Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidGil Nieves
    Ask Trek AI about this page

    Gil Nieves — Billing Profile & Reimbursement Data

    NPI 1477754000 · Caguas, PR · Urology Physician

    Customize your policy alerts

    Sign up for Gil Nieves — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Gil Nieves is a urology physician provider located in Caguas, Puerto Rico. This profile covers 11 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.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationGil Nieves
    AddressConsolidated Medical Plaza, Ave. Gautier Benitez
    CityCaguas
    StatePR
    ZIP00725
    TaxonomyUrology Physician
    NPI EnumeratedMay 30, 2007

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

    Payer SourceTotal Paid
    Medicare$55.7K
    Medicaid$0

    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.

    11 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J3315Injection, triptorelin pamoate, 3.75 mg90$290$26K
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…160$60$10.2K
    76872The provider inserts an ultrasound probe into the rectum and performs a transrectal ultrasound to assess disorders of the prostate, rectum, and surrounding tissues.40$100$3.6K
    52000In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a…20$170$3.6K
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…40$80$2.9K
    76770A retroperitoneal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e.Kidneys, urinary bladder, and aorta). This particular code is used when the ultrasound is…40$80$2.8K
    99203The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…30$80$1.9K
    76856A pelvic ultrasound is a noninvasive procedure used to assess body parts such as the bladder, ovaries, uterus, cervix, and fallopian tubes in females and the bladder, prostate gland, and seminal…30$60$1.9K
    99204The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…20$80$1.6K
    96402In this procedure, the provider administers chemotherapy either subcutaneously, meaning under the skin, or intramuscularly, meaning in muscle. He administers a hormonal anti–neoplastic drug.30$20$720

    Showing 1–10 of 11

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    11 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J3315310100$300$29.2K
    9921428647050$80$6.6K
    992131311,53050$60$4.2K
    5200042020$180$3.4K
    992046920020$110$2.7K
    7687221020$90$2K
    9920314948020$70$1.8K
    7677095020$60$1.3K
    7685633020$60$1.3K
    9640221030$20$700

    Showing 1–10 of 11

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Municipality Of San JuanPRMulti-Specialty Clinic/Center$0$4.5M
    Omayra GonzalezPRHematology & Oncology Physician$2.9K$1.6M
    Laboratorio Clinico Dr. Gualberto RabellPRClinical Medical Laboratory$0$1.5M
    Edilberto MartinezPRMaternal & Fetal Medicine Physician$0$1.4M
    Lauren LynchPRMaternal & Fetal Medicine Physician$0$1.4M
    Luis FontPRPediatric Endocrinology Physician$0$836.4K
    Soobin MaengPRGeneral Practice Physician$0$738.9K
    Laboratorio Clinico Cdt Dr. Jose Lopez AntongiorgiPRClinical Medical Laboratory$0$607.1K
    Ricardo Hernandez-castilloPRPulmonary Disease Physician$28.6K$211.9K
    Eva Gonzalez MendezPREndocrinology, Diabetes & Metabolism Physician$30.6K$56K

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Laboratorio Clinico Borinquen, IncPRClinical Medical Laboratory$1.4M$37.1M
    Msl Therapeutical Services, PscPROccupational Therapist$0$12.8M
    Laboratorio Clinico Bairoa IncPRClinical Medical Laboratory$271.3K$11.3M
    Centro Medico Del Turabo IncPRMulti-Specialty Clinic/Center$0$10.8M
    Mediko Imaging Inc.PRRadiology Clinic/Center$0$6.8M
    Consolidated Radiology Complex CspPRRadiology Clinic/Center$0$6.8M
    Caribbean Heart Institute LLCPRClinical Cardiac Electrophysiology Physician$0$5.7M
    Nuscan CspPRNuclear Medicine Physician$0$5.5M
    Conmed Laboratories IncPRClinical Medical Laboratory$105.5K$5.4M
    Sps Specialty Pharmacy Services IncPRSpecialty Pharmacy$0$4.2M

    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. Puerto Rico Distribution
    Gil Nieves — 0 of 11 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Puerto Rico