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NPI 1396729604 · Middletown, RI · Land Ambulance
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Town Of Middletown is a land ambulance provider located in Middletown, Rhode Island. This profile covers 3 Medicare and 3 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 | Organization |
| Organization | Town Of Middletown |
| Address | 350 E Main Rd |
| City | Middletown |
| State | RI |
| ZIP | 02842 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | November 30, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $324K |
| Medicaid | $162.5K |
TOWN OF MIDDLETOWN operates as a land ambulance service focused on emergency transports, with its Medicare and Medicaid revenue driven entirely by frontline ambulance codes; the top three Medicare codes (A0427, A0429, A0425) account for 100.0% of Medicare revenue and the top three Medicaid codes (same codes) account for 100.0% of Medicaid revenue, indicating operational specialization in ALS/BLS emergency transport and ground mileage billing.
Revenue scale is modest and skewed toward Medicare: lifetime Medicare revenue is $324K versus $162.5K in Medicaid, so Medicare accounts for roughly twice the Medicaid dollar total on file; both payers are material but Medicare represents the larger portion of lifetime billed revenue.
Medicare revenue concentration is dominated by A0427, which generates $247.6K and represents 76.3% of the provider's total Medicare revenue, signaling that advanced life support, emergency transports are the primary Medicare income stream for this entity. A0429 and A0425 together make up the remaining Medicare revenue (18.0% and 5.8% respectively), reinforcing an ALS-first mix with supplemental BLS and mileage.
On the Medicaid side A0427 is again the largest single source at $97.2K (60.2% of Medicaid revenue), with A0429 contributing $56.5K (35.0%) and A0425 a small share at $7.6K (4.7%); this mirrors the Medicare service mix but at materially lower per-claim payments for Medicaid compared with Medicare. The consistent top-three code set across payers suggests similar service offerings to both beneficiary populations.
In national and state competitive standing TOWN OF MIDDLETOWN is a modest participant: for Medicare A0427 activity ranks #1280 of 6841 providers (81th percentile) and A0429 ranks #2871 of 7808 (63th percentile), both described as typical, unremarkable volume for these codes rather than market-leading. For Medicaid in-state positioning, A0427 ranks #23 of 39 (42th percentile) and A0429 ranks #25 of 35 (29th percentile), which places the provider in the lower-to-middle range of peers statewide for these emergency ambulance services.
Claims volume profile highlights operational emphasis on transport encounters: Medicare claim counts include 598 for A0427 and 168 for A0429 with 2.7K mileage claims for A0425, while Medicaid shows 1.1K claims for A0427 and 673 for A0429 with 2.5K mileage claims for A0425. The relatively high mileage claim counts combined with concentrated revenue in ALS/BLS transport codes indicate routine ground-response activity with many transported miles billed.
Tenure is long-standing: the provider NPI was enumerated on 2005-11-30 (~21 years ago), indicating more than two decades of enrollment and suggesting established operations and billing history in both Medicare and Medicaid systems.
Across both payers there are no statistical red flags in the provided descriptors; each top code is labeled as typical or unremarkable in volume relative to peers rather than an outlier, so the provider appears to be a stable, local ambulance operator with expected utilization patterns for ALS/BLS emergency ground transport.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
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How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.
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.
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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
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| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 25 | 40 | 1,830 | $80 | $362.7K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 23 | 40 | 1,250 | $80 | $273.1K |
| A0425 | Ground mileage, per statute mile | 24 | 50 | 2,550 | $10 | $72.5K |
Other providers in the same ZIP code as Town Of Middletown, ranked by combined Medicare and Medicaid revenue.
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