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NPI 1902901804 · Wilmington, MA · Ambulance
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Action Ambulance Service Inc is a ambulance provider located in Wilmington, Massachusetts. This profile covers 7 Medicare and 11 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 | Action Ambulance Service Inc |
| Address | 1 Jewel Dr Ste 3 |
| City | Wilmington |
| State | MA |
| ZIP | 01887 |
| Taxonomy | Ambulance |
| NPI Enumerated | September 14, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $13.7M |
| Medicare | $3.4M |
Scale and payer mix: ACTION AMBULANCE SERVICE INC reports Medicare revenue of $3.4M and Medicaid revenue of $13.7M, indicating Medicaid is the dominant payer by scale on file. This provider is not effectively single-payer but shows a clear operational emphasis on Medicaid-covered transports given the larger aggregate Medicaid revenue figure.
Business and service-line profile: The billing mix is centered on emergency and basic ambulance transports plus heavy mileage volume, with prominent codes including A0427 (ALS emergency), A0428 (BLS non-emergency), and A0425 (ground mileage). The presence of A0434 (specialty care transport) and A0130 (wheelchair van) in the Medicaid mix also signals the operator offers both higher-acuity interfacility or monitored transports and routine non-emergency mobility services.
Medicare revenue concentration: The top three Medicare codes (A0427, A0428, A0425) account for 83.0% of this provider's Medicare revenue, indicating high concentration in core ambulance services. Within Medicare, A0427 alone represents 45.8% of Medicare revenue and is described as notably above typical national volume, while A0425 contributes 15.4% with very high claim counts (73.4K claims) and is also notably above typical national volume.
Medicaid revenue concentration: The top three Medicaid codes (A0427, A0429, A0428) account for 84.6% of the provider's Medicaid revenue, showing a similar concentration on a small set of transport services for Medicaid payers. A0427 and A0429 together make up the majority of Medicaid revenue (37.9% and 35.2% respectively), underlining that emergency ALS and BLS emergency transports dominate Medicaid billing.
Competitive standing — Medicare: For key Medicare services this provider ranks at or near the top nationally — A0427 ranks #182 of 6841 providers (notably above typical national volume) and A0425 ranks #240 of 8934 providers (notably above typical national volume). These rankings characterize the provider as a major national-volume participant for core ambulance and mileage codes on the Medicare side, rather than a marginal local operator.
Competitive standing — Medicaid (in-state): On Medicaid, the provider is a leading statewide participant for emergency transports: A0427 ranks #7 of 218 providers in-state (97th percentile) and A0429 ranks #11 of 242 providers in-state (96th percentile). Those placements indicate the company is one of the larger in-state suppliers of emergency ambulance services for Medicaid beneficiaries.
Payer rate differentials: Average paid-per-claim figures show materially higher Medicare reimbursements for the same transport codes than Medicaid — for example, A0427 is $418 avg paid/claim on Medicare versus $169 avg paid/claim on Medicaid, and A0428 is $231 on Medicare versus $87 on Medicaid. These differences imply the organization’s revenue mix and margins will be sensitive to payer mix shifts between Medicare and Medicaid for identical service lines.
Tenure and concentration risk: The NPI was enumerated 2006-09-14 (~20 years ago), indicating long tenure in the market and an established operational footprint. At the same time, the heavy reliance on a small set of transport codes (top-three shares of 83.0% for Medicare and 84.6% for Medicaid) suggests revenue vulnerability to reimbursement or utilization changes affecting ambulance transports and mileage.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 3,650 | $420 | $1.5M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 3,130 | $230 | $722.8K |
| A0425 | Ground mileage, per statute mile | 73,370 | $10 | $513.6K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 1,160 | $350 | $409K |
| A0434 | Specialty care transport (sct) | 180 | $720 | $127.1K |
| A0433 | Advanced life support, level 2 (als 2) | 50 | $600 | $27.6K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 10 | $280 | $3.6K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 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.
11 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 30,660 | $170 | $5.2M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 25,170 | $190 | $4.8M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 17,990 | $90 | $1.6M |
| A0425 | Ground mileage, per statute mile | 76,000 | $20 | $1.2M |
| A0434 | Specialty care transport (sct) | 1,910 | $300 | $570.8K |
| A0130 | Non-emergency transportation: wheelchair van | 6,350 | $30 | $190.6K |
| S0215 | Non-emergency transportation; mileage, per mile | 6,240 | $10 | $81.1K |
| A0433 | Advanced life support, level 2 (als 2) | 190 | $240 | $45.6K |
| 0011A | N/A | 60 | $50 | $2.8K |
| 0012A | N/A | 40 | $50 | $1.9K |
Showing 1–10 of 11
How this provider's Medicaid billing volume and revenue compare to other Massachusetts providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Massachusetts median
11 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 20 | 60 | 9,300 | $90 | $2.1M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 11 | 240 | 980 | $180 | $1.2M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 7 | 220 | 1,290 | $180 | $740.6K |
| A0130 | Non-emergency transportation: wheelchair van | 39 | 80 | 5,670 | $30 | $449K |
| A0434 | Specialty care transport (sct) | 5 | 30 | 210 | $390 | $404.6K |
| A0425 | Ground mileage, per statute mile | 9 | 300 | 2,300 | $20 | $267.6K |
| S0215 | Non-emergency transportation; mileage, per mile | 59 | 100 | 8,500 | $10 | $253.8K |
| A0433 | Advanced life support, level 2 (als 2) | 6 | 10 | 790 | $300 | $231.1K |
| 0012A | N/A | 130 | 230 | 70 | $30 | $14K |
| 0011A | N/A | 122 | 240 | 70 | $30 | $13.3K |
Showing 1–10 of 11
Other providers in the same ZIP code as Action Ambulance Service Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Caring Hearts Homecare, Inc. | MA | Home Health Agency | $0 | $16.9M |
| Sharon Stotsky | MA | Internal Medicine Physician | $870.6K | $3.9K |
| Town Of Wilmington | MA | Ambulance | $320.9K | $338.6K |
| Joanne Blouin | MA | Medical Physician Assistant | $333.1K | $0 |
| Faisal Malik | MA | Internal Medicine Physician | $216.1K | $74.7K |
| Holly Nguyen | MA | Medical Physician Assistant | $242.7K | $0 |
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