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NPI 1912115023 · Port Jefferson Station, NY · Nuclear Radiology Physician
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Tony Abraham is a nuclear radiology physician provider located in Port Jefferson Station, New York. This profile covers 19 Medicare and 4 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 | Tony Abraham |
| Address | 1500 Route 112 Bldg 2 |
| City | Port Jefferson Station |
| State | NY |
| ZIP | 11776 |
| Taxonomy | Nuclear Radiology Physician |
| NPI Enumerated | May 21, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $7.6M |
| Medicaid | $442.6K |
TONY ABRAHAM is operating as a high-volume nuclear radiology physician practice focused on PET imaging and radiopharmaceutical diagnostics: Medicare claims are dominated by PET/CT and radiotracer supply codes (78815, A9595, A9552), and the code descriptions indicate routine use of fused PET/CT imaging and tracer-based diagnostic studies rather than broad ambulatory primary care or procedural services. The claims mix (top Medicare codes) aligns with a specialized imaging center model that performs high volumes of PET studies and administers multiple radiopharmaceuticals.
Medicare revenue is heavily concentrated in a very small number of services: the precomputed top 3 Medicare codes account for 98.0% of this provider's total Medicare revenue, driven primarily by 78815 ($3.8M, 50.9% of Medicare revenue), A9595 ($2.8M, 36.9%), and A9552 ($772.3K, 10.2%). This indicates extreme revenue concentration in PET/ radiotracer studies and suggests the business is highly dependent on those procedures for Medicare income.
On Medicare competitive standing this provider is an extreme national outlier on two leading codes: the provider ranks #1 nationally for both 78815 (100th percentile; extreme outlier) and A9595 (100th percentile; extreme outlier), and #3 nationally for A9552 (100th percentile; extreme outlier). Those rankings imply this entity is a dominant national-volume provider for these PET/ radiopharmaceutical services rather than a typical local imaging practice.
Medicaid billing is present but much smaller in scale: lifetime Medicaid revenue is $442.6K versus total Medicare revenue of $7.6M, indicating Medicare is the primary payer by a large margin and the provider functions effectively as Medicare-focused. However, Medicaid billing follows the same service-line pattern with 78815 accounting for 77.0% of Medicaid revenue and the precomputed top 3 Medicaid codes accounting for 100.0% of Medicaid revenue, so the provider’s Medicaid activity is still concentrated in the same PET/radiotracer services.
Within the state Medicaid market the provider is a leading PET supplier for some codes: for Medicaid, 78815 ranks #8 in-state (94th percentile; notably above typical state volume) and A9595 ranks #1 in-state (100th percentile) despite much lower absolute Medicaid dollars. This profile suggests the provider has a significant local footprint for PET imaging and certain radiotracers even though Medicaid revenue is a small share of total lifetime revenue.
The practice also bills a modest number of supporting lab and routine outpatient codes across payers (e.g., 82947, 36415, 78816), but these generate negligible revenue relative to the PET/radiotracer codes (many individual lab codes each account for 0.0% of Medicare revenue). These ancillary items appear incidental to the core nuclear medicine business rather than primary revenue drivers.
Tenure data show the provider’s NPI was enumerated on 2007-05-21 (~19 years ago), indicating long-standing enrollment and a sustained presence in the Medicare/Medicaid markets; the duration supports the conclusion that observed high volumes reflect an established operation rather than a recent ramp-up.
Several individual code-level percentiles signal consistently atypical activity for a nuclear radiology specialist: across Medicare the provider’s volumes are characterized as “extreme outlier” or “notably above typical” for multiple radiotracer and PET/CT codes, reinforcing that this is a concentrated, high-throughput imaging practice that competes at top-tier volume levels both nationally (Medicare) and regionally (Medicaid).
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
19 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 78815 | PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.… | 2,490 | $1,540 | $3.8M |
| A9595 | Piflufolastat f-18, diagnostic, 1 millicurie | 5,760 | $480 | $2.8M |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 1,850 | $420 | $772.3K |
| A9587 | Gallium ga-68, dotatate, diagnostic, 0.1 millicurie | 1,890 | $50 | $96.4K |
| 78816 | The patient is injected with a radiopharmaceutical tracer called FDG (fluoro–deoxyglucose, a radioactive substance containing glucose) about one hour before the imaging is scheduled to begin. The… | 20 | $1,450 | $34.8K |
| 82947 | The lab analyst performs a test to measure the amount of glucose in a patient's blood using a method other than a reagent strip. | 1,720 | $1 | $6.9K |
| 79101 | In this procedure, the provider injects a radiopharmaceutical substance into the venous blood stream to treat the patient’s condition. | 40 | $140 | $5.4K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 280 | $10 | $2.2K |
| 96374 | The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition. | 30 | $40 | $970 |
| 99211 | An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional. | 20 | $20 | $420 |
Showing 1–10 of 19
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
19 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| A9595 | 1 | 50 | 190 | $470 | $251.1K |
| 78815 | 1 | 330 | 80 | $690 | $116.6K |
| A9587 | 1 | 10 | 910 | $50 | $57.3K |
| A9552 | 1 | 200 | 60 | $350 | $42.8K |
| 78816 | 88 | 140 | 40 | $590 | $31.8K |
| 80053 | 1,615 | 1,970 | 120 | $10 | $6.9K |
| 82378 | 145 | 150 | 90 | $20 | $5.1K |
| 85025 | 1,658 | 2,140 | 120 | $10 | $4.8K |
| 82728 | 681 | 770 | 50 | $10 | $4.6K |
| 96374 | 147 | 210 | 40 | $30 | $3K |
Showing 1–10 of 19
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.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 78815 | PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.… | 1,680 | $200 | $341.4K |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 1,020 | $80 | $77.5K |
| A9595 | Piflufolastat f-18, diagnostic, 1 millicurie | 50 | $450 | $24.2K |
| 82947 | The lab analyst performs a test to measure the amount of glucose in a patient's blood using a method other than a reagent strip. | 260 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other New York providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New York median
4 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 78815 | PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.… | 8 | 110 | 80 | $570 | $236.2K |
| A9595 | Piflufolastat f-18, diagnostic, 1 millicurie | 1 | 10 | 50 | $2,230 | $118.3K |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 11 | 70 | 90 | $150 | $72.3K |
| 82947 | The lab analyst performs a test to measure the amount of glucose in a patient's blood using a method other than a reagent strip. | 198 | 340 | 430 | $1 | $4.1K |
Other providers in the same ZIP code as Tony Abraham, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Long Island Digestive Endoscopy Center, LLC | NY | Ambulatory Surgical Clinic/Center | $1.6M | $1.4M |
| George Cyriac | NY | Hematology & Oncology Physician | $2.7M | $14.5K |
| Amishi Desai | NY | Hematology & Oncology Physician | $2.2M | $431.4K |
| Adriana Guigova | NY | Hematology & Oncology Physician | $2.3M | $46.9K |
| Alfredo Torres Gonzalez | NY | Hematology & Oncology Physician | $1.9M | $16K |
| Joshua Harris | NY | Hematology & Oncology Physician | $1.6M | $62.3K |
| Port Jefferson Asc, LLC | NY | Ambulatory Surgical Clinic/Center | $1.5M | $0 |
| Jerry George | NY | Hematology & Oncology Physician | $1.4M | $59.5K |
| Eric Mitchnick | NY | Urology Physician | $1.2M | $0 |
| Varghese Cherian | NY | Diagnostic Radiology Physician | $976.5K | $155.3K |
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