Agency
Gateway Healthcare, INC
Gateway Healthcare, INC was paid $1.13M by Medicaid between Oct 2024 and Nov 2024, across 16 billing codes. Its largest line is T1041, Medicaid certified community behavioral health clinic services, per month — 100% of everything it billed.
33Billing provider infoGATEWAY HEALTHCARE, INC
JOHNSTON, RI 02919
JOHNSTON, RI 02919
33aNPI1184658577assigned 07/10/2006
33bProvider typeCommunity/Behavioral Health Agency
28Total paid$1.13M
24GClaims4,895
24DCodes billed16
24AFirst – last monthOct 2024 – Nov 2024
Compared with peers
Next to other Community/Behavioral Health Agency providers in Rhode Island
Rank by total paid#21 of 51
Median peer was paid$731K
This provider vs. median1.5×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official MARKELL, PETER controls 20+ related entities in our dataset. Read more
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 | |
|---|---|---|---|
| 2024incomplete | 4,895 | $1.13M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1041 | Medicaid certified community behavioral health clinic services, per month | 100% | 1,076 | 1,040 | $1.13M |
| S9986 | Not medically necessary service (patient is aware that service not medically necessary) | <1% | 556 | 529 | $0.01 |
| H0036 | Community psychiatric support and treatment, per 15 minutesCommunity psychiatric supportive treatment, face-to-face, per 15 minutes | 0% | 1,921 | 897 | $0.00 |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | 0% | 55 | 52 | $0.00 |
| H0046 | Mental health services, not otherwise specified | 0% | 540 | 342 | $0.00 |
| J2426 | Injection, paliperidone palmitate extended release (invega sustenna), 1 mg | 0% | 36 | 29 | $0.00 |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 0% | 95 | 75 | $0.00 |
| H2023 | Supported employment, per 15 minutes | 0% | 49 | 29 | $0.00 |
| 90846 | Family psychotherapy without the patient present, 50 minutes | 0% | 27 | 13 | $0.00 |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 0% | 150 | 67 | $0.00 |
| 90847 | Family psychotherapy with the patient present, 50 minutes | 0% | 153 | 47 | $0.00 |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 0% | 53 | 43 | $0.00 |
4 more codes
| 99214 | Doctor's office visit, returning patient (more involved) | 0% | 85 | $0.00 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 0% | 55 | $0.00 |
| 99213 | Doctor's office visit, returning patient (routine) | 0% | 13 | $0.00 |
| H0038 | Self-help/peer services, per 15 minutes | 0% | 31 | $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 officialMARKELL, PETER (EVP & CFO)
| Provider | Location | Paid |
|---|---|---|
| Rhode Island Hospital | Providence, RI | $380.77M |
| The Miriam Hospital | Providence, RI | $138.58M |
| Gateway Healthcare INC | Pawtucket, RI | $122.93M |
| Emma Pendleton Bradley Hospital | Riverside, RI | $37.64M |
| Newport Hospital | Newport, RI | $15.82M |
| Rhode Island Hospital | Providence, RI | $13.22M |
| Lifespan Physician Group, INC. | Warwick, RI | $6.48M |
| Lifespan Physician Group, INC. | Providence, RI | $5.64M |
| Rhode Island Hospital | Providence, RI | $5.32M |
| Emma Pendleton Bradley Hospital | East Providence, RI | $5.03M |
| Lifespan Physician Group INC | Providence, RI | $4.41M |
| Rhode Island Hospital | Providence, RI | $3.97M |
| Newport Hospital | Newport, RI | $3.05M |
| Rhode Island Hospital | East Providence, RI | $2.58M |
| Vna Technicare, INC. | Providence, RI | $2.52M |
| Rhode Island Hospital | Providence, RI | $2.33M |
| Coastal Medical Physicians, INC. | Providence, RI | $1.33M |
| Gateway Healthcare, INC. | Pawtucket, RI | $1.31M |
| Coastal Medical Physicians, INC. | Providence, RI | $1.20M |
| Gateway Healthcare, INC | Charlestown, RI | $731K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.