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    v1.0.28
    OpenPayerNPI Medicare & MedicaidNPI 1831280536
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    NPI 1831280536 — Billing Profile & Reimbursement Data

    NPI 1831280536 · XX · healthcare

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    NPI 1831280536 is a healthcare provider located in Unspecified Location. This profile covers 34 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services. Note: "XX" is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; claims coded under it are grouped and benchmarked here the same way a traditional state would be.

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationNPI 1831280536
    Address
    City
    StateXX (Unspecified Location)
    ZIP
    TaxonomyN/A
    NPI Enumerated
    NPI DeactivatedJuly 2, 2025

    (source: CMS Medicare & Medicaid claims data)

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare Revenue by CPT/HCPCS Code

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    34 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    66984The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…380$790$300.6K
    64483This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral).830$250$210.6K
    27447In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The…20$6,730$154.7K
    27130In this procedure, the provider surgically replaces the hip joint by prosthesis, or artificial hip joint. He replaces both the femoral and acetabular components with or without using an autograft or…20$6,850$130.2K
    66991The provider inserts an intraocular lens prosthesis during the same session as extracapsular cataract extraction. The provider also inserts one or more anterior segment aqueous drainage devices in…40$2,360$104K
    45380The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…220$400$88.1K
    64635Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue.140$570$77.7K
    64493The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance…240$240$57.6K
    29848The provider inserts an endoscope into the wrist joint to divide the transverse carpal ligament and reduce compression on the median nerve in the carpal tunnel that results in pain and numbness.100$470$45.4K
    45385The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…100$420$43.6K

    Showing 1–10 of 34

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 34 CPT/HCPCS codes. Note: this provider's state, "XX," is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; the State panel below benchmarks against other providers coded under the same designation.

    View: State1 / 2

    Claims Volume vs. Unspecified Location Distribution
    NPI 1831280536 — 0 of 0 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Unspecified Location

    Full comparison — all codes billed, vs. state median

    34 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    116021540N/A$N/A$N/A
    205503270N/A$N/A$N/A
    2544790N/A$N/A$N/A
    26055290N/A$N/A$N/A
    2612320N/A$N/A$N/A
    2616030N/A$N/A$N/A
    2648050N/A$N/A$N/A
    271302220N/A$N/A$N/A
    274473350N/A$N/A$N/A
    29827760N/A$N/A$N/A

    Showing 1–10 of 34

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with NPI 1831280536, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Douglas McdonaldINCertified Registered Nurse Anesthetist$42.7K$42.2K
    Steven NolanILCertified Registered Nurse Anesthetist$46.2K$0
    Charles HeronILAnesthesiology Physician$7.8K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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    Lifetime revenue by payer source
    Payer SourceTotal Paid
    Medicare$1.6M
    Medicaid$0