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NPI 1548671852 · Forest Hills, NY · Diagnostic Radiology Physician
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Pejman Dalaie is a diagnostic radiology physician provider located in Forest Hills, New York. This profile covers 9 Medicare and 3 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 | Individual |
| Organization | Pejman Dalaie |
| Address | 9237 Metropolitan Ave |
| City | Forest Hills |
| State | NY |
| ZIP | 11375 |
| Taxonomy | Diagnostic Radiology Physician |
| NPI Enumerated | May 8, 2014 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $3.6M |
| Medicaid | $172.2K |
This provider’s Medicare billing is heavily concentrated in nuclear medicine / PET-related services: the top three Medicare codes (78815, A9595, A9552) account for 97.6% of total Medicare revenue, indicating the operation is focused on PET/CT imaging and PET radiopharmaceutical administration rather than routine radiography or office visits. The code mix and descriptions (PET/CT, piflufolastat f-18, and fluorodeoxyglucose f-18 FDG) point to a practice structured around diagnostic oncologic imaging workflows and substantial radiotracer usage.
Revenue scale is strongly Medicare-dominant: total Medicare revenue is $3.6M versus total Medicaid revenue of $172.2K, so Medicare represents the overwhelming share of lifetime public-payer receipts on file. Medicaid exists but is a much smaller portion of billed volume, indicating payer mix and cash flow are largely driven by Medicare reimbursements.
Competitive standing on key Medicare codes is exceptional and national in scope: the provider ranks #7 of 6566 for 78815 (100th percentile, labeled an extreme outlier), #5 of 528 for A9595 (99th percentile, extreme outlier), and #5 of 2411 for A9552 (100th percentile, extreme outlier). These rankings indicate this clinician is a major national outlier for high-volume PET/CT imaging and specific F-18 radiotracers compared with peers, suggesting either a high-throughput center or a specialized referral destination.
Medicaid competitive positioning is more modest but still meaningful for PET services: for Medicaid the provider ranks #18 of 109 for 78815 (84th percentile) and #15 of 72 for A9552 (80th percentile), which are above typical in-state volumes but not extreme. This pattern implies the provider is an established PET/CT supplier within the state Medicaid network, but its dominant footprint is more pronounced on the Medicare side.
Revenue concentration within Medicaid mirrors Medicare’s service focus: the top three Medicaid codes (78815, A9552 and 82947) account for 100.0% of total Medicaid revenue, with 78815 alone representing $133.7K (77.5% of Medicaid revenue) and A9552 $38.8K (22.5%). This confirms that even on the smaller Medicaid book, PET imaging and associated radiopharmaceuticals drive nearly all billings.
The provider’s Medicare code-level unit economics show a mix of high-paid imaging and lower-paid ancillary services: for Medicare, 78815 averaged $1503 paid/claim and generated $2.1M, A9595 averaged $480 paid/claim and generated $933.6K, while A9552 averaged $407 paid/claim and generated $481.9K. The presence of numerous low-revenue lab or venipuncture codes (e.g., 82947, 36415) is negligible as a revenue driver but indicates standard periprocedural testing and specimen collection are billed alongside imaging.
Tenure in the NPI registry is long enough to suggest an established practice footprint: the NPI was enumerated on 2014-05-08 (~12 years ago), consistent with a provider that has built referral relationships and scale over multiple years to support the observed high volumes on advanced PET radiotracer codes.
Statistical outlier labels reinforce operational specialization rather than routine mixed-modality imaging: multiple top Medicare codes are flagged as “extreme outlier” or “notably above typical national volume,” which in plain terms means this provider’s volumes for PET/CT and radiopharmaceutical administration are far above typical peers nationally. That pattern suggests a focused, high-volume PET service line likely serving a broad referral catchment rather than a general diagnostic radiology panel.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 78815 | PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.… | 1,420 | $1,500 | $2.1M |
| A9595 | Piflufolastat f-18, diagnostic, 1 millicurie | 1,950 | $480 | $933.6K |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 1,180 | $410 | $481.9K |
| A9587 | Gallium ga-68, dotatate, diagnostic, 0.1 millicurie | 1,570 | $50 | $79.9K |
| 82947 | The lab analyst performs a test to measure the amount of glucose in a patient's blood using a method other than a reagent strip. | 1,090 | $1 | $4.3K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 190 | $10 | $1.5K |
| 99211 | An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional. | 10 | $20 | $270 |
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 20 | $10 | $170 |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 20 | $10 | $150 |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 78815 | PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.… | 670 | $200 | $133.7K |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 520 | $80 | $38.8K |
| 82947 | The lab analyst performs a test to measure the amount of glucose in a patient's blood using a method other than a reagent strip. | 30 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other New York providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New York median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 78815 | PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.… | 18 | 110 | 80 | $570 | $236.2K |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 15 | 70 | 90 | $150 | $72.3K |
| 82947 | The lab analyst performs a test to measure the amount of glucose in a patient's blood using a method other than a reagent strip. | 293 | 340 | 430 | $1 | $4.1K |
Other providers in the same ZIP code as Pejman Dalaie, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Health Acquisition Corp. | NY | Home Health Agency | $0 | $1B |
| Caring Professionals, Inc | NY | Home Health Agency | $0 | $951.9M |
| Caring Professionals, Inc. | NY | Home Health Agency | $0 | $391.3M |
| Infiniti Home Care Inc | NY | Home Health Agency | $0 | $378.6M |
| New Millenium Ny, Inc | NY | Home Health Agency | $0 | $214.6M |
| Bilinguals Inc. | NY | Early Intervention Provider Agency | $0 | $103.6M |
| Infiniti Home Care, Inc Dba Continental Home Care | NY | Home Health Agency | $0 | $59.3M |
| The Child Center Of Ny, Inc. | NY | Adolescent and Children Mental Health Clinic/Center | $0 | $57.6M |
| Eva Homecare Agency, Inc. | NY | Home Health Agency | $0 | $55.3M |
| Attentive Home Care, Inc | NY | Home Health Agency | $0 | $31.4M |
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