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NPI 1730776816 · Wilmington, NC · Ambulance
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Novant Health New Hanover Regional Medical Center LLC is a ambulance provider located in Wilmington, North Carolina. This profile covers 7 Medicare and 10 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 | Novant Health New Hanover Regional Medical Center LLC |
| Address | 2131 S 17th St |
| City | Wilmington |
| State | NC |
| ZIP | 28401 |
| Taxonomy | Ambulance |
| NPI Enumerated | December 23, 2020 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $6.1M |
| Medicaid | $2.7M |
Operation and service mix are consistent with an ambulance and medical-transport provider: the top Medicare and Medicaid codes are A0427, A0428, A0425 and related transport codes, which represent advanced life support (ALS) and basic life support (BLS) emergency and non-emergency transports plus ground mileage. The presence of A0434 (specialty care transport) and A0433 (ALS level 2) on the Medicare list indicates the provider also bills for higher-acuity and specialized transfers, though those make up smaller shares of revenue.
Medicare revenue is tightly concentrated in a few transport codes: the top 3 Medicare codes by revenue account for 78.6% of this provider's total Medicare revenue, led by A0427 (36.4%), A0428 (21.2%), and A0425 (21.0%). This concentration shows that a small set of ambulance transport and mileage codes drive the majority of Medicare dollars for this entity.
Medicaid revenue is even more concentrated: the top 3 Medicaid codes by revenue account for 81.3% of this provider's total Medicaid revenue, with A0427 delivering 52.6% of Medicaid revenue, T2003 contributing 17.0%, and A0429 contributing 11.7%. That split indicates Medicaid dollars are dominated by ALS emergency transports and non-emergency trip encounters in-state.
The provider’s payer mix is dominated by Medicare in scale: total Medicare revenue is $6.1M compared with total Medicaid revenue of $2.7M. Medicare is the larger single source of programmatic revenue on file, while Medicaid represents a meaningful but smaller share of lifetime revenue.
For Medicare the provider shows national-scale volume on several codes and is characterized as an outlier on multiple measures: A0425 ranks #51 of 8934 providers nationally (99th percentile; extreme outlier), A0427 ranks #105 of 6841 (98th percentile; extreme outlier), and A0426 ranks #11 of 1568 (99th percentile; extreme outlier). These ranks and percentile labels indicate this provider is a major national participant for several high-revenue ambulance services rather than a low-volume or marginal supplier.
In-state competitive standing on Medicaid is less extreme but still above typical for key codes: A0427 ranks #16 of 168 providers in-state (91th percentile; typical, unremarkable volume for this code), A0425 ranks #19 of 222 (92th percentile; typical, unremarkable), and T2003 ranks #14 of 42 (68th percentile; typical, unremarkable). This suggests the provider is a meaningful Medicaid transport participant locally, but not universally an extreme outlier within the state.
Payer-level reimbursement dynamics are notable: Medicare-paid averages for the same ambulance codes are materially higher than Medicaid-paid averages (for example, A0427 Medicare avg paid/claim $377 vs Medicaid avg paid/claim $60; A0429 Medicare avg paid/claim $318 vs Medicaid $33). These per-claim payment differentials help explain why Medicare produces a larger revenue pool ($6.1M) even where Medicaid claim volumes are substantial.
Tenure and operational scale: the NPI was enumerated 2020-12-23 (~6 years ago), and despite this relatively recent enumeration the provider has high claim volumes and large national ranks on multiple Medicare ambulance codes. The combination of rapid scale on core ALS/BLS codes and the presence of specialty and ALS level-2 transports suggests an established operational footprint focused on both emergency and non-emergency ground transport 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.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 5,860 | $380 | $2.2M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 6,720 | $190 | $1.3M |
| A0425 | Ground mileage, per statute mile | 181,980 | $10 | $1.3M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,990 | $320 | $633.5K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1,580 | $240 | $381.5K |
| A0434 | Specialty care transport (sct) | 280 | $660 | $183.7K |
| A0433 | Advanced life support, level 2 (als 2) | 180 | $550 | $96.8K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 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.
10 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 23,780 | $60 | $1.4M |
| T2003 | Non-emergency transportation; encounter/trip | 1,480 | $310 | $461.1K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 9,600 | $30 | $316.9K |
| A0425 | Ground mileage, per statute mile | 26,320 | $10 | $263.2K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 12,320 | $10 | $147.8K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 2,880 | $30 | $72K |
| A0433 | Advanced life support, level 2 (als 2) | 300 | $80 | $22.8K |
| A0434 | Specialty care transport (sct) | 50 | $30 | $1.8K |
| A0998 | Ambulance response and treatment, no transport | 70 | $10 | $990 |
| A0398 | Als routine disposable supplies | 240 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other North Carolina providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. North Carolina median
10 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 16 | 170 | 2,470 | $140 | $1.2M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 29 | 140 | 2,410 | $110 | $686.8K |
| T2003 | Non-emergency transportation; encounter/trip | 14 | 40 | 620 | $250 | $522.5K |
| A0433 | Advanced life support, level 2 (als 2) | 14 | 30 | 280 | $140 | $100K |
| A0425 | Ground mileage, per statute mile | 19 | 220 | 3,930 | $10 | $86.1K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 13 | 110 | 1,530 | $20 | $74.5K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 5 | 50 | 250 | $50 | $51.4K |
| A0434 | Specialty care transport (sct) | 6 | 10 | 180 | $30 | $5K |
| A0998 | Ambulance response and treatment, no transport | 20 | 30 | 150 | $10 | $3.6K |
| A0398 | Als routine disposable supplies | 4 | 10 | 190 | $1 | $100 |
Other providers in the same ZIP code as Novant Health New Hanover Regional Medical Center LLC, ranked by combined Medicare and Medicaid revenue.
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