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NPI 1760497309 · Tamuning, GU · Podiatrist
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Maria Melinda Sangalang is a podiatrist provider located in Tamuning, Guam. This profile covers 11 Medicare and 2 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 | Maria Melinda Sangalang |
| Address | 633 Gov Carlos G Camacho Rd |
| City | Tamuning |
| State | GU |
| ZIP | 96913 |
| Taxonomy | Podiatrist |
| NPI Enumerated | July 30, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $32.3K |
| Medicaid | $9.7K |
This provider bills to both Medicare and Medicaid but at materially different scales: lifetime Medicare revenue is $32.3K while lifetime Medicaid revenue is $9.7K, so Medicare is the dominant payer by dollars on file. Both payers are active in the profile, so the practice cannot be treated as single-payer but is clearly Medicare-weighted in absolute revenue terms.
Medicare revenue is heavily concentrated in evaluation & management (E/M) codes: the top three Medicare codes (99213, 99214, 99222) account for 67.7% of total Medicare revenue. These codes correspond to established outpatient visits (99213, 99214) and initial hospital/observation inpatient evaluation (99222), indicating a practice model focused on clinic-based E/M encounters with a meaningful component of inpatient/observation admissions work.
Medicaid billing is almost exclusively office E/M work: the top three Medicaid codes account for 100.0% of Medicaid revenue and in practice are two codes — 99213 (72.2% of Medicaid revenue) and 99212 (27.8% of Medicaid revenue). This distribution implies virtually no procedural or surgical Medicaid activity and a reliance on routine established-patient visits for the Medicaid population.
Competitive standing on Medicare is mixed but not dominant: 99213 is relatively stronger nationally (ranks #95114 of 457151, 79th percentile) while 99214 (rank #259688 of 479517, 46th percentile) and 99222 (rank #40729 of 117621, 64th percentile) sit in mid-range positions. The source labels for these codes describe the volumes as "typical, unremarkable volume for this code," so the provider appears to be a modest-to-typical regional participant rather than a high-volume national leader.
Within the Guam Medicaid market the provider’s position is modest: 99213 ranks #37 of 48 in-state (23rd percentile) and 99212 ranks #12 of 21 in-state (45th percentile), and both are described as "typical, unremarkable volume for this code." These in-state ranks suggest the provider is not among the largest Medicaid E/M billers in Guam and has room to grow market share.
Procedural and surgical revenue is present but small relative to E/M: Medicare line items such as 11042 ($1.2K, ranks #9623 of 10712, 9th percentile) and nail debridement codes 11721 ($558, 7th percentile) and 11720 ($286, 15th percentile) contribute minimal dollars. That pattern reinforces a practice profile centered on diagnostic and management visits rather than high-volume procedural podiatry.
The provider has long tenure in the NPI registry (enumerated 2006-07-30, ~20 years ago), which suggests an established practice presence in the market. Coupled with the modest lifetime revenue totals ($32.3K Medicare, $9.7K Medicaid), this points to a stable but small-scale practice rather than a recently created or rapidly scaling enterprise.
From an operational risk/opportunity perspective, the practice’s heavy reliance on a small number of E/M codes creates sensitivity to reimbursement or utilization shifts: on Medicaid, 99213 alone represents 72.2% of Medicaid revenue, and on Medicare the top three codes represent 67.7% of Medicare revenue. Payers or network managers evaluating this provider should note the concentration in outpatient E/M and the presence of inpatient initial visits (99222) as areas that would most affect total revenue if utilization patterns change.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
11 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99213 | The 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… | 210 | $50 | $10.7K |
| 99214 | The 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… | 90 | $80 | $7K |
| 99222 | The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 40 | $110 | $4.1K |
| 99232 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 50 | $60 | $3.1K |
| 99203 | The provider sees a new 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 provider… | 40 | $60 | $2.1K |
| 99204 | The 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… | 10 | $110 | $1.4K |
| 11042 | The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2. | 30 | $50 | $1.2K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 30 | $30 | $950 |
| 99231 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical… | 20 | $40 | $840 |
| 11721 | The provider surgically debrides (debulks or removes) 6 or more abnormal, diseased, or infected nails. | 30 | $20 | $560 |
Showing 1–10 of 11
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
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.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99213 | The 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 | $70 | $7K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 90 | $30 | $2.7K |
How this provider's Medicaid billing volume and revenue compare to other Guam providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Guam median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99213 | The 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… | 37 | 50 | 900 | $80 | $201.7K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 12 | 20 | 120 | $60 | $35.1K |
Other providers in the same ZIP code as Maria Melinda Sangalang, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Thomas Lee | GU | Dentist | $0 | $10.9M |
| Guam Memorial Hospital | GU | General Acute Care Hospital | $0 | $3.5M |
| Rsa - Tumon, LLC | GU | End-Stage Renal Disease (ESRD) Treatment Clinic/Center | $0 | $2.9M |
| Robert Yang | GU | Dentist | $0 | $2.4M |
| Antonio Garcia | GU | Pediatrics Physician | $0 | $2.2M |
| Ma Gladys Linsangan | GU | Pediatrics Physician | $0 | $2.2M |
| Ari Katerelos | GU | Radiation Oncology Physician | $2.1M | $0 |
| Guam X-ray | GU | Vascular & Interventional Radiology Physician | $0 | $2.1M |
| Sarah Clegg | GU | General Practice Dentistry | $0 | $1.7M |
| Peter Kh Go | GU | Surgery Physician | $152.8K | $1.5M |
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