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NPI 1952386153 · Somerville, MA · Land Ambulance
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Cataldo Ambulance Service Inc is a land ambulance provider located in Somerville, Massachusetts. This profile covers 18 Medicare and 52 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 | Cataldo Ambulance Service Inc |
| Address | 137 Washington St |
| City | Somerville |
| State | MA |
| ZIP | 02143 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | December 9, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $66.7M |
| Medicare | $11.6M |
CATALDO AMBULANCE SERVICE INC’s billing profile is concentrated in routine ambulance transports: its Medicare top three codes account for 88.8% of Medicare revenue and its Medicaid top three codes account for 83.3% of Medicaid revenue, indicating operations are overwhelmingly focused on basic and advanced life support emergency and non-emergency ground transports rather than ancillary clinical services. The dominant Medicare codes are A0429, A0427, and A0428, while Medicaid mirrors this mix with A0429, A0427, and A0428, reflecting a consistent service-line emphasis across payers on ground ambulance and mileage billing.
Revenue scale is heavily weighted toward Medicaid: lifetime Medicaid revenue is $66.7M versus Medicare at $11.6M, so while the provider participates in both programs it is effectively much larger on Medicaid business, implying payer mix and demand in its service area drive a Medicaid-centric revenue base. The top three Medicare codes driving 88.8% of Medicare revenue and the top three Medicaid codes driving 83.3% of Medicaid revenue further underscore that most of the provider’s receipts come from a narrow set of transport services.
CATALDO shows dominant market standing on key transport codes. For Medicare, A0429 (BLS emergency) ranks #3 nationally of 7,808 providers and A0427 (ALS1 emergency) ranks #75 of 6,841 providers — both described as extreme outliers or near-extreme outliers — indicating this provider handles an exceptionally large volume of emergency ground transports compared with peers. On Medicaid, A0429 ranks #2 of 242 providers in-state and A0427 ranks #3 of 218 providers in-state, so within Massachusetts the provider is a clear major provider of both BLS and ALS emergency transports.
Ground mileage and non-emergency BLS are also material lines: Medicare A0425 (ground mileage) contributes $994.6K and ranks as an extreme outlier nationally, and Medicaid A0425 contributes $5.1M and ranks #2 in-state; similarly, A0428 (BLS non-emergency) is a top-three contributor for both payers. This pattern suggests operations include high trip volumes with substantial mileage-driven billing, consistent with a broad coverage footprint or high-frequency non-emergency transport contracts.
Several ancillary and specialty codes appear at modest volumes and generally align with typical peer activity rather than dominance. Examples on Medicare include A0433 (ALS2), A0426 (ALS non-emergency level 1), and A0434 (specialty care transport) which are described as notably or typically above peer volumes but collectively represent small shares of revenue. On Medicaid, codes like A0434 and A0433 likewise show modest shares and mid-range in-state ranks, indicating specialty transports are a secondary service line rather than the core business.
The provider’s national and state rank percentiles show mixed concentration signals: multiple codes are labeled "extreme outlier" or in the 99th–100th percentiles (e.g., A0429, A0427, A0425, A0999 on Medicaid), supporting characterization as a dominant local/state ambulance operator with nationally exceptional volumes for certain Medicare codes. At the same time, many vaccine- and administration-related codes on the Medicare side (e.g., 90694, 91322, 91320, G0008) appear at typical volumes and represent negligible revenue, reinforcing that immunization services are not a central revenue driver.
NPI tenure indicates long-standing presence: the NPI was enumerated on 2005-12-09 (~21 years ago), which supports that this is an established operator likely embedded in local EMS/transport networks. The combination of long tenure and concentrated, high-volume transport billing suggests longstanding contractual relationships or operational scale in the provider’s service area.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
18 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 15,790 | $360 | $5.7M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 7,360 | $430 | $3.2M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 6,600 | $220 | $1.4M |
| A0425 | Ground mileage, per statute mile | 142,090 | $10 | $994.6K |
| A0433 | Advanced life support, level 2 (als 2) | 140 | $630 | $90.3K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 330 | $270 | $88K |
| A0434 | Specialty care transport (sct) | 70 | $730 | $47.5K |
| 0124A | N/A | 550 | $50 | $24.8K |
| 0134A | N/A | 320 | $50 | $14.3K |
| 90694 | This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is an inactivated, adjuvanted, preservative–free vaccine given as a 0.5 mL… | 100 | $80 | $7.3K |
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How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
18 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| A0428 | 5 | 40 | 1,340 | $220 | $771.3K |
| A0427 | 2 | 260 | 270 | $430 | $215.4K |
| A0429 | 1 | 270 | 170 | $360 | $181.2K |
| A0434 | 12 | 20 | 70 | $740 | $123.1K |
| A0425 | 5 | 280 | 3,650 | $10 | $86K |
| A0426 | 6 | 30 | 120 | $270 | $53.2K |
| 91322 | 488 | 650 | 150 | $140 | $29.1K |
| 91320 | 375 | 640 | 80 | $130 | $25.1K |
| A0433 | 1 | 50 | 20 | $620 | $18.1K |
| 90480 | 683 | 1,130 | 160 | $40 | $9.4K |
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Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
52 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 177,120 | $190 | $33.1M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 76,620 | $180 | $14M |
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 83,200 | $100 | $8.3M |
| A0425 | Ground mileage, per statute mile | 339,740 | $20 | $5.1M |
| A0130 | Non-emergency transportation: wheelchair van | 80,950 | $30 | $2.4M |
| A0999 | Unlisted ambulance service | 47,270 | $20 | $992.6K |
| S0215 | Non-emergency transportation; mileage, per mile | 80,690 | $10 | $806.9K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 3,990 | $150 | $582.2K |
| A0434 | Specialty care transport (sct) | 820 | $460 | $376.9K |
| A0433 | Advanced life support, level 2 (als 2) | 1,000 | $290 | $285K |
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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
52 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0428 | Ambulance service, basic life support, non-emergency transport, (bls) | 2 | 60 | 9,300 | $90 | $2.1M |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 2 | 240 | 980 | $180 | $1.2M |
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 3 | 220 | 1,290 | $180 | $740.6K |
| A0130 | Non-emergency transportation: wheelchair van | 2 | 80 | 5,670 | $30 | $449K |
| A0434 | Specialty care transport (sct) | 10 | 30 | 210 | $390 | $404.6K |
| A0425 | Ground mileage, per statute mile | 2 | 300 | 2,300 | $20 | $267.6K |
| S0215 | Non-emergency transportation; mileage, per mile | 3 | 100 | 8,500 | $10 | $253.8K |
| A0433 | Advanced life support, level 2 (als 2) | 3 | 10 | 790 | $300 | $231.1K |
| A0999 | Unlisted ambulance service | 1 | 20 | 690 | $30 | $155.8K |
| A0426 | Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) | 2 | 40 | 510 | $140 | $137K |
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Other providers in the same ZIP code as Cataldo Ambulance Service Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Somerville Cambridge Elder Services | MA | Case Management Agency | $0 | $90.2M |
| Somerville Cambridge Elder Services | MA | Case Management Agency | $0 | $27.1M |
| Walnut Street Center, Inc | MA | Developmentally Disabled Services Day Training Agency | $0 | $12M |
| Caspar, Inc. | MA | Community/Behavioral Health Agency | $0 | $10.7M |
| Ahou Meydani-korb | MA | Dermatology Physician | $18.2K | $49K |
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