Physician
ST. Nicholas Pediatrics, PC
ST. Nicholas Pediatrics, PC was paid $29K by Medicaid between Jan 2018 and Jul 2024, across 44 billing codes. Its largest line is 90472, Immunization administration, each additional vaccine (list separately) — 19% of everything it billed.
33Billing provider infoST. NICHOLAS PEDIATRICS, PC
BRONX, NY 10463
BRONX, NY 10463
33aNPI1568512408assigned 01/11/2007
33bProvider typePediatrics Physician
28Total paid$29K
24GClaims17,417
24DCodes billed44
24AFirst – last monthJan 2018 – Jul 2024
Compared with peers
Next to other Pediatrics Physician providers in New York
Rank by total paid#915 of 1,983
Median peer was paid$17K
This provider vs. median1.7×
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 | 2,039 | $9K | |
| 2019 | 1,533 | $6K | |
| 2020 | 855 | $3K | |
| 2021 | 419 | $335.00 | |
| 2022 | 3,705 | $3K | |
| 2023 | 5,077 | $5K | |
| 2024incomplete | 3,789 | $3K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 90472 | Immunization administration, each additional vaccine (list separately) | 19% | 223 | 221 | $6K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 19% | 927 | 918 | $5K |
| G0397 | Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes | 16% | 290 | 289 | $5K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 13% | 245 | 243 | $4K |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | 5.2% | 174 | 169 | $1K |
| 36425 | 4.2% | 1,163 | 1,128 | $1K | |
| 87110 | 3.6% | 59 | 59 | $1K | |
| 92553 | 3.2% | 770 | 769 | $907.62 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.1% | 251 | 242 | $887.97 |
| G9622 | Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method | 2.0% | 268 | 267 | $575.00 |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.9% | 296 | 277 | $530.76 |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 1.7% | 1,824 | 1,712 | $486.68 |
32 more codes
| G9820 | Documentation of a chlamydia screening test with proper follow-up | 1.2% | 264 | $334.30 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 1.1% | 214 | $312.00 |
| S9470 | Nutritional counseling, dietitian visit | <1% | 679 | $230.00 |
| S9452 | Nutrition classes, non-physician provider, per session | <1% | 676 | $230.00 |
| 86480 | <1% | 12 | $229.56 | |
| S9449 | Weight management classes, non-physician provider, per session | <1% | 676 | $220.00 |
| S9451 | Exercise classes, non-physician provider, per session | <1% | 676 | $220.00 |
| 80061 | Lipid panel | <1% | 36 | $132.24 |
| H0001 | Alcohol and/or drug assessment | <1% | 82 | $130.00 |
| H0049 | Alcohol and/or drug screening | <1% | 83 | $120.00 |
| 97802 | <1% | 890 | $115.74 | |
| 90686 | <1% | 465 | $57.09 | |
| 3016F | 0% | 175 | $0.00 | |
| 3725F | 0% | 232 | $0.00 | |
| 90461 | 0% | 13 | $0.00 | |
| 3078F | 0% | 117 | $0.00 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 84 | $0.00 |
| 99173 | 0% | 543 | $0.00 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 0% | 461 | $0.00 |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 0% | 15 | $0.00 |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 0% | 201 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 14 | $0.00 |
| 3008F | 0% | 1,483 | $0.00 | |
| G9275 | Documentation that patient is a current non-tobacco user | 0% | 218 | $0.00 |
| 99000 | 0% | 1,742 | $0.00 | |
| 3074F | 0% | 180 | $0.00 | |
| 96127 | 0% | 245 | $0.00 | |
| 1000F | 0% | 120 | $0.00 | |
| 1036F | 0% | 120 | $0.00 | |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 116 | $0.00 |
| 36406 | 0% | 15 | $0.00 | |
| 3044F | 0% | 80 | $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 |
|---|---|---|
| Pediatric Family MDPC | Jackson Heights, NY | $45K |
| 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.