Physician
Pediatric Family MDPC
Pediatric Family MDPC was paid $45K by Medicaid between Jan 2018 and Sep 2024, across 44 billing codes. Its largest line is G0397, Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes — 40% of everything it billed.
33Billing provider infoPEDIATRIC FAMILY MDPC
JACKSON HEIGHTS, NY 11372
JACKSON HEIGHTS, NY 11372
33aNPI1104975796assigned 01/10/2007
33bProvider typePediatrics Physician
28Total paid$45K
24GClaims34,270
24DCodes billed44
24AFirst – last monthJan 2018 – Sep 2024
Compared with peers
Next to other Pediatrics Physician providers in New York
Rank by total paid#831 of 1,983
Median peer was paid$17K
This provider vs. median2.6×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 3,272 | $11K | |
| 2019 | 3,601 | $12K | |
| 2020 | 930 | $2K | |
| 2021 | 2,285 | $1K | |
| 2022 | 8,454 | $12K | |
| 2023 | 6,854 | $4K | |
| 2024incomplete | 8,874 | $2K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| G0397 | Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes | 40% | 899 | 891 | $18K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 18% | 961 | 949 | $8K |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | 10% | 620 | 601 | $5K |
| 87110 | 9.4% | 215 | 215 | $4K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 4.5% | 2,172 | 2,051 | $2K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 3.1% | 53 | 52 | $1K |
| 36425 | 2.4% | 2,551 | 2,439 | $1K | |
| G9622 | Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method | 2.4% | 750 | 744 | $1K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 2.1% | 359 | 339 | $925.44 |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 1.9% | 51 | 51 | $857.10 |
| G9820 | Documentation of a chlamydia screening test with proper follow-up | 1.3% | 817 | 810 | $575.00 |
| 92553 | 1.2% | 1,388 | 1,386 | $518.64 |
32 more codes
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.0% | 778 | $467.40 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 987 | $402.36 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 758 | $390.00 |
| H0001 | Alcohol and/or drug assessment | <1% | 453 | $270.00 |
| H0049 | Alcohol and/or drug screening | <1% | 455 | $260.00 |
| 3078F | <1% | 518 | $70.00 | |
| 3074F | <1% | 584 | $70.00 | |
| 90686 | <1% | 519 | $19.03 | |
| 80061 | Lipid panel | <1% | 37 | $16.53 |
| 3044F | <1% | 404 | $0.03 | |
| 99173 | 0% | 975 | $0.00 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 386 | $0.00 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 0% | 250 | $0.00 |
| 3725F | 0% | 919 | $0.00 | |
| S9470 | Nutritional counseling, dietitian visit | 0% | 966 | $0.00 |
| 3016F | 0% | 754 | $0.00 | |
| S9449 | Weight management classes, non-physician provider, per session | 0% | 959 | $0.00 |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 0% | 87 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 49 | $0.00 |
| 86480 | 0% | 17 | $0.00 | |
| G9275 | Documentation that patient is a current non-tobacco user | 0% | 775 | $0.00 |
| S9451 | Exercise classes, non-physician provider, per session | 0% | 1,043 | $0.00 |
| S9452 | Nutrition classes, non-physician provider, per session | 0% | 958 | $0.00 |
| 3048F | 0% | 81 | $0.00 | |
| 1000F | 0% | 715 | $0.00 | |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 631 | $0.00 |
| 99000 | 0% | 2,611 | $0.00 | |
| 3008F | 0% | 2,477 | $0.00 | |
| 97802 | 0% | 1,666 | $0.00 | |
| 96127 | 0% | 843 | $0.00 | |
| 1036F | 0% | 715 | $0.00 | |
| G8418 | Bmi is documented below normal parameters and a follow-up plan is documented | 0% | 64 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialVALENCIA, HECTOR (OWNER)
| Provider | Location | Paid |
|---|---|---|
| ST. Nicholas Pediatrics, PC | Bronx, NY | $29K |
| ST. Nicholas Pediatrics, PC | New York, NY | $0.00 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.