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    OpenPayerNPI Medicare & MedicaidAkash Vadalia
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    Akash Vadalia — Billing Profile & Reimbursement Data

    NPI 1225564222 · Manchester, NH · Psychiatry Physician

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    Akash Vadalia is a psychiatry physician provider located in Manchester, New Hampshire. This profile covers 13 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
    OrganizationAkash Vadalia
    Address138 Webster St
    CityManchester
    StateNH
    ZIP03104
    TaxonomyPsychiatry Physician
    NPI EnumeratedMay 11, 2017

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

    Payer SourceTotal Paid
    Medicare$328.5K
    Medicaid$0

    Key Findings

    This provider is effectively single-payer Medicare: lifetime Medicare revenue is $328.5K and there is no Medicaid billing on file, so Medicaid does not appear in the payer mix and Medicare is the sole recorded public-payer revenue source. Analysts should treat results as reflective of a Medicare-focused practice rather than a mixed Medicaid/Medicare operation.

    Revenue is highly concentrated in a small set of services: the top three Medicare codes are 99232 ($184.3K, 56.3%), 99308 ($31.2K, 9.5%), and 99309 ($22.3K, 6.8%), and these three codes together account for 72.7% of this provider's total Medicare revenue. This concentration indicates that a few institutional E/M services drive most of the revenue exposure.

    The code mix indicates a practice oriented to institutional and post-acute psychiatry: 99232 is the leading revenue generator (subsequent hospital inpatient/observation E/M), with substantial nursing facility follow-up represented by 99308 and 99309. Additional codes for initial and subsequent hospital care (99222, 99223), nursing facility initial visits (99305), and home/residence visits (99349, 99348, 99344) point to a blended model of hospital rounds, SNF care, and home-based follow-up rather than a strictly outpatient clinic practice.

    Competitive standing on the dominant code is extreme: 99232 ($184.3K, 56.3% of Medicare revenue) ranks #536 of 177383 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code), indicating the provider is a very high-volume national outlier for subsequent inpatient/observation psychiatry visits. This suggests a major operational emphasis or a local referral relationship driving hospital-based volumes.

    Other high-volume codes show a more typical competitive posture: 99308 ($31.2K, 9.5%) ranks #5544 of 25763 (78th percentile; typical, unremarkable volume) and 99309 ($22.3K, 6.8%) ranks #12052 of 28092 (57th percentile; typical, unremarkable volume), so nursing-facility work is meaningful but not anomalously large relative to peers. The psychiatric evaluation code 90792 ($17.6K, 5.4%) ranks #704 of 8250 (91th percentile; typical, unremarkable volume), indicating reasonable volume of diagnostic/medical psychiatric evaluations.

    The provider bills a measurable amount of home-based E/M: 99349 ($15.6K, 4.8%) and 99348 ($13.8K, 4.2%) together represent nearly 9% of Medicare revenue and are ranked in the mid-to-upper percentiles nationally (99349 rank #5211 of 14284, 63th percentile; 99348 rank #1754 of 11547, 85th percentile). This pattern supports a service line that includes home visits for established patients in addition to institutional care.

    Specialized procedures are present but limited: 90870 (ECT) appears with 57 claims generating $4.7K (1.4% of Medicare revenue) and ranks #403 of 512 providers nationally (21th percentile; typical, unremarkable volume), indicating the provider performs electroconvulsive therapy only at modest frequency relative to the small national pool of ECT providers. Analysts should view ECT as a niche, not a primary revenue driver.

    This NPI has been enumerated since 2017-05-11 (~9 years ago), so the provider is established but not a long-tenured practitioner by multi-decade standards; the observed high-volume 99232 activity has been developed within that ~9-year span. Tenure combined with the concentrated code mix suggests a focused, stable service footprint centered on hospital and post-acute psychiatric care rather than a recent or transient billing anomaly.

    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.

    13 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    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…2,970$60$184.3K
    99308The 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…550$60$31.2K
    99309The 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…270$80$22.3K
    90792In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…130$140$17.6K
    99349The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…160$100$15.6K
    99348The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30…240$60$13.8K
    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…60$140$7.9K
    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…80$100$7.8K
    99305The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…70$100$7.2K
    99239The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…70$90$6.6K

    Showing 1–10 of 13

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    13 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    9930961170190$70$21.7K
    9930815150130$50$11.2K
    9923332360070$90$10.9K
    99232299070$60$9.8K
    99349147050$80$7.5K
    9087061070$80$7.3K
    9922319270030$130$7.2K
    9923917138060$90$7.1K
    9934876050$50$5.7K
    99305146040$90$5.6K

    Showing 1–10 of 13

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Michael SpatcherNHPsychiatry Physician$251K$0
    Jwalant Vadalia Md PCNHPsychiatry Physician$0$157.3K
    Bryan FisherNHPsychiatric/Mental Health Nurse Practitioner$151.7K$0
    Reinhard ViehoffNHGeriatric Psychiatry Physician$144.6K$0
    Meagan LentzNHClinical Neuropsychologist$105.1K$0
    Katherine GormanNHClinical Neuropsychologist$87.9K$0
    Lauren GelinasNHPhysician Assistant$84.2K$0
    Benjamin FernandesNHGeriatric Psychiatry Physician$84K$0
    Jwalant VadaliaNHGeriatric Psychiatry Physician$80.4K$0
    Deborah MoserNHPsychiatric/Mental Health Nurse Practitioner$68.6K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Interim Healthcare Of The Neast, LLCNHHome Health Agency$0$32.6M
    Carepoint Plus LLCNHHome Health Agency$0$19.2M
    Home Base Collaborative Family CounselingNHClinical Social Worker$0$18.2M
    Summit New Hampshire LLCNHPhysical Disabilities Residential Treatment Facility$0$11.8M
    Interim Healthcare Of The Neast, LLCNHHome Health Agency$0$4.5M
    Ofemz Home Healthcare Agency, LLCNHHome Health Agency$0$2.5M
    Masonic HomeNHAssisted Living Facility$0$2.4M
    Maxwell EliaNHOphthalmology Physician$2.3M$0
    Bio-medical Applications Of Manchester, Inc.NHEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center$0$2.3M
    Ahad FazelatNHOphthalmology Physician$2.1M$0

    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. New Hampshire Distribution
    Akash Vadalia — 2 of 13 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — New Hampshire