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NPI 1609585454 · Wilmington, DE · Ambulance
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St Francis Emergency Medical Services LLC is a ambulance provider located in Wilmington, Delaware. 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 | St Francis Emergency Medical Services LLC |
| Address | 701 N Clayton St |
| City | Wilmington |
| State | DE |
| ZIP | 19805 |
| Taxonomy | Ambulance |
| NPI Enumerated | November 21, 2022 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2M |
| Medicaid | $1.8M |
ST FRANCIS EMERGENCY MEDICAL SERVICES LLC presents as a high-volume ground ambulance operator: the Medicare and Medicaid top codes are dominated by basic life support emergency and mileage codes (A0429, A0425/A0380, A0428), which indicates its primary service line is BLS emergency transport and routine non-emergency BLS runs rather than specialty/ALS services. The presence of both emergency (A0429) and non-emergency BLS (A0428) codes suggests the company performs a mix of 911/urgent responses and scheduled or repeat transports for patients who do not require ALS-level care.
Revenue concentration is extreme for both payers: the top three Medicare codes account for 99.9% of the provider's total Medicare revenue and the top three Medicaid codes account for 99.9% of its total Medicaid revenue, implying this business is highly dependent on a very small set of ambulance services for nearly all billed revenue. For Medicare, A0429 alone represents 90.0% of Medicare revenue; for Medicaid, A0429 represents 94.7% of Medicaid revenue, highlighting single-code dominance across both programs.
On payer mix, the provider reports approximately comparable lifetime scale across programs with Total Medicare revenue listed as $2M and Total Medicaid revenue listed as $1.8M, indicating it is not a single-payer operation but instead generates substantial revenue from both Medicare and Medicaid. This near parity means operational decisions or reimbursement changes in either program could materially affect overall revenue.
The provider is a national outlier on the Medicare emergency BLS code: A0429 has 5.4K claims and $1.8M revenue and the provider ranks #47 of 7808 nationally (99th percentile; extreme outlier), signaling unusually high Medicare emergency-BLS volume versus peers. That standing suggests dominant scale for this specific code on a national basis, rather than a typical or modest participation level.
In-state competitive standing on Medicaid also shows above-typical concentration: for Medicaid A0429 the provider ranks #3 of 61 in-state (97th percentile; typical, unremarkable volume) while A0380 (BLS mileage) is described as an extreme outlier in-state (rank #3 of 51, 96th percentile; extreme outlier), indicating the provider is among the largest in Delaware for mileage- and BLS-emergency billing even if ranks for some codes are characterized as typical by the data source. These rankings together describe a prominent Medicaid presence within-state for core ambulance services.
The code mix shows limited use of advanced life support: A0426 (ALS 1) appears only minimally on Medicare (12 claims, $3K revenue) and is not a meaningful revenue driver, reinforcing that the operation is focused on BLS-level care rather than ALS. This operational profile reduces exposure to ALS-specific reimbursement but increases sensitivity to policies affecting BLS emergency transport rates.
Tenure is relatively short: the NPI was enumerated on 2022-11-21 (~4 years ago), so the organization has been on the Medicare/Medicaid rolls for a moderate period but already achieved sizable scale in its core codes. Rapid accumulation of high-volume claims for A0429 within this timeframe may indicate concentrated growth or an acquisition of large transport contracts after enumeration.
Statistical outlier signals should inform network and utilization reviews: nationally the provider is an "extreme outlier" for Medicare A0429 and within-state the provider is an "extreme outlier" for Medicaid A0380 mileage, so payers should treat claims for those specific codes as candidates for benchmarking or audit of utilization patterns relative to other regional ambulance providers. Conversely, other billed codes (A0425, A0428) fall in typical percentile ranges, implying normal volumes for supplementary services.
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 |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 5,390 | $340 | $1.8M |
| A0425 | Ground mileage, per statute mile | 15,760 | $10 | $110.3K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 420 | $210 | $89.9K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 10 | $250 | $3K |
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) | 15,640 | $110 | $1.7M |
| A0380 | Bls mileage (per mile) | 9,410 | $10 | $84.7K |
| A0425 | Ground mileage, per statute mile | 6,390 | $1 | $6.4K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 110 | $10 | $1.1K |
How this provider's Medicaid billing volume and revenue compare to other Delaware providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Delaware 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) | 3 | 60 | 1,700 | $50 | $211.4K |
| A0425 | Ground mileage, per statute mile | 3 | 50 | 670 | $10 | $18.9K |
| A0380 | Bls mileage (per mile) | 3 | 50 | 860 | $10 | $16.1K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 5 | 10 | 170 | $1 | $7K |
Other providers in the same ZIP code as St Francis Emergency Medical Services LLC, ranked by combined Medicare and Medicaid revenue.
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