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NPI 1689703860 · East Providence, RI · Land Ambulance
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City Of East Providence is a land ambulance provider located in East Providence, Rhode Island. This profile covers 3 Medicare and 5 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 | City Of East Providence |
| Address | 913 Broadway |
| City | East Providence |
| State | RI |
| ZIP | 02914 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | March 5, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $1.3M |
| Medicare | $585.3K |
CITY OF EAST PROVIDENCE is registered under the Land Ambulance taxonomy and its billed services are concentrated in ambulance transport codes, with high volumes reported for emergency advanced life support and basic life support plus ground mileage. Medicare top codes include A0427 (1.1K claims, $409 avg paid/claim, $434.8K revenue), A0429 (292 claims, $335 avg paid/claim, $97.8K revenue) and A0425 (7.8K claims, $7 avg paid/claim, $54.7K revenue), while Medicaid top codes show A0429 (7.3K claims, $83 avg paid/claim, $606.6K revenue), A0427 (6.5K claims, $86 avg paid/claim, $555.2K revenue) and A0425 (14.4K claims, $5 avg paid/claim, $72K revenue). These patterns are consistent with an EMS-first responder operation that performs both ALS and BLS emergency transports and bills per-mile ground mileage.
Revenue concentration is extreme within the ambulance service line: the top three Medicare codes account for 100.0% of the provider's total Medicare revenue, and the top three Medicaid codes account for 98.0% of the provider's total Medicaid revenue. On Medicare the single code A0427 alone represents 74.0% of Medicare revenue, while on Medicaid A0429 and A0427 together represent 48.2% and 44.1% of Medicaid revenue respectively, signaling heavy dependence on a very narrow set of transport services.
Payer mix is Medicaid-weighted in scale: lifetime Medicaid revenue is $1.3M compared with total Medicare revenue of $585.3K, so the provider generates a larger dollar volume from Medicaid than from Medicare. This makes reimbursement policy and payer-specific contract terms with Medicaid particularly material to the provider's topline stability.
National competitive standing on Medicare is solid but not dominant for its highest-revenue ALS code: A0427 ranks #694 of 6841 providers nationally (90th percentile) and is described in the source as a typical, unremarkable volume for this code, indicating a meaningful national presence in ALS emergency transports without being an extreme outlier. Its Medicare volumes for A0429 (rank #1856 of 7808; 76th percentile) and A0425 (rank #2453 of 8934; 73th percentile) are likewise characterized as typical, suggesting modest participation relative to national peers for those lines.
In-state competitive standing on Medicaid is comparatively much stronger: A0429 ranks #5 of 35 providers in-state (88th percentile) and A0427 ranks #6 of 39 providers in-state (87th percentile), placing CITY OF EAST PROVIDENCE among the higher-volume Medicaid ambulance providers locally. A0425 also sits above typical in-state (rank #10 of 46; 80th percentile), so the organization appears to be a major regional player for both BLS and ALS emergency transport within Rhode Island.
Clinical/operational detail in Medicaid billing shows routine use of diagnostic monitoring during transports: code 93005 appears with 3K claims, $8 avg paid/claim, $24.3K revenue (1.9% of Medicaid revenue) and ranks #7 of 76 providers in-state (92th percentile), which suggests frequent 12-lead ECG recordings during patient encounters. By contrast, ancillary items such as A0422 (oxygen supplies) are minimal in revenue contribution (65 claims, $8 avg, $520 revenue), indicating oxygen supply billing is not a major revenue driver.
Tenure and stability: the NPI was enumerated on 2007-03-05 (~19 years ago), which indicates a long-established presence in the market and suggests the patterns observed represent sustained operational focus rather than a very recent entrant's profile. That longevity reinforces the interpretation that the organization’s core business is municipal EMS/ambulance transport.
The narrow service-line footprint—top-three codes representing 100.0% of Medicare revenue and 98.0% of Medicaid revenue—means the provider's financial performance is highly sensitive to changes in ambulance reimbursement rates, volume of emergency transports, and state Medicaid payment policy. Analysts should treat reimbursement updates, contract negotiations, or changes to ambulance payment rules as high-impact events for this provider, given the concentrated revenue base.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1,060 | $410 | $434.8K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 290 | $340 | $97.8K |
| A0425 | Ground mileage, per statute mile | 7,820 | $10 | $54.7K |
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.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 7,310 | $80 | $606.6K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 6,460 | $90 | $555.2K |
| A0425 | Ground mileage, per statute mile | 14,400 | $10 | $72K |
| 93005 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to… | 3,040 | $10 | $24.3K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 70 | $10 | $520 |
How this provider's Medicaid billing volume and revenue compare to other Rhode Island providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Rhode Island median
5 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 5 | 40 | 1,830 | $80 | $362.7K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 6 | 40 | 1,250 | $80 | $273.1K |
| 93005 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to… | 7 | 80 | 120 | $80 | $124.6K |
| A0425 | Ground mileage, per statute mile | 10 | 50 | 2,550 | $10 | $72.5K |
| A0422 | Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation | 6 | 10 | 60 | $1 | $3.6K |
Other providers in the same ZIP code as City Of East Providence, ranked by combined Medicare and Medicaid revenue.
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