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NPI 1962495051 · Scarborough, ME · Land Ambulance
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Town Of Scarborough is a land ambulance provider located in Scarborough, Maine. This profile covers 3 Medicare and 3 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 | Town Of Scarborough |
| Address | 259 Us Route 1 |
| City | Scarborough |
| State | ME |
| ZIP | 04074 |
| Taxonomy | Land Ambulance |
| NPI Enumerated | August 24, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $809.9K |
| Medicare | $359.6K |
Business model and service mix: TOWN OF SCARBOROUGH is coded as Land Ambulance and its revenue is almost exclusively generated from emergency transport services, with A0427 (advanced life support, emergency transport), A0429 (basic life support, emergency transport) and A0425 (ground mileage) comprising the entirety of billings reported to both Medicare and Medicaid. The prominence of A0427 and A0429 indicates the operation primarily provides ALS and BLS emergency ambulance runs rather than non-emergency or ancillary services, and the inclusion of high-volume A0425 mileage claims shows frequent point-to-point transports.
Revenue concentration — Medicare: The provider’s total Medicare revenue is $359.6K and the precomputed top-3 codes account for 100.0% of that amount, driven by A0427 (67.2% of Medicare revenue), A0429 (20.3%), and A0425 (12.5%). This concentration means Medicare receipts are narrowly focused on a small set of emergency-transport services, with very limited diversification of Medicare revenue sources.
Revenue concentration — Medicaid: Total Medicaid revenue is $809.9K and the top-3 Medicaid codes also account for 100.0% of Medicaid revenue, dominated by A0427 (70.7% of Medicaid revenue), followed by A0429 (16.5%) and A0425 (12.8%). Medicaid receipts are therefore even more heavily weighted to ALS emergency transport than Medicare, making the provider effectively dependent on a single service line within Medicaid.
Payer mix: The provider receives substantially more revenue from Medicaid ($809.9K) than from Medicare ($359.6K), indicating that Medicaid is the larger payer relationship in scale for this entity. That disparity suggests operational emphasis and financial exposure are more tightly linked to Medicaid reimbursement patterns and in-state payer dynamics than to national Medicare volumes.
Competitive standing — Medicare (national): For Medicare, A0427 ranks #1262 of 6841 providers (82th percentile), A0429 ranks #2354 of 7808 (70th percentile), and A0425 ranks #2830 of 8934 (68th percentile); each top code is described in the source as falling in a typical, unremarkable volume range. These percentile placements suggest TOWN OF SCARBOROUGH is a modest, regionally typical participant in national Medicare ambulance activity rather than a dominant national player.
Competitive standing — Medicaid (statewide): Within Maine, A0427 ranks #27 of 103 providers (75th percentile), A0429 ranks #46 of 96 (53th percentile), and A0425 ranks #42 of 138 (70th percentile), positioning the provider above median for ALS emergency transport and mileage in-state. The stronger in-state ranking for A0427 signals a relatively meaningful presence in Maine’s Medicaid ambulance market for advanced-life-support emergency runs, even though volumes are still characterized as typical versus peers.
Operational volume signals: Claims and unit-level payments show different patterns across payers — Medicare A0427 reports 608 claims at $399 avg paid/claim for $242.6K revenue while Medicaid A0427 reports 2.5K claims at $230 avg paid/claim for $572K revenue; similarly, Medicare A0425 shows 6.4K claims at $7 avg paid/claim ($45K) versus Medicaid A0425 with 3.6K claims at $29 avg paid/claim ($103.7K). These figures indicate Medicaid generates more claim volume and aggregate dollars for ALS transports and yields higher total Medicaid revenue despite lower per-claim payments for A0427, reflecting payer-specific utilization and payment mix differences the analyst should investigate further.
Tenure and registry: The NPI was enumerated on 2005-08-24 (~21 years ago), indicating long-standing enrollment and operational continuity under the Land Ambulance taxonomy; this tenure can be relevant when assessing contract history, local market relationships, and cumulative billing patterns.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
3 rows
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 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.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 2,490 | $230 | $572K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 690 | $190 | $133.3K |
| A0425 | Ground mileage, per statute mile | 3,580 | $30 | $103.7K |
How this provider's Medicaid billing volume and revenue compare to other Maine providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Maine median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A0427 | Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) | 27 | 100 | 670 | $200 | $363.5K |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | 46 | 100 | 660 | $180 | $316.3K |
| A0425 | Ground mileage, per statute mile | 42 | 140 | 1,400 | $50 | $201.8K |
Other providers in the same ZIP code as Town Of Scarborough, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Nordx | ME | Clinical Medical Laboratory | $2.4M | $21.8M |
| New England Life Care, Inc. | ME | Home Infusion Therapy Pharmacy | $0 | $12.4M |
| Northeast Mobile Health Services | ME | Ambulance | $930.3K | $9.5M |
| Choices Are For Everyone, Inc. | ME | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | $0 | $9.7M |
| Skilled Care Solutions | ME | Home Health Agency | $0 | $6.8M |
| Surgi-care, Inc | ME | Prosthetic/Orthotic Supplier | $0 | $5.6M |
| Mainehealth | ME | Family Medicine Physician | $0 | $5M |
| Mainehealth | ME | Neurology Physician | $0 | $4.2M |
| Mainehealth | ME | Cardiovascular Disease Physician | $0 | $3.9M |
| Maine Home Care Solutions | ME | In Home Supportive Care Agency | $0 | $3.2M |
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