NPI 1568635357 — Billing Profile & Reimbursement Data
NPI 1568635357 · XX · healthcare
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NPI 1568635357 is a healthcare provider located in Unspecified Location. This profile covers 34 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. Note: "XX" is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; claims coded under it are grouped and benchmarked here the same way a traditional state would be.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | NPI 1568635357 |
| Address | |
| City | |
| State | XX (Unspecified Location) |
| ZIP | |
| Taxonomy | N/A |
| NPI Enumerated | |
| NPI Deactivated | March 26, 2026 |
(source: CMS Medicare & Medicaid claims data)
Key Findings
The provider’s Medicare revenue profile is centered on cardiology diagnostic and high-acuity ambulatory care: the top three Medicare codes by revenue are 93306 ($55.8K, echo), 78452 ($49K, SPECT myocardial perfusion), and 99215 ($48.6K, high‑level office E/M). This mix of noninvasive imaging plus high-complexity office visits indicates a practice focused on outpatient cardiology evaluations with in‑house imaging capabilities rather than a pure primary‑care panel.
Revenue concentration is high within a few services: the precomputed top‑3 Medicare codes account for 43.5% of the provider’s total Medicare revenue, which totals $355.8K. That concentration suggests the practice derives a large share of its Medicare dollars from a narrow set of cardiology diagnostic and evaluation services, increasing sensitivity to utilization or reimbursement changes for those codes.
Payer mix is effectively single‑payer Medicare: Total Medicare revenue is $355.8K while Total Medicaid revenue is none (no Medicaid billing on file), so this provider has no recorded Medicaid activity. For payers and network managers, that implies limited exposure to Medicaid populations and that Medicaid contracting or risk‑adjustment considerations are unlikely to be material for this NPI.
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.
34 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 93306 | The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent… | 430 | $130 | $55.8K |
| 78452 | In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood… | 130 | $390 | $49K |
| 99215 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the… | 280 | $170 | $48.6K |
| 99214 | The 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… | 400 | $110 | $44.8K |
| 92928 | The provider inserts a catheter through the skin (percutaneous approach) and guides it into the heart's arteries. They deploy one or more stents (small tubes) to keep the artery open and may expand a… | 50 | $530 | $26K |
| 93458 | In this procedure, the provider performs imaging supervision and interpretation for a coronary angiography with left heart catheterization and intraprocedural injections for left ventriculography. He… | 100 | $240 | $22.8K |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 240 | $90 | $21.9K |
| J2785 | Injection, regadenoson, 0.1 mg | 410 | $40 | $17.5K |
| 99233 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 90 | $120 | $10.4K |
| 99223 | The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 60 | $180 | $10.4K |
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Medicare: Competitive Analysis & Benchmarks
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 34 CPT/HCPCS codes. Note: this provider's state, "XX," is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; the State panel below benchmarks against other providers coded under the same designation.
View: State1 / 2
Full comparison — all codes billed, vs. state median
Frequently Asked Questions
References
- 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
- 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.
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