Behavioral
Coastal Medical Physicians, INC.
Coastal Medical Physicians, INC. was paid $1.20M by Medicaid between Apr 2021 and Dec 2024, across 44 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 50% of everything it billed.
33Billing provider infoCOASTAL MEDICAL PHYSICIANS, INC.
PROVIDENCE, RI 02903
PROVIDENCE, RI 02903
33aNPI1780273540assigned 01/15/2021
33bProvider typeClinical Social Worker
28Total paid$1.20M
24GClaims25,956
24DCodes billed44
24AFirst – last monthApr 2021 – Dec 2024
Compared with peers
Next to other Clinical Social Worker providers in Rhode Island
Rank by total paid#11 of 358
Median peer was paid$27K
This provider vs. median44×
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 | |
|---|---|---|---|
| 2021 | 3,576 | $81K | |
| 2022 | 7,907 | $314K | |
| 2023 | 8,283 | $481K | |
| 2024incomplete | 6,190 | $324K |
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 | 50% | 9,801 | 9,200 | $602K |
| 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 | 21% | 4,853 | 4,474 | $254K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 6.6% | 735 | 724 | $79K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 4.6% | 799 | 519 | $55K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 4.2% | 504 | 439 | $50K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 3.3% | 3,652 | 1,718 | $40K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 2.4% | 273 | 272 | $29K |
| 90461 | 2.0% | 1,138 | 661 | $24K | |
| 87428 | 1.0% | 223 | 216 | $13K | |
| 99050 | <1% | 248 | 236 | $9K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 890 | 875 | $8K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 675 | 646 | $7K |
32 more codes
| 90791 | Psychiatric diagnostic evaluation | <1% | 55 | $6K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 344 | $4K |
| 92587 | <1% | 57 | $3K | |
| 99174 | <1% | 87 | $2K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 68 | $2K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 167 | $2K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 17 | $2K |
| 20611 | <1% | 34 | $2K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 13 | $877.23 |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 66 | $804.98 |
| 93000 | <1% | 190 | $730.73 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 31 | $671.64 |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 14 | $637.42 |
| 0002A | <1% | 13 | $541.19 | |
| 96161 | <1% | 137 | $497.77 | |
| 90480 | <1% | 13 | $438.26 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 104 | $377.87 |
| 87807 | <1% | 41 | $371.39 | |
| 96127 | <1% | 100 | $256.95 | |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 42 | $248.84 |
| 92552 | <1% | 13 | $247.89 | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 55 | $167.26 |
| 94760 | <1% | 50 | $134.91 | |
| 90686 | <1% | 160 | $77.93 | |
| 96160 | <1% | 26 | $70.94 | |
| 99000 | <1% | 12 | $59.20 | |
| G0008 | Administration of influenza virus vaccine | <1% | 114 | $33.86 |
| 85018 | <1% | 12 | $23.82 | |
| S0257 | Counseling and discussion regarding advance directives or end of life care planning and decisions, with patient and/or surrogate (list separately in addition to code for appropriate evaluation and management service) | <1% | 29 | $23.14 |
| 90662 | <1% | 56 | $16.93 | |
| 90656 | <1% | 13 | $6.50 | |
| 99442 | 0% | 32 | $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)
Parent organizationCOASTAL MEDICAL PHYSICIANS, INC.
| 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 |
| Gateway Healthcare, INC | Johnston, RI | $1.13M |
| Gateway Healthcare, INC | Charlestown, RI | $731K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.