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NPI 1497974687 · Providence, RI · Land Ambulance
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City Of Providence Rhode Island is a land ambulance provider located in Providence, Rhode Island. This profile covers 4 Medicare and 4 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 | City Of Providence Rhode Island |
| Address | 325 Washington St |
| City | Providence |
| State | RI |
| ZIP | 02903 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | April 25, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $6.4M |
| Medicare | $917.7K |
Service-line profile: Taxonomy listed as Land Ambulance and the billed codes are almost exclusively emergency transport codes — A0427 (ALS 1 emergency), A0429 (BLS emergency) and A0425 (ground mileage) — indicating this entity operates as a front‑line municipal ambulance service focused on emergency response rather than non-emergency transport or ancillary services. Medicare claim counts (A0427: 1.2K claims; A0429: 1K claims) and the much larger Medicaid claim volumes (A0429: 54.4K claims; A0427: 30.9K claims; A0425: 85.8K claims) reinforce an operational profile centered on repeated, high-frequency emergency pickups in the state.
Revenue concentration by code: This provider’s Medicare revenue is highly concentrated in a small set of ambulance codes — the precomputed top 3 Medicare codes by revenue account for 99.1% of total Medicare revenue — with A0427 generating $512.1K (55.8%), A0429 $358.8K (39.1%), and A0425 $39.3K (4.3%). The Medicaid side is even more concentrated: the precomputed top 3 Medicaid codes by revenue account for 99.9% of total Medicaid revenue, driven by A0429 at $3.8M (58.6%), A0427 at $2.5M (38.7%), and A0425 at $171.7K (2.7%).
Payer mix and scale: The provider reports $917.7K in total Medicare revenue versus $6.4M in total Medicaid revenue, making it effectively Medicaid‑dominant in scale on the billing side. Analysts should treat Medicaid patterns as the primary driver of this entity’s revenue footprint while Medicare activity appears materially smaller in absolute dollars.
National competitive standing on Medicare codes: For Medicare, the top ambulance codes show typical national volumes rather than dominance — A0427 ranks #596 of 6841 providers (91th percentile; typical, unremarkable volume) and A0429 ranks #499 of 7808 providers (94th percentile; typical, unremarkable volume), indicating this provider is a recognizable but not nationally dominant participant for those codes. Lower-ranked Medicare codes such as A0425 (rank #3089 of 8934, 65th percentile) and A0433 (rank #1256 of 1632, 18th percentile) further suggest limited Medicare breadth beyond core emergency transports.
State-level competitive standing on Medicaid: In contrast to Medicare, the provider is an extreme outlier within Rhode Island on its highest-volume Medicaid codes — A0429 ranks #1 of 35 providers in-state (100th percentile; extreme outlier) and A0427 ranks #1 of 39 providers in-state (100th percentile; extreme outlier). Those #1 rankings and the very large claim counts (A0429: 54.4K; A0427: 30.9K; A0425: 85.8K) indicate this provider is a dominant supplier of emergency ambulance services to the Medicaid population in-state.
Payment-rate differentials and operational impact: Average payments per claim differ substantially by payer for the same service — Medicare A0427 average paid/claim is $414 versus Medicaid A0427 average paid/claim of $80, and Medicare A0429 average paid/claim is $348 versus Medicaid A0429 average paid/claim of $69; mileage shows the same pattern (Medicare A0425 $7 avg paid/claim vs Medicaid A0425 $2 avg paid/claim). These disparities mean the provider achieves far more revenue per individual Medicare transport but relies on very high Medicaid claim volumes to produce the larger absolute Medicaid revenue figure.
Tenure and stability: The NPI was enumerated on 2007-04-25 (~19 years ago), consistent with a long‑standing municipal or public EMS operation with an established billing history across both Medicare and Medicaid. That longevity, combined with concentrated emergency-transport billing, suggests operational continuity and an entrenched role in local emergency medical services.
Analytical implications and follow-up priorities: Given the extremely concentrated revenue mix (99.1% of Medicare and 99.9% of Medicaid tied to the top three codes) and the provider’s statewide dominance on Medicaid emergency transport codes, analysts should prioritize review of Medicaid utilization drivers, state contracting or routing policies, and capacity/coverage implications for the region. The contrast between modest national Medicare presence and extreme in‑state Medicaid volumes makes this entity especially relevant for state-level network planning and Medicaid cost analyses.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1,240 | $410 | $512.1K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,030 | $350 | $358.8K |
| A0425 | Ground mileage, per statute mile | 5,610 | $10 | $39.3K |
| A0433 | Advanced life support, level 2 (als 2) | 10 | $590 | $8.2K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 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.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 54,370 | $70 | $3.8M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 30,940 | $80 | $2.5M |
| A0425 | Ground mileage, per statute mile | 85,850 | $1 | $171.7K |
| A0433 | Advanced life support, level 2 (als 2) | 10 | $300 | $3.6K |
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
4 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1 | 40 | 1,830 | $80 | $362.7K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1 | 40 | 1,250 | $80 | $273.1K |
| A0425 | Ground mileage, per statute mile | 1 | 50 | 2,550 | $10 | $72.5K |
| A0433 | Advanced life support, level 2 (als 2) | 1 | 10 | 10 | $300 | $3.6K |
Other providers in the same ZIP code as City Of Providence Rhode Island, ranked by combined Medicare and Medicaid revenue.
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