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NPI 1760590962 · Cape Coral, FL · Medical Oncology Physician
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Florida Cancer Specialists & Research Institute, LLC is a medical oncology physician provider located in Cape Coral, Florida. This profile covers 0 Medicare and 111 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 | Florida Cancer Specialists & Research Institute, LLC |
| Address | 1708 Cape Coral Pkwy W |
| City | Cape Coral |
| State | FL |
| ZIP | 33914 |
| Taxonomy | Medical Oncology Physician |
| NPI Enumerated | August 28, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $63.5M |
| Medicare | $0 |
This provider has no Medicare billing on file and reported $63.5M in lifetime Medicaid revenue, making its public billing footprint effectively single-payer and concentrated in Medicaid. The absence of Medicare activity means analyses should treat Medicaid as the primary commercial touchpoint and consider payer-concentration exposure when evaluating reimbursement risk.
Revenue is heavily concentrated in a small set of laboratory and diagnostic codes: the top three Medicaid codes (36415, 85025, 80053) account for 75.4% of the provider's Medicaid revenue, with 36415 contributing $20M (31.6%), 85025 contributing $18.2M (28.8%), and 80053 contributing $9.5M (15.0%). This concentration indicates that a majority of dollars flow from specimen collection and common lab panels rather than a broad mix of outpatient procedures.
The code mix points to an operation built around high-volume phlebotomy and lab services combined with oncology treatment workflows: 36415 (venipuncture) and 85025 (CBC) dominate revenue, while oncology treatment codes such as 96413 (chemotherapy, $2.7M, 4.3%) and infusion administration codes (96365, 96372, 96367) are meaningful secondary revenue streams. Together these patterns are consistent with an oncology practice that pairs frequent lab monitoring with infusion-based therapies.
Competitive standing in-state is dominant for several high-volume codes. The provider ranks #5 of 1329 for 36415 (100th percentile; extreme outlier) and #9 of 820 for 85025 (99th percentile; notably above typical), while 80053 sits at #27 of 642 (96th percentile; typical). High ranks for these core lab services indicate the provider is an outlier in Florida phlebotomy and routine lab volume relative to peers.
Beyond labs, the practice shows outsized volume in office-based oncology E/M and injection administration: 99214 generated $5.2M (8.2%) and ranks #12 of 6379 (100th percentile; extreme outlier), while 96372 produced $2.2M (3.6%) and ranks #2 of 792 (100th percentile; extreme outlier). These rankings suggest a large clinic footprint with heavy throughput of established outpatient visits and supervised injection/infusion encounters.
Operational scale is evident from claim volumes reported for key codes: 36415 appears on 262.9K claims and 85025 on 364.3K claims, implying substantial ongoing needs for phlebotomy staffing, specimen handling, and lab logistics to support daily outpatient operations. High claim counts combined with dominant percentile ranks indicate the practice handles an unusually large testing and collection load compared to other Florida providers.
The provider also shows notable presence in imaging-related and specialty supplies used in oncology care: 78815 (PET/CT) generated $1.4M and ranks #3 of 54 (96th percentile; notably above typical), and A9552 (FDG dose) ranks #2 of 41 (98th percentile; notably above typical). This reinforces that the practice’s service mix extends beyond basic labs into imaging and radiotracer utilization necessary for cancer diagnosis and management.
The NPI was enumerated on 2006-08-28 (~20 years ago), indicating an established market presence in Cape Coral. Combined with the strong statewide ranks and concentrated Medicaid revenue base, the provider appears to be a longstanding, high-throughput oncology and lab services provider whose financial performance is highly sensitive to Medicaid reimbursement and code-level policy changes.
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.
111 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 262,890 | $80 | $20M |
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 364,350 | $50 | $18.2M |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 89,670 | $110 | $9.5M |
| 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… | 129,440 | $40 | $5.2M |
| 96413 | Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These… | 13,760 | $200 | $2.7M |
| 96372 | A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician… | 53,550 | $40 | $2.2M |
| 78815 | PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.… | 4,550 | $300 | $1.4M |
| 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… | 41,260 | $20 | $907.7K |
| 96365 | The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease. | 14,420 | $50 | $706.5K |
| 96367 | The provider administers an additional intravenous infusion or infusions, after an initial infusion, of a different medication or substance for a period up to one hour to prevent, treat, or diagnose… | 3,470 | $130 | $461.4K |
Showing 1–10 of 111
How this provider's Medicaid billing volume and revenue compare to other Florida providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Florida median
111 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 88374 | The lab analyst applies a single multiplex in situ hybridization probe stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. The lab analyst processes the slides… | 3 | 10 | 7,070 | $110 | $956.3K |
| 96361 | The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration. | 204 | 210 | 2,890 | $70 | $321.6K |
| 74177 | The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 48 | 350 | 1,160 | $80 | $308.7K |
| J1756 | Injection, iron sucrose, 1 mg | 128 | 390 | 1,800 | $100 | $279.4K |
| 96413 | Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These… | 6 | 100 | 650 | $80 | $238.6K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 27 | 640 | 4,400 | $10 | $193.4K |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | 6 | 10 | 520 | $70 | $169.8K |
| 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… | 90 | 5,930 | 460 | $40 | $169.3K |
| 96365 | The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease. | 4 | 230 | 1,060 | $60 | $150.1K |
| 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… | 12 | 6,380 | 430 | $50 | $139.3K |
Showing 1–10 of 111
Other providers in the same ZIP code as Florida Cancer Specialists & Research Institute, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Gamini Sooriyaarachchi | FL | Medical Oncology Physician | $2.2M | $0 |
| Jessica Burke | FL | Family Nurse Practitioner | $248.5K | $0 |
| Lazaro Castillo | FL | Allergy & Immunology Physician | $227.7K | $0 |
| Ngoc Han Pham | FL | Podiatrist | $171K | $0 |
| Publix Super Markets Inc | FL | Community/Retail Pharmacy | $96.8K | $0 |
| Allison Sexton | FL | Speech-Language Pathologist | $49.4K | $0 |
| Drew Huffman | FL | Rheumatology Physician | $13.5K | $0 |
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