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NPI 1790228062 · Mount Vernon, NY · Ambulance
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American Medical Response Of New York, LLC is a ambulance provider located in Mount Vernon, New York. This profile covers 6 Medicare and 9 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 | American Medical Response Of New York, LLC |
| Address | 521 E 3rd St |
| City | Mount Vernon |
| State | NY |
| ZIP | 10553 |
| Taxonomy | Ambulance |
| NPI Enumerated | November 18, 2016 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $9.3M |
| Medicare | $6.4M |
AMERICAN MEDICAL RESPONSE OF NEW YORK, LLC bills predominantly as an ambulance transport operation, with a heavy mix of basic life support non-emergency transports and mileage-driven claims. The Medicare and Medicaid top codes are dominated by A0428 (basic life support non-emergency), A0429/A0427 (BLS emergency / ALS emergency) and A0425 (ground mileage), and the presence of A0434 (specialty care transport) indicates they also provide higher-acuity interfacility transfers. The code mix is consistent with a fleet-based EMS/ambulance service that handles both non-emergent patient relocations and emergency responses.
Medicare revenue is concentrated heavily in a small set of codes: the precomputed top-3 Medicare codes account for 79.7% of this provider's total Medicare revenue. Specifically, A0428 generated $3.1M (47.9%), A0427 generated $1.1M (16.7%), and A0425 generated $976.3K (15.1%) of Medicare revenue, indicating these line items drive most Medicare payments to the entity.
Medicaid revenue is similarly concentrated, with the precomputed top-3 Medicaid codes accounting for 77.4% of Medicaid revenue. On Medicaid A0428 contributed $5.1M (55.3%), A0429 contributed $1.2M (12.7%), and A0427 contributed $881.5K (9.5%), showing a comparable dependence on BLS non-emergency and emergency transports plus ALS services for Medicaid payor receipts.
On payer mix, this provider reports $6.4M in total Medicare revenue versus $9.3M in total Medicaid revenue, making Medicaid the larger single public-payer source by scale. Both payers are material to the business, so operational and contracting decisions that affect either Medicare or Medicaid volumes will meaningfully impact overall revenue.
National competitive standing on Medicare shows extreme relative concentration for certain codes: A0428 ranks #31 of 2772 (99th percentile; extreme outlier, far above typical national volume for this code) and A0425 ranks #81 of 8934 (99th percentile; extreme outlier, far above typical national volume for this code). A0427 is also above typical for its peer group (rank #295 of 6841, 96th percentile) but less extreme, which together position the provider as a very high-volume national biller for BLS non-emergency transports and mileage.
In-state competitive standing on Medicaid is elevated but not as extreme as Medicare: A0428 ranks #11 of 85 (88th percentile; typical, unremarkable volume in-state) and A0425 ranks #21 of 483 (96th percentile; typical, unremarkable volume in-state). Other Medicaid codes such as A0999 (unlisted ambulance service) rank #9 of 18 (53rd percentile), indicating niche or less-consistent use of some unlisted services within the state peer set.
The provider’s NPI was enumerated on 2016-11-18 (~10 years ago), indicating roughly a decade of billing history under this identifier. That tenure, combined with multi-million-dollar lifetime Medicare ($6.4M) and Medicaid ($9.3M) receipts and repeated placement at high percentiles for core ambulance codes, supports the interpretation of an established, high-volume ambulance operator in the Mount Vernon, NY market.
Several codes are explicitly labeled as statistical outliers in the supplied benchmarking: Medicare A0428 and A0425 are marked 'extreme outlier' while A0429 and A0427 are described as 'notably above typical' or higher-percentile performers. These labels signal unusually large claim volumes relative to national peers for specific ambulance line items and are important context for payers or network managers evaluating utilization, capacity, or contracting strategies for this provider.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 12,800 | $240 | $3.1M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 2,330 | $460 | $1.1M |
| A0425 | Ground mileage, per statute mile | 139,470 | $10 | $976.3K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 2,220 | $390 | $861.6K |
| A0434 | Specialty care transport (sct) | 340 | $780 | $269K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 620 | $290 | $180.7K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 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.
9 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 45,390 | $110 | $5.1M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 6,910 | $170 | $1.2M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 4,870 | $180 | $881.5K |
| A0999 | Unlisted ambulance service | 1,600 | $530 | $851.2K |
| A0425 | Ground mileage, per statute mile | 52,430 | $10 | $734K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 1,890 | $170 | $328.2K |
| A0434 | Specialty care transport (sct) | 820 | $180 | $143.5K |
| A0170 | Transportation ancillary: parking fees, tolls, other | 11,190 | $1 | $22.4K |
| A0380 | Bls mileage (per mile) | 2,200 | $10 | $15.4K |
How this provider's Medicaid billing volume and revenue compare to other New York providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New York median
9 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0999 | Unlisted ambulance service | 9 | 20 | 1,140 | $790 | $2.3M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 11 | 90 | 2,220 | $120 | $1.7M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 49 | 420 | 950 | $170 | $1.6M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 47 | 310 | 830 | $200 | $1.1M |
| A0434 | Specialty care transport (sct) | 8 | 20 | 560 | $230 | $309.6K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 8 | 40 | 290 | $200 | $227K |
| A0425 | Ground mileage, per statute mile | 21 | 480 | 1,360 | $20 | $191.3K |
| A0170 | Transportation ancillary: parking fees, tolls, other | 18 | 250 | 540 | $10 | $30.5K |
| A0380 | Bls mileage (per mile) | 8 | 20 | 470 | $10 | $13.6K |
Other providers in the same ZIP code as American Medical Response Of New York, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| The Guidance Center Of Westchester, Inc | NY | Community/Behavioral Health Agency | $257K | $23.6M |
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