Loading...
NPI 1346680790 · Brooklyn, NY · Surgery Physician
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Joseph Sidaoui is a surgery physician provider located in Brooklyn, New York. This profile covers 18 Medicare and 12 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 | Joseph Sidaoui |
| Address | 27 Kingsland Ave Apt 2l |
| City | Brooklyn |
| State | NY |
| ZIP | 11211 |
| Taxonomy | Surgery Physician |
| NPI Enumerated | June 30, 2013 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $16.3M |
| Medicaid | $297.2K |
This provider is effectively Medicare-dominant: lifetime Medicare revenue is $16.3M compared with $297.2K in lifetime Medicaid revenue, indicating Medicare accounts for the vast majority of billed dollars. The scale difference suggests the practice’s commercial footprints, contracts, and operational focus are primarily aligned with Medicare patients and reimbursements rather than Medicaid.
Medicare revenue is highly concentrated: the precomputed top-3 Medicare codes account for 85.5% of this provider’s total Medicare revenue, driven primarily by Q4236 ($10M, 61.5% of Medicare revenue), Q4205 ($3.2M, 19.5%), and 99309 ($730.6K, 4.5%). These top lines point to a service mix centered on skin/substitute products and related procedures plus frequent nursing-facility E/M visits, where a small set of codes supplies the majority of incoming Medicare dollars.
Medicaid billing is also concentrated: the precomputed top-3 Medicaid codes account for 63.5% of this provider’s total Medicaid revenue, led by 99308 ($94.7K, 31.1%), 99309 ($55.3K, 18.2%), and 11042 ($43.5K, 14.3%). The Medicaid mix emphasizes nursing-facility subsequent visits and wound debridement, mirroring the Medicare service footprint but at a much smaller revenue scale.
The provider’s national competitive standing on several Medicare codes is elevated: Q4236 ranks #7 of 79 (92th percentile; notably above typical national volume) and Q4205 ranks #12 of 63 (82th percentile; typical volume), indicating above‑typical national activity for skin substitute and membrane graft billing. Separately, multiple nursing-facility E/M and debridement codes (for example 99309, 11043, 11042, 11046) are reported as “extreme outlier” or 100th percentile rankings nationally, marking exceptionally high utilization relative to most peers.
State-level Medicaid positioning shows dominance in specific lines: 99308 ranks #19 of 2087 in-state (99th percentile; extreme outlier) and 11042 ranks #2 of 144 in-state (99th percentile; notably above typical state volume). These rankings indicate the provider is a major in-state participant for nursing-facility E/M visits and debridement procedures, even though the absolute Medicaid revenue ($297.2K) is small compared with Medicare.
Operational patterns point to a wound-care and post-acute services model: large Medicare receipts for Q4236 and Q4205 combined with high-volume surgical debridement codes (11042: 7.6K Medicare claims, $62 avg paid/claim; 11043: 2.8K Medicare claims, $176 avg paid/claim) and many nursing-facility E/M codes imply frequent on-site procedural work plus longitudinal facility visits. The coexistence of skin substitute add-on codes and repeated debridements is consistent with a practice specializing in wound management and surgical tissue care in post-acute settings.
There is a marked reimbursement disparity between payers on identical procedure volumes: for 11042 the provider reports 7.6K Medicare claims with $62 avg paid/claim and 14.5K Medicaid claims with $3 avg paid/claim, showing similar or greater Medicaid utilization but far lower per-claim reimbursement. This gap suggests the same service mix operates across both payers but with materially different revenue per encounter, which impacts margin and payer negotiation priorities.
Tenure and cumulative performance: the NPI was enumerated 2013-06-30 (~13 years ago), and the lifetime reporting shows concentrated, sustained billing patterns (e.g., 10K claims for Q4236, 9.1K claims for 99308 on Medicare). The combination of sustained high-volume coding and multi-year activity supports the view of an established, narrowly focused service operation with entrenched volume in wound-care and nursing-facility E/M services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
18 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| Q4236 | Carepatch, per square centimeter (add-on, list separately in addition to primary procedure) | 10,050 | $1,000 | $10M |
| Q4205 | Membrane graft or membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure) | 2,740 | $1,160 | $3.2M |
| 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… | 7,610 | $100 | $730.6K |
| 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… | 9,150 | $70 | $612.7K |
| 11043 | The provider uses surgical instruments to remove the dead tissue in muscle and/or fascia, including any debridement of the epidermis, dermis, and subcutaneous tissue, for the first or only 20 cm2 or… | 2,780 | $180 | $489.5K |
| 11042 | The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2. | 7,600 | $60 | $471.3K |
| 11046 | The provider uses surgical instruments to remove the dead tissue from the muscle and/or fascia, as well as the subcutaneous tissue layer, epidermis, and dermis if needed. She performs this service at… | 3,800 | $60 | $228.2K |
| 99307 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the… | 4,740 | $40 | $165.7K |
| 99305 | The 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… | 740 | $120 | $88.9K |
| 99304 | The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves straightforward or low medical decision making or the provider… | 1,230 | $70 | $88.6K |
Showing 1–10 of 18
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
18 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| Q4236 | 1 | 10 | 10,050 | $1,000 | $10M |
| Q4205 | 1 | 10 | 2,740 | $1,160 | $3.2M |
| 99308 | 8 | 2,360 | 250 | $60 | $44.9K |
| 99309 | 2 | 2,150 | 220 | $90 | $41.7K |
| 11043 | 2 | 100 | 50 | $170 | $29K |
| 99349 | 234 | 790 | 100 | $100 | $27.3K |
| 11046 | 2 | 30 | 110 | $60 | $27.3K |
| 99305 | 30 | 940 | 60 | $110 | $16.9K |
| 99306 | 461 | 1,060 | 60 | $150 | $16.6K |
| 99348 | 97 | 670 | 80 | $60 | $13.9K |
Showing 1–10 of 18
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.
12 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 18,940 | $10 | $94.7K |
| 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… | 11,070 | $10 | $55.3K |
| 11042 | The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2. | 14,500 | $1 | $43.5K |
| 11043 | The provider uses surgical instruments to remove the dead tissue in muscle and/or fascia, including any debridement of the epidermis, dermis, and subcutaneous tissue, for the first or only 20 cm2 or… | 5,020 | $10 | $40.2K |
| 99307 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the… | 11,050 | $1 | $33.1K |
| 99305 | The 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… | 1,130 | $10 | $14.7K |
| 99304 | The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves straightforward or low medical decision making or the provider… | 1,870 | $10 | $11.2K |
| 11046 | The provider uses surgical instruments to remove the dead tissue from the muscle and/or fascia, as well as the subcutaneous tissue layer, epidermis, and dermis if needed. She performs this service at… | 2,090 | $1 | $4.2K |
| 99310 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends… | 510 | $10 | $4.1K |
| 11045 | The provider uses surgical instruments to remove dead tissue from the subcutaneous layer, as well as the epidermis and dermis if needed. She performs this service at the same session as a separately… | 1,940 | $1 | $1.9K |
Showing 1–10 of 12
How this provider's Medicaid billing volume and revenue compare to other New York providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New York median
12 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 11042 | The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2. | 2 | 140 | 180 | $140 | $184.1K |
| 11045 | The provider uses surgical instruments to remove dead tissue from the subcutaneous layer, as well as the epidermis and dermis if needed. She performs this service at the same session as a separately… | 1 | 10 | 230 | $190 | $96K |
| 11043 | The provider uses surgical instruments to remove the dead tissue in muscle and/or fascia, including any debridement of the epidermis, dermis, and subcutaneous tissue, for the first or only 20 cm2 or… | 2 | 30 | 140 | $40 | $69K |
| 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… | 19 | 2,090 | 420 | $10 | $18.7K |
| 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… | 24 | 1,840 | 390 | $10 | $17.1K |
| 99310 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends… | 36 | 240 | 70 | $20 | $5.8K |
| 99305 | The 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… | 26 | 490 | 50 | $20 | $4.6K |
| 99306 | The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves high medical decision making, and/or the provider spends at least… | 123 | 440 | 50 | $30 | $4.4K |
| 99307 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the… | 4 | 870 | 130 | $10 | $3.7K |
| 11046 | The provider uses surgical instruments to remove the dead tissue from the muscle and/or fascia, as well as the subcutaneous tissue layer, epidermis, and dermis if needed. She performs this service at… | 2 | 10 | 1,280 | $1 | $2.7K |
Showing 1–10 of 12
Other providers in the same ZIP code as Joseph Sidaoui, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| B& H Healtcare Services Inc | NY | Home Health Agency | $0 | $281.2M |
| Parent Care Home Care, LLC | NY | Home Health Agency | $0 | $176M |
| St. Nicks Alliance Home Care Corp. | NY | In Home Supportive Care Agency | $0 | $112.1M |
| Gj Apex Company, LLC | NY | Home Health Agency | $0 | $111.5M |
| School Settlement Home Attendant Service Corp | NY | Home Health Agency | $0 | $63.1M |
| Emanuel Cdpap LLC | NY | Home Health Agency | $0 | $47.5M |
| Emanuel Services, Inc. | NY | Home Health Agency | $0 | $26.9M |
| Human Development Association | NY | Home Health Agency | $0 | $20M |
| Fastrad LLC | NY | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | $892.8K | $104.1K |
| David Mahony | NY | Clinical Psychologist | $21.8K | $449.9K |
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.