenue is dominated by diagnostic upper endoscopy with biopsy and colonoscopy with biopsy rather than drug infusion.
Service-line implication: the combination of high Medicare revenue from injectable biologics (J3380, J1745) and high Medicaid revenue from endoscopic procedures (43239, 45380) points to a gastroenterology practice that operates both an infusion service (for IBD/immune-modulating biologics) and a high-volume endoscopy/ambulatory procedure line. This split suggests the provider manages mixed clinical workflows—infusion administration for Medicare patients and procedural endoscopy throughput that is billed heavily to Medicaid.
Competitive standing is mixed across payers and codes. For Medicare biologic codes the provider is a modest national participant (J3380 ranks #388 of 620, 35th percentile; J1745 ranks #917 of 1352, 32th percentile), described in the data as typical/unremarkable volume for these codes. At the same time, several endoscopy procedure codes show relatively strong national procedural standing (e.g., 43239 ranks #2250 of 17140, 87th percentile; 45380 ranks #2683 of 16427, 83th percentile), indicating above-average national activity on core GI procedures.
State-level competitive standing for Medicaid endoscopy is strong: 43239 ranks #6 of 37 in-state (86th percentile) and 45380 ranks #4 of 15 in-state (79th percentile), both labeled typical/unremarkable in the dataset but numerically placing the provider among higher-volume Medicaid endoscopists in Rhode Island. This suggests the provider is a notable in-state resource for upper endoscopy and colonoscopy services billed to Medicaid.
Operational detail and billing patterns show some notable volume/price combinations: for Medicare the provider reported 20.3K claims for J1439 at an average paid/claim of $1 and $20.3K revenue, which the dataset characterizes as typical/unremarkable volume for that code. On Medicaid, the average paid/claim is substantially higher for procedural services (43239 average $145; 45380 average $258), consistent with facility-based or procedure-focused reimbursement rather than per-unit drug billing.
Tenure and stability: the NPI was enumerated on 2009-06-19 (~17 years ago), indicating an established practice history that aligns with the mixed infusion-and-procedure business model reflected in the billing mix. That longevity supports the interpretation that the observed split between infusion-dominant Medicare billing and procedure-dominant Medicaid billing is a sustained operational pattern rather than a brief anomaly.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
22 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J3380 | Injection, vedolizumab, intravenous, 1 mg | 6,600 | $20 | $112.2K |
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | 1,910 | $30 | $49.7K |
| J1439 | Injection, ferric carboxymaltose, 1 mg | 20,250 | $1 | $20.3K |
| 45380 | The 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… | 120 | $120 | $14.9K |
| 45385 | The 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… | 50 | $190 | $9.8K |
| 99222 | The 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… | 80 | $110 | $8.5K |
| 43239 | The 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. | 160 | $50 | $7.2K |
| 43259 | An esophagogastroduodenoscopy is a procedure to view the esophagus, stomach, and duodenum by means of flexible endoscope through the mouth. During this procedure, the physician uses endoscopic… | 40 | $170 | $6K |
| 99214 | The 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 | $100 | $5.6K |
| 43242 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where, under endoscopic ultrasound guidance, he carries out a fine needle aspiration or… | 30 | $200 | $5K |
Showing 1–10 of 22
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 22 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
22 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J3380 | 3 | 10 | 8,700 | $20 | $152.8K |
| J1745 | 2 | 10 | 1,850 | $30 | $65K |
| 45385 | 35 | 60 | 60 | $310 | $27.9K |
| 45380 | 11 | 60 | 60 | $210 | $17.9K |
| J1439 | 2 | 10 | 18,000 | $1 | $15.1K |
| 43239 | 6 | 60 | 60 | $130 | $12.3K |
| 99214 | 1,243 | 1,950 | 100 | $80 | $11.7K |
| 96413 | 8 | 10 | 50 | $110 | $8.6K |
| G0121 | 16 | 20 | 20 | $310 | $8.4K |
| 99213 | 1,810 | 1,950 | 70 | $60 | $7.4K |
Showing 1–10 of 22
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.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 43239 | The 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. | 830 | $150 | $119.8K |
| 45380 | The 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… | 390 | $260 | $99.3K |
| 99214 | The 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… | 340 | $60 | $21.3K |
| 99222 | The 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… | 50 | $90 | $4.1K |
| 99152 | The provider performing a diagnostic or therapeutic procedure administers medication to reduce consciousness, but not render the patient unconscious or asleep, in a patient five years of age or… | 30 | $50 | $1.5K |
How this provider's Medicaid billing volume and revenue compare to other Rhode Island providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Rhode Island median
5 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 45380 | The 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… | 4 | 20 | 110 | $460 | $140.3K |
| 43239 | The 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. | 6 | 40 | 70 | $300 | $116.1K |
| 99214 | The 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… | 701 | 1,730 | 220 | $70 | $75.2K |
| 99222 | The 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… | 34 | 60 | 60 | $90 | $32.5K |
| 99152 | The provider performing a diagnostic or therapeutic procedure administers medication to reduce consciousness, but not render the patient unconscious or asleep, in a patient five years of age or… | 13 | 20 | 60 | $80 | $28.3K |
Other providers in the same ZIP code as Jason Ferreira, ranked by combined Medicare and Medicaid revenue.
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