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    OpenPayerNPI Medicare & MedicaidWorcester Pediatric Dental Group LLC
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    Worcester Pediatric Dental Group LLC — Billing Profile & Reimbursement Data

    NPI 1245402577 · Worcester, MA · Pediatric Dentistry

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    Worcester Pediatric Dental Group LLC is a pediatric dentistry provider located in Worcester, Massachusetts. This profile covers 0 Medicare and 23 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 TypeOrganization
    OrganizationWorcester Pediatric Dental Group LLC
    Address144 Pleasant St
    CityWorcester
    StateMA
    ZIP01609
    TaxonomyPediatric Dentistry
    NPI EnumeratedMarch 27, 2008

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

    Payer SourceTotal Paid
    Medicaid$5.9M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    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

    Medicaid: Complete Services Breakdown

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

    23 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    D1120Prophylaxis–child20,540$50$1M
    D0120Periodic oral evaluation - established patient22,230$30$644.6K
    D1206Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients23,810$30$619.2K
    D2392Post 2 surface resin‑based composite5,520$110$591.1K
    D2391Resin‑based composite – one surface, posterior4,280$80$359.4K
    D2150Amalgam - two surfaces, primary or permanent3,630$80$304.6K
    D0272N/A9,740$30$282.4K
    D1351Sealant - per tooth7,110$40$277.4K
    D1110Prophylaxis - adult; cleaning and polishing of the teeth3,870$70$259K
    D2930N/A1,290$180$235.1K

    Showing 1–10 of 23

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Massachusetts median

    23 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    D2930N/A3590830$180$325.7K
    D1120Prophylaxis–child201,050470$50$119.2K
    D1110Prophylaxis - adult; cleaning and polishing of the teeth2461,480900$50$118.2K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)79440410$70$115.7K
    D2392Post 2 surface resin‑based composite43780420$80$109.6K
    D1351Sealant - per tooth53450490$40$101.3K
    D2391Resin‑based composite – one surface, posterior56660340$60$84.9K
    D1206Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients22690460$30$81.1K
    D0120Periodic oral evaluation - established patient441,510980$20$78.6K
    D0274N/A811,160580$30$60.6K

    Showing 1–10 of 23

    Nearby Providers

    Other providers in the same ZIP code as Worcester Pediatric Dental Group LLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Counseling & Assessment Clinic Of Worcester LLCMACommunity/Behavioral Health Agency$0$17.5M
    Wells Health Care LLCMAHome Health Agency$0$11.5M
    Worcester Hills Dental PCMAGeneral Practice Dentistry$0$11.4M
    Jewish Healthcare Center, Inc.MACommunity Based Hospice Care Agency$0$8.2M
    Prestige Health Care Services IncMAHome Health Agency$0$7.4M
    Family Care AdhMAAdult Day Care Clinic/Center$0$7.3M
    Anas Al NajjarMAOrthodontics and Dentofacial Orthopedics Dentistry$0$6.3M
    Melinda ThackerMAOtolaryngology Physician$122.6K$3K
    Jonathon SillmanMAOtolaryngology Physician$61.1K$4.4K
    Susan FoleyMAAudiologist$22K$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.

    Medicaid Revenue by Year vs. Massachusetts Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Massachusetts Distribution
    Worcester Pediatric Dental Group LLC — 6 of 23 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Massachusetts