Private Medical Group of New Rochelle

Private Medical Group of New Rochelle was paid $46K by Medicaid between Jan 2018 and Aug 2024, across 10 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 98% of everything it billed.

33Billing provider infoPRIVATE MEDICAL GROUP OF NEW ROCHELLE
NEW ROCHELLE, NY 10801

33aNPI1154439941assigned 08/29/2006

33bProvider typeInternal Medicine Physician

28Total paid$46K

24GClaims2,013

24DCodes billed10

24AFirst – last monthJan 2018 – Aug 2024

Compared with peers

Next to other Internal Medicine Physician providers in New York

Rank by total paid#1,782 of 6,049

Median peer was paid$11K

This provider vs. median4.1×

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	152	$9K
2019	167	$11K
2020	379	$9K
2021	556	$5K
2022	150	$1.32
2023	385	$7K
2024incomplete	224	$6K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	98%	697	642	$45K
99214	Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	2.5%	13	12	$1K
G8510	Screening for depression is documented as negative, a follow-up plan is not required	<1%	482	466	$3.75
G8783	Normal blood pressure reading documented, follow-up not required	0%	111	109	$0.00
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	0%	490	455	$0.00
G9744	Patient not eligible due to active diagnosis of hypertension	0%	38	36	$0.00
G8417	Bmi is documented above normal parameters and a follow-up plan is documented	0%	143	133	$0.00
G8752	Most recent systolic blood pressure < 140 mmhg	0%	13	12	$0.00
G8482	Influenza immunization administered or previously received	0%	13	13	$0.00
G8754	Most recent diastolic blood pressure < 90 mmhg	0%	13	12	$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 officialMUSSMAN, JAMES (PHYSICIAN)