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NPI 1699161075 · Fairfield, CT · Nephrology Physician
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Denzil Douglas is a nephrology physician provider located in Fairfield, Connecticut. This profile covers 22 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 | Denzil Douglas |
| Address | 501 Kings Hwy E Ste 109 |
| City | Fairfield |
| State | CT |
| ZIP | 06825 |
| Taxonomy | Nephrology Physician |
| NPI Enumerated | April 13, 2015 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $731.8K |
| Medicaid | $70.4K |
This provider’s billing profile is firmly procedural and dialysis–access focused: the top Medicare revenue drivers are 36902, 36906, and 36905, codes for angiography with balloon angioplasty, thrombectomy with stent placement, and thrombectomy with balloon angioplasty respectively. Those three Medicare codes together account for 59.3% of this provider’s total Medicare revenue, indicating the practice generates the majority of its payer receipts from interventional dialysis access work rather than routine office visits or primary care E/M services.
Medicare revenue ($731.8K) dominates the payer mix relative to Medicaid ($70.4K), so this provider operates with a heavy Medicare orientation in scale and earnings. The absolute Medicare take is roughly an order of magnitude larger than Medicaid in dollar terms, making Medicare the primary commercial driver of the practice’s volume and revenue profile.
Medicaid billing is extremely concentrated: the precomputed top-3 share is 100.0% and 36902 alone represents 96.9% of this provider’s total Medicaid revenue. This means Medicaid activity is effectively single-code dependent and centered on dialysis access angiography, exposing Medicaid revenue to any changes in reimbursement or utilization policy for that specific service.
Competitive standing on the high-volume dialysis-access codes is mixed but generally above average nationally: 36902 ranks #218 of 1666 providers nationally (87th percentile; typical, unremarkable volume), 36905 ranks #44 of 396 (88th percentile; typical, unremarkable volume), and 36906 ranks #48 of 155 (68th percentile; typical, unremarkable volume). These rank/percentile placements indicate the provider is a notable, above-median participant in dialysis-access interventions among national peers but not a top-tier outlier.
The provider posts unusually high relative volume for procedural sedation on Medicare: code 99152 appears with 211 claims, ranks #813 of 19266 providers nationally (96th percentile), and is flagged as notably above typical national volume. This elevated sedation billing is consistent with frequent complex interventional procedures requiring monitored anesthesia care, reinforcing the interpretation of a procedure-centric practice.
Other procedural capabilities visible in the code mix include peripheral venous angioplasty and intravascular ultrasound (37248 and 37252), plus central venous access device management (36581, 36589, 36558). Presence of these additional endovascular and access-related codes supports a service line that handles both dialysis circuit salvage and broader vascular access interventions rather than only diagnostic imaging.
There are some unusual administrative signal points: Q9967 shows 14.5K claims on Medicare with $0 avg paid/claim and $0 revenue while still ranking #1758 of 11759 providers nationally (85th percentile; typical, unremarkable volume). That pattern indicates frequent reporting of contrast material units or supply items that did not generate recorded payments in the dataset and should be considered when reconciling supply coding versus reimbursed services.
Tenure and credentialing are established: the NPI was enumerated on 2015-04-13 (~11 years ago), indicating the provider has been present in Medicare/Medicaid billing data for about a decade. This duration, combined with concentrated procedural volumes, suggests an established interventional nephrology/vascular access practice rather than a newly emergent billing pattern.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
22 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 36902 | The provider introduces a needle and/or catheter under fluoroscopic guidance (live X–rays that can be viewed on a monitor) and injects contrast material into the dialysis access point to visualize… | 150 | $1,110 | $166.8K |
| 36906 | Under fluoroscopic guidance (live X–rays which can be viewed on a monitor), the provider introduces a catheter into a vessel in the dialysis circuit and extracts a blood clot (hematoma) with special… | 30 | $5,040 | $146.2K |
| 36905 | Under fluoroscopic guidance (live X–rays that can be viewed on a monitor), the provider introduces a catheter into a vessel in the dialysis circuit and extracts a blood clot (hematoma) with special… | 60 | $2,100 | $119.9K |
| 36903 | The provider introduces a needle and/or catheter under fluoroscopic guidance (live X–rays that can be viewed on a monitor) and injects contrast material into the dialysis access point to visualize… | 20 | $3,950 | $83K |
| 36907 | During a primary procedure on a patient's dialysis circuit, the provider finds an obstructedcentralsegment, which he dilates and opens up using a balloon expanded within the vessel lumen (channel).… | 90 | $550 | $47.6K |
| 37248 | Using an open incision or a percutaneous (small incision in the skin) approach, the provider places a balloon–tipped catheter into the lumen (interior) of a vein (except for the dialysis circuit) and… | 40 | $1,210 | $47.3K |
| 37252 | In this add–on procedure, the provider inserts a specially designed catheter with an ultrasound transducer, a device that sends high–frequency sound waves through the tissues and detects their… | 30 | $880 | $24.7K |
| 36215 | The provider advances a catheter into each first order thoracic or brachiocephalic branch within a vascular family, typically to perform angiography of these arteries. | 30 | $510 | $16.9K |
| 36581 | This procedure is a complete replacement of a tunneled CVA catheter in cases of blockage, damage, or malfunction. | 30 | $450 | $13.1K |
| 36901 | The provider introduces a needle and/or catheter under fluoroscopic guidance (live X–rays that can be viewed on a monitor) and injects intravenous contrast material to visualize and record images of… | 20 | $560 | $12.4K |
Showing 1–10 of 22
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 22 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
22 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 36906 | 1 | 10 | 30 | $5,040 | $146.2K |
| 36902 | 2 | 10 | 70 | $1,040 | $75.6K |
| 36903 | 2 | 10 | 20 | $3,780 | $71.9K |
| 37252 | 14 | 20 | 40 | $830 | $49.7K |
| 36905 | 1 | 10 | 20 | $1,890 | $41.6K |
| 37248 | 1 | 10 | 30 | $1,200 | $35.9K |
| 37253 | 15 | 20 | 60 | $150 | $19.5K |
| 36907 | 1 | 10 | 30 | $510 | $18K |
| 36215 | 1 | 10 | 30 | $510 | $16.9K |
| 99214 | 5,932 | 6,480 | 90 | $90 | $14.2K |
Showing 1–10 of 22
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 |
|---|---|---|---|---|
| 36902 | The provider introduces a needle and/or catheter under fluoroscopic guidance (live X–rays that can be viewed on a monitor) and injects contrast material into the dialysis access point to visualize… | 230 | $300 | $68.4K |
| 99152 | The provider performing a diagnostic or therapeutic procedure administers medication to reduce consciousness, but not render the patient unconscious or asleep, in a patient five years of age or… | 120 | $20 | $2.2K |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 100 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Connecticut providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Connecticut median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 36902 | The provider introduces a needle and/or catheter under fluoroscopic guidance (live X–rays that can be viewed on a monitor) and injects contrast material into the dialysis access point to visualize… | 4 | 10 | 1,590 | $140 | $217.5K |
| 99152 | The provider performing a diagnostic or therapeutic procedure administers medication to reduce consciousness, but not render the patient unconscious or asleep, in a patient five years of age or… | 36 | 40 | 650 | $1 | $5.7K |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 48 | 50 | 4,920 | $1 | $590 |
Other providers in the same ZIP code as Denzil Douglas, ranked by combined Medicare and Medicaid revenue.
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