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    OpenPayerNPI Medicare & MedicaidMagdalena Krzystolik
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    Magdalena Krzystolik — Billing Profile & Reimbursement Data

    NPI 1629074752 · Providence, RI · Ophthalmology Physician

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    Magdalena Krzystolik is a ophthalmology physician provider located in Providence, Rhode Island. This profile covers 11 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.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationMagdalena Krzystolik
    Address1 Randall Sq
    CityProvidence
    StateRI
    ZIP02904
    TaxonomyOphthalmology Physician
    NPI EnumeratedJune 23, 2005

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$451.3K
    Medicaid$0

    Key Findings

    This provider’s billings are concentrated entirely in Medicare with Total Medicare revenue of $451.3K and no Medicaid billing on file, so the payer mix is effectively single-payer Medicare for the dataset provided. Analysts should treat this profile as Medicare-dominant when modeling revenue exposure or network participation.

    Revenue concentration is high: the precomputed top 3 Medicare codes (J0178, J2778, 67028) account for 80.5% of this provider’s total Medicare revenue. In particular J0178 represents 41.3% of Medicare revenue, J2778 19.7%, and 67028 19.6%, indicating a small number of services drive most income.

    The code mix and descriptions identify a medical-retina practice focus: high-revenue drug codes J0178 (aflibercept) and J2778 (ranibizumab) plus the intravitreal procedure 67028 point to routine anti-VEGF therapy delivery. This pattern, combined with frequent posterior-segment imaging, is consistent with ongoing management of retinal vascular disease (for example wet AMD or diabetic macular edema) rather than primarily cataract or refractive surgery.

    Competitive standing for injected drugs is modest to typical: J0178 ranks #2394 of 3204 providers (25th percentile) and J2778 ranks #753 of 1208 providers (38th percentile), both labeled typical/unremarkable volumes nationally. By contrast, procedural injection 67028 ranks #1293 of 4255 (70th percentile), indicating this provider performs intravitreal injection procedures at an above-typical rate compared with peers.

    Retinal imaging is a clear outlier within the dataset: 92134 accounts for $35.8K (7.9% of Medicare revenue) and ranks #1461 of 26868 providers (95th percentile), described as notably above typical national volume. That elevated imaging intensity suggests frequent monitoring cadence for retinal disease, reinforcing the medical-retina service line interpretation.

    Office evaluation volumes are present but secondary to procedures and drug therapy: 92014 generates $34.8K (7.7% of Medicare revenue) and ranks #5038 of 35415 providers (86th percentile), while common E/M code 99213 accounts for $6.1K (1.3% of Medicare revenue) with a national rank indicating typical volume. Overall revenue appears more procedure- and drug-driven than visit-driven, which is important for forecasting visit capacity versus procedure capacity.

    The provider has a long-enumerated NPI (NPI enumerated (registered): 2005-06-23 (~21 years ago)), indicating substantial tenure in the Medicare program. Combined with the concentrated retina-centric billing profile, this suggests an established practice pattern focused on ongoing retinal treatment and monitoring rather than a newly formed or broadly diversified ophthalmology practice.

    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.

    11 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J0178Injection, aflibercept, 1 mg270$690$187.1K
    J2778Injection, ranibizumab, 0.1 mg490$180$89.1K
    67028The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.1,080$80$88.6K
    92134The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.1,560$20$35.8K
    92014An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…530$70$34.8K
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…110$60$6.1K
    99204The provider sees a new 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 provider…50$110$5.6K
    99214The 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…40$80$3.4K
    92235The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken…20$40$940
    92250Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…40$20$820

    Showing 1–10 of 11

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    11 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J01781210670$690$601.6K
    J2778210460$180$78.7K
    67028420610$90$58.9K
    9201417190120$80$16.3K
    992141,4181,950100$80$11.7K
    992136711,95070$60$7.4K
    92134512050$30$6.6K
    9920416674030$110$4.6K
    9223551020$100$3.6K
    922508715050$30$2.3K

    Showing 1–10 of 11

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Magdalena Krzystolik, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Massachusetts Eye And Ear InfirmaryMAGeneral Acute Care Hospital$0$68.1M
    Massachusetts Eye And Ear Associates, Inc.MAOphthalmology Physician$0$6.6M
    Jay WangCAOphthalmology Physician$2.2M$0
    Corey WesterfeldMAOphthalmology Physician$1.2M$0
    Tomasz StryjewskiMAOphthalmology Physician$935.2K$0
    Mehnaz KhanMAOphthalmology Physician$871.2K$37.7K
    Marlene WangNJOphthalmology Physician$831.5K$0
    Karen Jeng-millerMAOphthalmology Physician$698.7K$0
    David SmitsMAOphthalmology Physician$661.4K$0
    Miin RohMAOphthalmology Physician$510.9K$0

    Nearby Providers

    Other providers in the same ZIP code as Magdalena Krzystolik, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    The Providence Center IncRIMental Health Clinic/Center (Including Community Mental Health Center)$0$170.9M
    Re-focus Inc.RIDevelopmentally Disabled Services Day Training Agency$0$102.5M
    Hopehealth Hospice & Palliative CareRICommunity Based Hospice Care Agency$0$33.3M
    Mas Medical StaffingRIHome Health Agency$0$24.5M
    Generations Adult Day Health CenterRIAdult Day Care Clinic/Center$0$16.3M
    Prospect Chartercare Sjhsri, LLCRIGeneral Acute Care Hospital$0$10.9M
    Global Homecare And Staffing IncRIHome Health Agency$0$8.3M
    Emergency Care Services Of New England PCRIEmergency Medicine Physician$0$6.9M
    State Of Rhode IslandRIClinical Medical Laboratory$570$6.4M
    The Providence CenterRICommunity/Behavioral Health Agency$0$5.9M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Rhode Island Distribution
    Magdalena Krzystolik — 1 of 11 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Rhode Island