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NPI 1790335834 · Waterbury, CT · Ambulance
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Trinity Health Of New England Emergency Medical Services, Inc. is a ambulance provider located in Waterbury, Connecticut. 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 | Trinity Health Of New England Emergency Medical Services, Inc. |
| Address | 15 W Dover St |
| City | Waterbury |
| State | CT |
| ZIP | 06706 |
| Taxonomy | Ambulance |
| NPI Enumerated | September 19, 2019 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $13M |
| Medicare | $2.5M |
Service-line profile: The provider is an ambulance operator (Taxonomy: Ambulance) whose Medicare and Medicaid billing is dominated by emergency and basic/advanced life-support transport codes — specifically A0429, A0427 and A0428 appear as the primary service lines on both payers. Medicare shows A0429 with $362 avg paid/claim and A0427 with $431 avg paid/claim, while Medicaid shows A0429 at $163 avg paid/claim and A0427 at $177 avg paid/claim, indicating the same operational mix is billed to both payers but at materially different per‑claim payment levels by payer. These code-level averages suggest routine provision of both BLS emergency and ALS level‑1 emergency transports as core offerings, with non‑emergency BLS (A0428) also active.
Medicare revenue concentration: Medicare revenue is highly concentrated in a single service mix — the precomputed top 3 Medicare codes (A0429, A0427, A0428) account for 87.0% of this provider's total Medicare revenue. The distribution shows A0429 (37.5%), A0427 (31.5%) and A0428 (18.0%) together driving nearly all Medicare receipts, which concentrates reimbursement exposure on emergency and BLS/ALS transport lines. This concentration creates sensitivity to utilization or rate changes for those specific transport codes.
Medicaid revenue concentration: Medicaid receipts are even more concentrated with the precomputed top 3 Medicaid codes (A0429, A0427, A0428) accounting for 91.2% of this provider's total Medicaid revenue. The largest single Medicaid driver is A0429 at 51.6% of Medicaid revenue, followed by A0427 at 28.5% and A0428 at 11.1%, indicating the provider’s Medicaid business is overwhelmingly emergency transport revenue. High concentration on a few codes heightens the operational importance of those service lines for payer negotiations and network positioning.
Payer mix and scale: This provider’s Medicaid business ($13M) substantially exceeds its Medicare business ($2.5M), making it effectively a Medicaid‑dominant revenue stream by scale. Analysts should treat Medicaid reimbursement dynamics and state network positioning as the primary commercial lens for this entity, while Medicare represents a smaller but still meaningful portion of total public-payer revenue. The difference in scale also means cash‑flow and strategic decisions are likely governed more by state Medicaid policy and contracts than by Medicare rate changes.
Competitive standing — Medicare (national): For Medicare emergency BLS transports the provider ranks highly: A0429 ranks #137 of 7808 providers nationally (98th percentile) and is labeled notably above typical national volume, while A0427 ranks #375 of 6841 (95th percentile) and A0428 ranks #363 of 2772 (87th percentile). These positions indicate the provider is a nationally high‑volume participant for key ambulance emergency services, particularly for BLS emergency transports, positioning it well above the typical national operator on those codes. Other Medicare observations such as A0425 ground mileage ranking #497 of 8934 (94th percentile) further underscore above‑typical national activity in mileage reporting.
Competitive standing — Medicaid (state): In Connecticut Medicaid billing this provider is a major in‑state participant for emergency transports: A0429 ranks #5 of 122 providers in-state (97th percentile) and A0427 ranks #6 of 80 (94th percentile), both characterized as typical, unremarkable volume relative to peer counts but located near the top of statewide ranks. Ground mileage A0425 is especially prominent in-state (66.7K claims, $800.7K revenue) and ranks #4 of 128 providers (98th percentile) with the label notably above typical state volume, indicating strong operational reach or long-distance transports within the state Medicaid population. The combination of top ranks on A0429/A0427 and A0425 suggests the provider is a leading Medicaid ambulance operator in Connecticut.
Operational footprint indicators: Claim counts for mileage and response show large operational throughput across payers — A0425 appears with 41.4K Medicare claims (Medicare revenue $289.5K) and 66.7K Medicaid claims (Medicaid revenue $800.7K), while Medicaid shows very large claim counts for A0429 (41.3K claims, $6.7M) and A0427 (21K claims, $3.7M). These volumes imply frequent transports and substantial distance or time on the road, which has implications for fleet capacity, staffing and per‑trip cost structure; it also makes the provider sensitive to mileage reimbursement policy and per‑mile payment levels. Ancillary codes such as S0215 and 4701Y appear in the Medicaid mix at smaller revenue shares but with above‑typical state ranking for 4701Y (rank #2 of 12, 91st percentile), suggesting additional nonstandard charge lines that may be material at scale.
Tenure and profile: The provider’s NPI was enumerated on 2019-09-19 (~7 years ago), indicating a relatively recent but established presence in the public-payer datasets. Within that timeframe the entity has generated $2.5M in Medicare and $13M in Medicaid revenue, showing rapid attainment of meaningful volume particularly in state Medicaid emergency transport services; this tenure should be factored into network contracting and competitive assessments as a mid‑established ambulance operator rather than a long legacy incumbent.
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 |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 2,600 | $360 | $942.6K |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 1,840 | $430 | $791.3K |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 2,000 | $230 | $452.9K |
| A0425 | Ground mileage, per statute mile | 41,360 | $10 | $289.5K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 90 | $270 | $24.2K |
| A0433 | Advanced life support, level 2 (als 2) | 20 | $630 | $11.9K |
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 |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 41,260 | $160 | $6.7M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 21,030 | $180 | $3.7M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 17,430 | $80 | $1.4M |
| A0425 | Ground mileage, per statute mile | 66,730 | $10 | $800.7K |
| S0215 | Non-emergency transportation; mileage, per mile | 4,760 | $60 | $266.8K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 420 | $140 | $58.9K |
| 4701Y | N/A | 1,280 | $20 | $23K |
| A0998 | Ambulance response and treatment, no transport | 40 | $60 | $2.1K |
| A0888 | Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility) | 170 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Connecticut providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Connecticut median
9 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 9 | 20 | 17,430 | $80 | $2.7M |
| S0215 | Non-emergency transportation; mileage, per mile | 10 | 20 | 10,360 | $20 | $2.6M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 5 | 120 | 1,930 | $180 | $1.3M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 6 | 80 | 900 | $190 | $1.3M |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 6 | 10 | 360 | $120 | $206.1K |
| A0425 | Ground mileage, per statute mile | 4 | 130 | 2,510 | $10 | $141.8K |
| A0998 | Ambulance response and treatment, no transport | 12 | 20 | 100 | $60 | $18.3K |
| 4701Y | N/A | 2 | 10 | 390 | $20 | $8.1K |
| A0888 | Noncovered ambulance mileage, per mile (e.g., for miles traveled beyond closest appropriate facility) | 4 | 10 | 190 | $1 | $910 |
Other providers in the same ZIP code as Trinity Health Of New England Emergency Medical Services, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Saint Mary's Hospital, Inc. | CT | General Acute Care Hospital | $0 | $163.2M |
| Franklin Medical Group, PC | CT | Internal Medicine Physician | $0 | $13.5M |
| Middle Ct Emergency Physicians LLC | CT | Emergency Medicine Physician | $0 | $6.8M |
| Campion Ambulance Service Inc | CT | Ambulance | $0 | $4.5M |
| Naugatuck Valley Radiological Associates PC | CT | Diagnostic Radiology Physician | $0 | $2.1M |
| Brass Mill Mall Dental L.L.P | CT | General Practice Dentistry | $0 | $1.3M |
| Joseph Pruner | CT | Internal Medicine Physician | $211.3K | $0 |
| Monica Hughes | CT | Adult Health Nurse Practitioner | $176.2K | $0 |
| Sarah Gao | CT | Therapeutic Radiology Physician | $169.7K | $0 |
| Reza Pakdaman | CT | Diagnostic Radiology Physician | $160.6K | $0 |
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