Physician

None

According to 2025 Medicare claims, NPI 1902909617 (NPI: 1902909617) practices mass immunization roster billers in the Cleveland, OH market, with the plurality of this provider's patient population coming from Cuyahoga, OH. 1902909617 uses personal NPI as billing NPI and primary practice location at 44130-4806.

1902909617's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 295 traditional Medicare patients, billed 940 HCPCS/CPT codes, and received $73,440 in Medicare payments. The top billing code was 90677 (Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use). No Open Payments records. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has moved sharply higher in recent years, from $7,961 to $73,440. Concurrently, this provider has fewer than 5 years of reported Part D prescription costs data, so a reliable trend cannot be assigned. For DME billing, this provider has fewer than 5 years of reported data, so a reliable trend cannot be assigned.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	128	276	$7,961
2016	118	244	$8,483
2017	125	260	$9,665
2018	169	346	$12,596
2019	164	342	$12,983
2020	212	435	$15,976
2021	848	1,187	$44,295
2022	670	2,470	$63,798
2023	391	1,699	$64,438
2024	295	940	$73,440

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

No connected Part D records

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

No connected DME records

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
90677	Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	12	12	$290
91322	Sarscov2 vac 50 mcg/0.5ml im	213	227	$157
90662	Influenza vaccine split virus, preservative free	204	204	$82
90480	Admn sarscov2 vacc 1 dose	215	229	$37
G0008	Administration of influenza virus vaccine	227	229	$30

Top 5 Part D drugs in 2024

By total drug costs.

No connected Part D drug-level records for 2024.

Top 5 DME services in 2024

No connected or detailed DME service-level records for 2024.

Open Payments Summary

No connected Open Payments records were found for this physician in General Payments, Research Payments, or Ownership / Investment Interests.

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FAQ

What Medicare data is available for NPI 1902909617?

Tedicare shows public-source Medicare data for NPI 1902909617 (NPI 1902909617), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does NPI 1902909617 have ACO affiliation data?

No ACO affiliation record is shown in the available Tedicare data for this profile.

What billing organization is linked to NPI 1902909617?

A separate primary affiliated billing organization is not shown for this profile in the available data.

Does NPI 1902909617 have Open Payments data?

No connected Open Payments records are shown for this physician in the available General Payments, Research Payments, or Ownership / Investment Interests data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.