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 New York for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to New York 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. New York (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.

Robert Gelfand (NPI 1407855612)

Field	Value
Entity Type	Individual
Organization	Robert Gelfand
Address	1751 York Ave
City	New York
State	NY
ZIP	10128
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	July 19, 2005

Payer Source	Total Paid
Medicare	$4.2M
Medicaid	$0

Key Findings

This provider is a Hematology & Oncology physician whose Medicare billing is dominated by high-cost biologic and specialty injectable therapies and related infusion services, consistent with an infusion-centric oncology practice. Top-line code activity includes J0897 with 51.3K claims and $923.4K revenue, J3111 with 108.2K claims and $865.2K revenue, and J1561 with 19.4K claims and $735.3K revenue, and additional large contributions from infusion administration codes such as 96365 and 96401. These patterns indicate point-of-care drug administration and outpatient infusion services are core to the business model rather than a visit-only ambulatory practice.

Revenue concentration is high: the precomputed top-3 Medicare codes account for 60.9% of this provider’s total Medicare revenue. Those three drivers are J0897 ($923.4K; 22.3%), J3111 ($865.2K; 20.9%), and J1561 ($735.3K; 17.8%), so a majority of Medicare dollars are tied to a small set of injectable biologic agents. This concentration implies that changes in utilization, pricing, or access to any of these specific therapies would materially affect overall Medicare revenue.

Payer mix is effectively single-payer: lifetime Medicare revenue is $4.2M while there is no Medicaid billing on file. The absence of any Medicaid claims means commercial/Medicaid comparisons or dual-payer strategy discussions should be approached with caution; operational and contracting efforts are likely focused on Medicare reimbursement dynamics.

Competitive standing for certain drug codes is unusually strong at a national level. For J0897 the provider ranks #18 of 10057 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code), and for J3111 the provider ranks #14 of 970 providers nationally (99th percentile; extreme outlier), indicating national-scale volume leadership for these specific injectable products. J1561 also ranks highly at #12 of 180 providers nationally (94th percentile; typical, unremarkable volume for this code), showing above-average placement among peers for immune globulin.

Several administration and E/M codes show elevated activity, signaling a high-throughput clinic workflow that pairs drug delivery with office-based evaluation. 99212 appears with 1.3K claims and $64.9K revenue and is described as an extreme outlier (ranks #114 of 99011 providers nationally; 100th percentile), while infusion administration codes such as 96401 (926 claims, $63.9K revenue) and 96365 (793 claims, $47.6K revenue) are noted as notably above typical national volume. These volumes suggest frequent short follow-up or treatment visits combined with substantial in-clinic administration activity.

The provider’s coding mix includes both complex oncology infusions and routine outpatient visit codes, indicating an integrated model that bills for both drug administration and associated evaluation/management. New-patient and higher-complexity visit codes are present (e.g., 99203 with 312 claims and $30.6K revenue, 99214 with 316 claims and $35.4K revenue), but the largest visit volume is concentrated in lower-complexity E/M codes, consistent with recurring treatment visits and periodic clinical assessments. This blend supports a steady stream of repeat visits tied to ongoing infusion therapy.

Multiple individual codes are flagged as statistical outliers or notably above typical volume, pointing to concentrated clinical services rather than broad general practice activity. In addition to the J0897 and J3111 extreme outlier status, 96372 is called an extreme outlier (1.7K claims, $22.6K revenue; ranks #92 of 58224 providers nationally; 100th percentile) and 96401 and 96365 are described as notably above typical national volume, underscoring unusually high throughput for injections and infusions relative to national peers. These labels indicate this provider operates at volumes well above typical peers for several therapy- and administration-related codes.

The provider’s NPI has been enumerated since 2005-07-19 (~21 years ago), indicating long tenure in Medicare billing. This extended enrollment timeframe, combined with concentrated high-volume specialty drug billing, is consistent with an established, steady-state oncology/hematology infusion practice rather than a recent entrant or transient operation.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

50 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0897	Injection, denosumab, 1 mg	51,300	$20	$923.4K
J3111	Injection, romosozumab-aqqg, 1 mg	108,150	$10	$865.2K
J1561	Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg	19,350	$40	$735.3K
J9144	Injection, daratumumab, 10 mg and hyaluronidase‑fihj	18,720	$40	$711.4K
J0517	Injection, benralizumab, 1 mg	1,620	$120	$194.4K
J3032	Injection, eptinezumab-jjmr, 1 mg	5,300	$10	$74.2K
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,…	1,300	$50	$64.8K
Q5106	Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units	10,800	$10	$64.8K
96401	The provider administers nonhormonal, antineoplastic chemotherapy drugs subcutaneously or intramuscularly to the patient.	930	$70	$63.9K
Q5115	Injection, rituximab-abbs, biosimilar, (truxima), 10 mg	1,540	$30	$52.4K

Showing 1–10 of 50

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 50 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New York Distribution

Robert Gelfand — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New York

Full comparison — all codes billed, vs. state median

50 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9144	4	20	10,440	$40	$499.4K
J3111	1	20	19,950	$10	$260.1K
J1561	2	40	3,100	$40	$234.9K
J0517	4	10	1,520	$130	$188.9K
J1745	45	50	2,980	$30	$124.1K
J0897	3	490	2,820	$20	$84.4K
Q5115	2	10	1,710	$30	$56.8K
J3032	3	10	4,450	$10	$53.2K
J3490	20	120	60	$470	$50.8K
J1439	73	90	39,750	$1	$42K

Showing 1–10 of 50

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ayesha Siddiqui	DC	Family Medicine Physician	$2.4M	$0
Rachel Kramer	NY	Hematology & Oncology Physician	$2.1M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Advantagecare Physicians PC	NY	General Practice Physician	$0	$60.4M
Carnegie Hill Institute, Inc.	NY	Methadone Clinic	$49.1K	$3.7M
Yorkville Endoscopy, LLC	NY	Ambulatory Surgical Clinic/Center	$1.6M	$1M
Vicken Pamoukian	NY	Vascular Surgery Physician	$1.7M	$860
George Young	NY	Urology Physician	$128.7K	$818.3K
Carnegie Hill Of New York, Inc	NY	Methadone Clinic	$52.9K	$815.9K
Zaher Hamadeh	NY	Internal Medicine Physician	$624.2K	$164.5K
Newsha Ghodsi	NY	Cardiovascular Disease Physician	$666K	$2.9K
Jonathan Schiff	NY	Urology Physician	$556.2K	$780
Jonathan Freilich	NY	Ophthalmology Physician	$521.3K	$14.4K

Robert Gelfand — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References