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    v1.0.28
    OpenPayerNPI Medicare & MedicaidHeather Carroll
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    Heather Carroll — Billing Profile & Reimbursement Data

    NPI 1902246689 · Traverse City, MI · Gastroenterology Physician

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    Heather Carroll is a gastroenterology physician provider located in Traverse City, Michigan. This profile covers 16 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
    OrganizationHeather Carroll
    Address4100 Park Forest Dr Ste 208
    CityTraverse City
    StateMI
    ZIP49684
    TaxonomyGastroenterology Physician
    NPI EnumeratedJune 26, 2013

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

    Payer SourceTotal Paid
    Medicare$87.2K
    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.

    16 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…120$200$24.8K
    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…150$80$12.1K
    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.100$70$7K
    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…70$90$6.1K
    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$5.8K
    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…50$120$5.8K
    99222The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…50$100$5.2K
    G0121Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk20$180$3.5K
    G0105Colorectal cancer screening; colonoscopy on individual at high risk20$180$3.3K
    43248The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum; then through the scope, he passes a guidewire over which he passes dilators through the…30$120$3.2K

    Showing 1–10 of 16

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    16 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    453854853040$270$18.3K
    992323,1826,73090$60$12K
    992144,82415,47080$80$11.4K
    G010516026020$260$10.1K
    453809949030$170$9.4K
    992233,8974,88040$130$8.3K
    432398351050$110$8.2K
    G012110823020$260$7.5K
    43248244030$170$7K
    992138,64214,81060$60$6.6K

    Showing 1–10 of 16

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Munson Medical CenterMIGeneral Acute Care Hospital$0$44.1M
    Lakeland Medical PracticesMIInternal Medicine Physician$0$20.9M
    Andrew KaiserVADiagnostic Radiology Physician$334.7K$23.7K
    Janelle PilarskiMIPhysician Assistant$314.4K$0
    Eric ManciniFLOrthopaedic Surgery Physician$282K$0
    Michael BlackmerALAdult Reconstructive Orthopaedic Surgery Physician$239K$0
    Bhikam MehtaMIInternal Medicine Physician$212.4K$21.3K
    James MackenzieMIPhysical Medicine & Rehabilitation Physician$204.4K$0
    Stephen AndrieseMIPhysical Medicine & Rehabilitation Physician$185K$0
    Todd GaldesMIAdult Reconstructive Orthopaedic Surgery Physician$176.8K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Northern Lakes Community Mental Health AuthorityMICommunity/Behavioral Health Agency$0$148.6M
    Northwestern Michigan Emergency Physicians PCMIEmergency Medicine Physician$0$7.5M
    Grand Traverse Radiologists PCMIDiagnostic Radiology Physician$0$7.3M
    Northern Michigan Pediatric DentistryMIDental Clinic/Center$0$7M
    Grand Traverse Womens Clinic PLLCMIObstetrics Physician$0$6.7M
    Northern Lakes Community Mental Health AuthorityMICase Management Agency$0$5.9M
    Northwest Michigan Surgery Center LLCMIAmbulatory Surgical Clinic/Center$2.9M$1.5M
    Alliance Surgery Center, LLCMIAmbulatory Surgical Clinic/Center$3M$0
    Michael MawbyMIRheumatology Physician$628.2K$0
    Surgery Center PlcMIAmbulatory Surgical Clinic/Center$584.8K$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.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Michigan Distribution
    Heather Carroll — 0 of 16 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Michigan