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    OpenPayerNPI Medicare & MedicaidKalpesh Ganatra
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    Kalpesh Ganatra — Billing Profile & Reimbursement Data

    NPI 1700878980 · Hastings, NE · Specialist

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    Kalpesh Ganatra is a specialist provider located in Hastings, Nebraska. This profile covers 18 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
    OrganizationKalpesh Ganatra
    Address715 N Kansas Ave
    CityHastings
    StateNE
    ZIP68901
    TaxonomySpecialist
    NPI EnumeratedAugust 16, 2005

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

    Payer SourceTotal Paid
    Medicare$139.8K
    Medicaid$0

    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.

    18 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    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…580$80$46.1K
    95811During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.210$90$19.5K
    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…130$110$14.4K
    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…200$50$10.9K
    95810Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…90$90$7.2K
    G0399Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation200$30$6.5K
    99233The 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…70$90$5.8K
    99215The 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…40$130$4.7K
    99291Critical care services include the treatment of vital organ failure  or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…30$160$4.5K
    99205The provider sees a new 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 provider…20$150$3.5K

    Showing 1–10 of 18

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    18 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992142623,210110$70$14.9K
    9923345283080$90$11.7K
    9929122736040$160$9.3K
    9581112060$120$8.6K
    992321,3801,39080$60$8.6K
    992137243,22090$50$7.9K
    9921546792040$110$7K
    992237091,06040$120$6.3K
    G039921070$60$5.6K
    99204961,32030$100$5.3K

    Showing 1–10 of 18

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    The Mary Lanning Memorial Hospital AssociationNERural Acute Care Hospital$0$12.9M
    The Mary Lanning Memorial Hospital AssociationNEFamily Medicine Physician$0$4.3M
    The Mary Lanning Memorial Hospital AssociationNECounselor$0$3.1M
    Kearney Co Health ServicesNERural Health Clinic/Center$0$789K
    Thomas ClinchNEOphthalmology Physician$594.4K$0
    Jacqueline KellyNERadiation Oncology Physician$516.1K$0
    Sean DenneyNEInterventional Cardiology Physician$397.2K$0
    The Mary Lanning Memorial Hospital AssociationNEFamily Medicine Physician$0$346.5K
    Matthew RutmanNYUrology Physician$277.1K$39.9K
    Douglas NetzNEInterventional Cardiology Physician$316.4K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    John WelchNERetina Specialist (Ophthalmology) Physician$10.2M$0
    William TerrellNERetina Specialist (Ophthalmology) Physician$8.6M$0
    The Bridge, IncNESubstance Abuse Rehabilitation Facility$0$6.8M
    South Central Behavioral Services. IncNEAdult Mental Health Clinic/Center$0$5.4M
    Hastings Surgical Center, LLCNEAmbulatory Surgical Clinic/Center$238.6K$2.2M
    Retina Center Of Nebraska, P.C.NERetina Specialist (Ophthalmology) Physician$0$2.3M
    South Central Behavioral ServicesNEMental Health Clinic/Center (Including Community Mental Health Center)$0$1.9M
    Larry L Baker, Md, Dds, PCNEOral & Maxillofacial Surgery (D.M.D.)$0$1.2M
    Obstetricians & Gynecologists, P.C.NEObstetrics & Gynecology Physician$0$1.1M
    Family Medical Center Of HastingsNEFamily Medicine Physician$0$1.1M

    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. Nebraska Distribution
    Kalpesh Ganatra — 5 of 18 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Nebraska