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NPI 1801904180 · Woonsocket, RI · Diagnostic Radiology Physician
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Charles Rosenthal is a diagnostic radiology physician provider located in Woonsocket, Rhode Island. This profile covers 74 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 | Charles Rosenthal |
| Address | 115 Cass Ave |
| City | Woonsocket |
| State | RI |
| ZIP | 02895 |
| Taxonomy | Diagnostic Radiology Physician |
| NPI Enumerated | August 28, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $414.6K |
| Medicaid | $740 |
This provider is a Diagnostic Radiology Physician with an NPI enumerated 2006-08-28 (~20 years ago) and a lifetime Medicare revenue of $414.6K versus lifetime Medicaid revenue of $744, indicating an operation that is effectively Medicare-driven rather than Medicaid-focused. The billing mix and revenue scale point to a practice that primarily serves older adults and Medicare beneficiaries, rather than a broad dual-payer population.
Revenue concentration on Medicare is high: the precomputed top 3 Medicare codes by revenue account for 51.5% of total Medicare revenue, driven by 77067 ($117.7K, 33.3%), 77063 ($33.1K, 9.4%), and 74177 ($31.1K, 8.8%). This concentration shows the practice’s revenue is materially dependent on a small set of imaging services—chiefly mammography/tomosynthesis and abdominal/pelvic CT.
Mammography and breast imaging are the dominant service line on Medicare: 77067 alone represents 33.3% of Medicare revenue and 77063 contributes another 9.4%. Both 77067 and 77063 rank in the 94th percentile nationally and are described as notably above typical national volume, signaling a high local throughput for screening and tomosynthesis relative to national peers.
Beyond breast imaging, the provider shows a mixed imaging portfolio: notable Medicare volumes for abdominal/pelvic CT (74177 ranks in the 80th percentile, labelled typical/unremarkable) plus chest X-ray and DXA work. DXA (77080) is also relatively high (96th percentile, notably above typical national volume), suggesting the practice supports bone density screening alongside its high mammography throughput.
Chest radiography appears in both payers but at different competitive positions. On Medicare, 71046 ranks in the 99th percentile (typical, unremarkable volume) and contributes meaningfully to Medicare claims, whereas on Medicaid the same code (71046) accounts for 77.9% of this provider’s Medicaid revenue but ranks #103 of 131 in-state (22th percentile), indicating modest in-state Medicaid chest X-ray volume compared with Rhode Island peers.
Medicaid revenue is negligible in scale: total Medicaid revenue $744 with the precomputed top 3 Medicaid codes by revenue accounting for 100.0% of Medicaid revenue. That Medicaid revenue is entirely attributable to 71046 ($570, 77.9%) and 71045 ($162, 22.1%), which together underscore that the provider is not a major Medicaid imaging supplier in-state.
Competitive standing is selective: the provider is a major national-volume outlier for specific procedures—77067, 77063, and 77080 are in the mid-90s percentiles and described as notably above typical national volume—while many CT and ultrasound lines sit at more typical/median national percentiles. This pattern is consistent with a practice that is regionally strong in high-volume screening modalities but more average in cross-sectional and vascular imaging.
Operational and go-to-market implications for payers and providers: the heavy reliance on screening mammography and related breast services implies equipment and workflow specialization (mammography units, tomosynthesis, ultrasound/biopsy capacity) and a business model tied to Medicare volumes. Given the very small Medicaid footprint, payer contracting or network strategies should treat this provider primarily as a Medicare-centric imaging source rather than a dual-payer outpatient imaging partner.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
74 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 77067 | The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software… | 1,230 | $100 | $117.7K |
| 77063 | The provider captures three dimensional images of the breast using X–rays at various angles for routine checkup. He checks for the presence of any abnormality within the breasts. Tomosynthesis… | 1,230 | $30 | $33.1K |
| 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. | 230 | $140 | $31.1K |
| 71046 | In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and… | 1,080 | $20 | $17.2K |
| 77080 | The provider performs an imaging procedure, called dual–energy X–ray absorptiometry (DXA), of one or more bony areas on the trunk to determine the bone mineral density (BMD) and whether the patient… | 660 | $30 | $17.2K |
| 76536 | The provider performs real–time ultrasound examination of the soft tissues of the head and neck and records and saves the images for later review. | 200 | $70 | $14.3K |
| 74178 | The provider performs computed tomography of the abdomen and pelvis without contrast material in one or both body regions followed by contrast material in one or both body regions and additional… | 60 | $230 | $13.3K |
| 71250 | In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the thorax without using contrast material. | 190 | $70 | $12.4K |
| 74176 | The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 150 | $80 | $11.5K |
| 77065 | The provider performs X–ray imaging on one breast in a patient with a known lump or suspected cancer and may use specially designed computer software to help identify or diagnose potential… | 130 | $80 | $10K |
Showing 1–10 of 74
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 74 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 |
|---|---|---|---|---|
| 71046 | In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and… | 40 | $20 | $570 |
| 71045 | In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby… | 20 | $10 | $160 |
How this provider's Medicaid billing volume and revenue compare to other Rhode Island providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Rhode Island median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 71046 | In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and… | 103 | 130 | 260 | $30 | $52K |
| 71045 | In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby… | 71 | 80 | 240 | $20 | $34.8K |
Other providers in the same ZIP code as Charles Rosenthal, ranked by combined Medicare and Medicaid revenue.
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