Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidPouneh Nikrooz
    Ask Trek AI about this page

    Pouneh Nikrooz — Billing Profile & Reimbursement Data

    NPI 1992738983 · Charlotte, NC · Gastroenterology Physician

    Customize your policy alerts

    Sign up for Pouneh Nikrooz — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Pouneh Nikrooz is a gastroenterology physician provider located in Charlotte, North Carolina. 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.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationPouneh Nikrooz
    Address16817 Marvin Rd
    CityCharlotte
    StateNC
    ZIP28277
    TaxonomyGastroenterology Physician
    NPI EnumeratedJuly 10, 2006

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

    Payer SourceTotal Paid
    Medicare$69K
    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…150$200$30K
    88305The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…280$20$6.4K
    99223The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…40$130$5.6K
    G0105Colorectal cancer screening; colonoscopy on individual at high risk30$160$4.7K
    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.50$70$3.7K
    88313The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,…70$50$3.6K
    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…40$60$2.5K
    G0121Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk20$160$2.4K
    88312The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets…40$60$2.2K
    45378The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush…10$140$1.7K

    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
    88305285440470$40$50.4K
    4538511556070$290$33.4K
    9921417,93218,060110$80$15.1K
    4538046552040$180$13.7K
    G010515034030$270$12.4K
    4323931356060$120$11K
    992323,7705,69070$60$8.1K
    G012117126020$280$8.1K
    9921314,37716,32070$50$7.1K
    8831211419040$50$6.5K

    Showing 1–10 of 16

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Diane GeorgeSCRheumatology Physician$811K$0
    Alison JohnsonNCRheumatology Physician$679.7K$0
    Gastroenterology Associates PANCAmbulatory Surgical Clinic/Center$529.6K$102.2K
    Carolina Digestive Health Associates, PANCAmbulatory Surgical Clinic/Center$375.3K$169.1K
    Joshua EickstaedtNCMOHS-Micrographic Surgery Physician$532K$0
    Richard MillerNCCardiovascular Disease Physician$427.1K$0
    Anthony ColvinNCGastroenterology Physician$385.5K$0
    David FrammNCCardiovascular Disease Physician$354.1K$0
    Stephen DealNCGastroenterology Physician$334.6K$0
    Robert BowenNCInternal Medicine Physician$319.2K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Heather HoldenNCRheumatology Physician$1.1M$0
    Firas KassabNCRheumatology Physician$1M$0
    Eric OrlowskyNCRheumatology Physician$927.4K$0
    Carolinas Physicians Network IncNCAmbulatory Surgical Clinic/Center$685.2K$138.2K
    Tryon Endoscopy Center, LLCNCEndoscopy Clinic/Center$812.8K$0
    Laura RosenzweigNCMOHS-Micrographic Surgery Physician$534.1K$0
    Charlotte Gastroenterology & Hepatology, PLLCNCAmbulatory Surgical Clinic/Center$443.9K$3.6K
    Patrick McelgunnNCDermatology Physician$441.3K$0
    Jonathan OlsonNCMOHS-Micrographic Surgery Physician$391.5K$0
    Ronald SingerNCOrthopaedic Surgery Physician$380.5K$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. North Carolina Distribution
    Pouneh Nikrooz — 0 of 16 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — North Carolina