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NPI 1487884987 · Providence, RI · Ambulance
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Professional Ambulance LLC is a ambulance provider located in Providence, Rhode Island. This profile covers 5 Medicare and 6 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 | Professional Ambulance LLC |
| Address | 52 River Ave |
| City | Providence |
| State | RI |
| ZIP | 02908 |
| Taxonomy | Ambulance |
| NPI Enumerated | July 17, 2009 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.7M |
| Medicaid | $1.4M |
PROFESSIONAL AMBULANCE LLC’s revenue mix and top service lines indicate a ground ambulance operator focused on basic life support non-emergency transports and mileage-based billing, with some emergency advanced life support capability. The provider’s top Medicare and Medicaid codes include A0428 (BLS non-emergency), A0425 (ground mileage), and A0427 (ALS 1 emergency), showing an operational profile centered on routine patient transports supplemented by higher-acuity emergency runs.
Revenue is highly concentrated in a small set of codes on both payers: the precomputed top 3 Medicare codes account for 90.9% of Medicare revenue, and the top 3 Medicaid codes account for 86.8% of Medicaid revenue. This concentration means changes in reimbursement or utilization for a few codes—particularly A0428 and A0425—would materially affect overall revenue.
The provider bills both Medicare and Medicaid at similar scales: Total Medicare revenue is $1.7M while Total Medicaid revenue is $1.4M, so it is not a single-payer operation but has a slightly larger Medicare footprint. Both payers are meaningful contributors to the business, so network participation and state-level Medicaid policy changes could shift the payer mix materially.
Against national Medicare peers, the provider posts high percentile ranks on its largest Medicare codes but is characterized in the file as typical volume: A0428 is $1.1M (61.2% of Medicare revenue) and ranks #119 of 2772 (96th percentile; typical, unremarkable volume), while A0425 contributes $359.6K (20.8%) and ranks #375 of 8934 (96th percentile; typical, unremarkable volume). A0427 is smaller at $152.9K (8.9%) and ranks #1970 of 6841 (71th percentile; typical, unremarkable volume), suggesting the provider sits comfortably within national norms for ambulance services rather than being an extreme outlier.
In-state Medicaid positioning shows the provider is a meaningful operator for core ambulance services, with A0428 generating $746.6K (53.5% of Medicaid revenue) and ranking #3 of 6 in-state (60th percentile; typical, unremarkable volume). Notably, A0425 is $206.7K (14.8% of Medicaid revenue) and ranks #4 of 46 in-state (93th percentile; notably above typical state volume), indicating mileage billing is a conspicuous strength relative to state peers and a potential competitive differentiator.
There are specific Medicaid statistical flags to note: A0888 (noncovered ambulance mileage) appears with $13.7K (1.0% of Medicaid revenue) and is the only in-state reporter (rank #1 of 1, no state peer comparison available), so peer benchmarking is not possible for that code. A0426 appears as $8.5K (0.6% of Medicaid revenue) and ranks #1 of 4 in-state (100th percentile; typical, unremarkable volume), signaling presence but not unusual deviation from peer activity labels in the file.
Operational volume metrics reinforce the service-line characterization: on Medicare the provider reported 5.2K claims for A0428 and 51.4K claims for A0425, while on Medicaid it reported 24.9K claims for A0428 and 34.4K claims for A0425. These high claim counts for mileage and BLS non-emergency transport underscore a business model built on frequent ground transports and per-mile reimbursement.
The provider’s tenure is long-standing, with NPI enumeration on 2009-07-17 (~17 years ago), which supports interpreting observed patterns as established business behavior rather than a short-term fluctuation. Analysts should therefore treat the concentration in a few ambulance codes and the state-level mileage strength as persistent characteristics when assessing network value or contract negotiations.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 5,210 | $200 | $1.1M |
| A0425 | Ground mileage, per statute mile | 51,370 | $10 | $359.6K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 370 | $410 | $152.9K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 430 | $350 | $148.7K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 30 | $260 | $8.2K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 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.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 24,890 | $30 | $746.6K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 5,050 | $50 | $257.5K |
| A0425 | Ground mileage, per statute mile | 34,450 | $10 | $206.7K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 2,750 | $60 | $162.5K |
| A0888 | Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility) | 570 | $20 | $13.7K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 110 | $80 | $8.5K |
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
6 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 3 | 10 | 19,390 | $60 | $1M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 16 | 40 | 1,830 | $80 | $362.7K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 7 | 40 | 1,250 | $80 | $273.1K |
| A0425 | Ground mileage, per statute mile | 4 | 50 | 2,550 | $10 | $72.5K |
| A0888 | Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility) | 1 | 10 | 570 | $20 | $13.6K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1 | 10 | 90 | $90 | $7.9K |
Other providers in the same ZIP code as Professional Ambulance LLC, ranked by combined Medicare and Medicaid revenue.
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