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    OpenPayerNPI Medicare & MedicaidRobert Malcolm
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    Robert Malcolm — Billing Profile & Reimbursement Data

    NPI 1831382670 · East Stroudsburg, PA · Gastroenterology Physician

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    Robert Malcolm is a gastroenterology physician provider located in East Stroudsburg, Pennsylvania. This profile covers 15 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.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationRobert Malcolm
    Address239 E Brown St
    CityEast Stroudsburg
    StatePA
    ZIP18301
    TaxonomyGastroenterology Physician
    NPI EnumeratedAugust 24, 2007

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$130K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    15 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    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…180$200$36.2K
    91110The provider performs a capsule endoscopy for gastrointestinal tract imaging from esophagus to ileum. He interprets the results and prepares a report for this service.30$560$16.8K
    43239The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.200$80$15.2K
    99204The provider sees a new 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 provider…100$100$9.9K
    99214The 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…110$90$9.7K
    G0121Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk40$180$6.8K
    99232The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…100$60$6K
    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…60$100$5.4K
    G0105Colorectal cancer screening; colonoscopy on individual at high risk30$180$5.2K
    45378The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush…30$130$4.3K

    Showing 1–10 of 15

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    15 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    453857186050$290$24.3K
    9921410,96123,230100$80$14.5K
    4538031284040$180$12.5K
    G010522350030$270$12.4K
    432394788050$130$9.6K
    992324,56610,87080$60$9.6K
    9111063020$360$8.6K
    G01217138020$270$8.1K
    992234,3717,02040$130$7.8K
    9920490910,29030$110$5K

    Showing 1–10 of 15

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    St. Luke's Physician Group, Inc.PAEmergency Medicine Physician$0$28.8M
    St Lukes HospitalPAGeneral Acute Care Hospital$0$20.8M
    St. Luke's Physician Group, Inc.PAMental Health Clinic/Center (Including Community Mental Health Center)$0$6.1M
    Ellen FieldPARheumatology Physician$2.1M$0
    Timothy HowardPARheumatology Physician$1.5M$0
    Joseph ZaladonisPASpecialist$1.4M$0
    Shawna MurphyPAEmergency Medicine Physician$989.5K$0
    Gary LuTXHematology & Oncology Physician$848.4K$0
    Steven LovittPANeurology Physician$470.8K$0
    Patrick BroglePAOrthopaedic Surgery Physician$469.1K$0

    Nearby Providers

    Other providers in the same ZIP code as Robert Malcolm, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Matrix Behavior Solutions, LLCPABehavior Analyst$0$75.6M
    Loving Care Agency, Inc.PAHome Health Agency$0$27.4M
    Lehigh Valley Hospital PoconoPAGeneral Acute Care Hospital$0$11.9M
    Family Care Centers Inc.PAInternal Medicine Physician$0$11.1M
    Family Care Centers IncPAFamily Medicine Physician$0$6.1M
    Gerald NegveskyPAOphthalmology Physician$446.1K$0
    Laszlo SzollasPAInterventional Pain Medicine Physician$417.3K$0
    Gordon FriedPAInterventional Cardiology Physician$305.5K$130
    Roger ComponovoPAAdult Reconstructive Orthopaedic Surgery Physician$299.8K$0
    Javed MalikPADiagnostic Radiology Physician$205.4K$65.7K

    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.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Pennsylvania Distribution
    Robert Malcolm — 0 of 15 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Pennsylvania