Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Rhode Island for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Rhode Island only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Rhode Island (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Nardone Medical Associates, Inc. (NPI 1205939097)

Field	Value
Entity Type	Organization
Organization	Nardone Medical Associates, Inc.
Address	333 School St
City	Pawtucket
State	RI
ZIP	02860
Taxonomy	Internal Medicine Physician
NPI Enumerated	September 6, 2006

Payer Source	Total Paid
Medicaid	$569K
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	4,710	$60	$272.9K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	4,160	$50	$199.7K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	710	$70	$47.1K
93000	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	1,030	$20	$19.6K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	230	$60	$12.8K
G0444	Annual depression screening, 5 to 15 minutes	290	$10	$3.7K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	490	$10	$3K
96160	The provider administers a questionnaire aimed at helping to identify a specific health risk to a patient, analyzes the results, assigns a score, and documents the findings. Use this code for each…	650	$1	$2.6K
0002A	N/A	40	$40	$1.6K
99497	The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…	30	$60	$1.6K

Showing 1–10 of 18

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Rhode Island providers billing the same CPT/HCPCS codes.

Claims Volume vs. Rhode Island Distribution

Nardone Medical Associates, Inc. — 3 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

18 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	70	1,730	220	$70	$75.2K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	127	2,050	300	$50	$72.3K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	17	50	170	$10	$38.1K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	358	500	90	$50	$24.9K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	24	50	290	$10	$16.1K
0002A	N/A	21	30	90	$30	$10.5K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	5	120	50	$70	$9.9K
0001A	N/A	29	40	50	$20	$9.7K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	24	150	50	$70	$9.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	305	500	90	$10	$8.5K

Showing 1–10 of 18

Related Providers

Other providers that share a Tax Identification Number (TIN) with Nardone Medical Associates, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Amber Gul	RI	Internal Medicine Physician	$56.5K	$431.8K
Ahmad Al-raqqad	RI	Internal Medicine Physician	$0	$324.4K

Nearby Providers

Other providers in the same ZIP code as Nardone Medical Associates, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gateway Healthcare Inc	RI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$122.7M
Nursing Placement, Inc.	RI	Home Health Agency	$0	$63.4M
United Cerebral Palsy Of Rhode Island, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$21.3M
Lifetime Financial Management Inc.	RI	Home Health Agency	$0	$20.9M
Addiction Recovery Institute	RI	Community/Behavioral Health Agency	$180.1K	$15.4M
Blackstone Valley Community Health Care	RI	Federally Qualified Health Center (FQHC)	$0	$14.2M
Blackstone Valley Community Health Care, Inc.	RI	Federally Qualified Health Center (FQHC)	$0	$12.4M
United Cerebral Palsy Of Rhode Island, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$9.6M
Dr. Day Care, Inc.	RI	Counselor	$0	$8.7M
Sheila Brijade	RI	Pediatric Dentistry	$0	$7.7M

Nardone Medical Associates, Inc. — Billing Profile & Reimbursement Data

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Nardone Medical Associates, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References