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NPI 1538566138 · Nutley, NJ · Land Ambulance
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Metro Ambulance LLC is a land ambulance provider located in Nutley, New Jersey. This profile covers 3 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 | Metro Ambulance LLC |
| Address | 43 River Rd |
| City | Nutley |
| State | NJ |
| ZIP | 07110 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | November 25, 2014 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.9M |
| Medicaid | $496K |
METRO AMBULANCE LLC operates as a land ambulance provider with Medicare revenue of $2.9M and Medicaid revenue of $496K, so Medicare represents the materially larger payer on file. The provider is not a single-payer operation, but the scale of Medicare billing substantially exceeds Medicaid billing in absolute dollars on the record.
Medicare revenue is extremely concentrated: the precomputed top 3 Medicare codes (A0428, A0425, A0429) account for 100.0% of this provider's total Medicare revenue. This mix — dominated by A0428 (basic life support non-emergency), A0425 (ground mileage), and A0429 (basic life support emergency) — indicates the business is focused on routine ambulance transports with mileage-based billing as a significant component of Medicare receipts.
On Medicare, A0428 (9.9K claims, $218 avg paid/claim, $2.2M revenue) ranks #50 of 2772 providers nationally (98th percentile) and is described as an "extreme outlier, far above typical national volume for this code." A0425 (71.6K claims, $6 avg paid/claim, $429.8K revenue) ranks #252 of 8934 providers nationally (97th percentile) and is "notably above typical national volume," while A0429 (741 claims, $384 avg paid/claim, $284.5K revenue) sits in a more typical national range (rank #759 of 7808, 90th percentile). These rankings signal a strong national presence for non-emergency BLS and mileage billing, with emergency BLS at a more typical volume.
Medicaid billing is likewise concentrated: the precomputed top 3 Medicaid codes (A0428, A0429, A0425) account for 99.9% of the provider's total Medicaid revenue. The Medicaid top-line is driven by the same operational services (BLS non-emergency and BLS emergency transports plus ground mileage), with A0428 contributing $334.9K (67.1% of Medicaid revenue) and A0429 and A0425 representing the remainder.
Within-state competitive standing on Medicaid is mixed: A0428 (16.7K claims, $20 avg paid/claim, $334.9K revenue) ranks #11 of 86 providers in-state (88th percentile), indicating above-typical in-state volume but not a statewide monopoly. By contrast A0429 (1.8K claims, $50 avg paid/claim, $91.3K revenue) ranks #131 of 264 providers in-state (51th percentile) and A0425 (18.1K claims, $4 avg paid/claim, $72.5K revenue) ranks #93 of 426 providers in-state (78th percentile), both described as typical or unremarkable in-state volumes.
Payment-per-claim differs markedly between payers for the same codes: for A0428 the reported averages are $218 per claim on Medicare versus $20 per claim on Medicaid, and for A0429 averages are $384 on Medicare versus $50 on Medicaid. Those payment differentials indicate that the same service mix yields materially higher revenue per event from Medicare than from Medicaid, making total revenue highly sensitive to each payer's fee schedule and case mix.
The underlying claim counts reinforce an operational model built around high-volume transports and mileage: Medicare A0425 shows 71.6K claims and Medicaid A0425 shows 18.1K claims, while A0428 tallies 9.9K Medicare claims and 16.7K Medicaid claims. Combined with the concentration of revenue in the precomputed top-three codes, this pattern suggests the business is optimized for frequent, lower-dollar transports (BLS non-emergency plus mileage) rather than sporadic high-acuity emergency runs.
METRO AMBULANCE LLC has an NPI enumerated on 2014-11-25 (~12 years ago), indicating established tenure in the market. That duration, together with the high national ranks on key Medicare codes, supports characterization of the provider as a long-standing, high-volume BLS/mileage operator with significant Medicare dependence and a measurable in-state presence on Medicaid transports.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
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.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 16,750 | $20 | $334.9K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,830 | $50 | $91.3K |
| A0425 | Ground mileage, per statute mile | 18,130 | $1 | $72.5K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 420 | $1 | $420 |
How this provider's Medicaid billing volume and revenue compare to other New Jersey providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Jersey 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) | 131 | 260 | 1,770 | $110 | $683K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 11 | 90 | 2,490 | $20 | $164.4K |
| A0425 | Ground mileage, per statute mile | 93 | 430 | 3,700 | $10 | $106.9K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 14 | 40 | 220 | $10 | $7K |
Other providers in the same ZIP code as Metro Ambulance LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Essex Medical Day Care LLC | NJ | Adult Day Care Clinic/Center | $0 | $29.3M |
| Roman Rubin | NJ | Community/Behavioral Health Agency | $0 | $8.8M |
| Jan Youssef | NJ | Specialist | $192.5K | $1.9M |
| James Agresti | NJ | Internal Medicine Physician | $382.1K | $2.3K |
| Frank Femino | NJ | Specialist | $368.2K | $0 |
| Dominick Ligresti | NJ | Specialist | $275.3K | $38.8K |
| Edward Vecchione | NJ | Internal Medicine Physician | $253.8K | $0 |
| Philip Fiore | NJ | Ophthalmology Physician | $250.4K | $0 |
| Ligaya Prystowsky | NJ | Ophthalmology Physician | $208.4K | $0 |
| Vincent Coppola | NJ | Podiatrist | $206.4K | $0 |
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