Delaware Medicare Revenue Analysis

CMS Medicare Physician & Other Practitioners data

Delaware has 5K Medicare providers who collectively received $434.2M in Medicare payments, averaging $95K per provider. Delaware providers earn moderate Medicare revenue per provider, with significant opportunity to capture additional revenue through program enrollment and coding optimization.

The most common specialty is Nurse Practitioner with 670 providers, followed by Physical Therapist in Private Practice (462) and Physician Assistant (416). Nurse Practitioner providers in Delaware average $36K annually, with room to grow through CCM, RPM, and AWV program adoption.

The largest Medicare provider concentration is in Newark (1,442 providers), with Wilmington and Dover also serving as major healthcare hubs. Practices in these areas face competitive pressure, making revenue optimization through proper coding and program enrollment critical for financial performance.

Data: CMS Medicare Physician & Other Practitioners, 2024Coverage: 4,560 providers analyzedLast updated: January 2026

Total Providers

5K

in Delaware

Total Medicare Payment

$434.2M

Avg Payment / Provider

$95K

Total Services

11.8M

Delaware Performance Signals

Revenue per Provider

$95,220

+19.4% vs benchmark · national avg $79,744

Provider Market Share

0.4% of US

-80.6% vs benchmark · 4,560 providers

CCM Adoption

1.7%

-84.6% vs benchmark · national 11.3%

RPM Adoption

0.5%

-91.9% vs benchmark · national 6.5%

AWV Completion

10.7%

-38.9% vs benchmark · national 17.5%

Key Stats

5K
Total Providers(Delaware)
$95K
Avg Medicare Payment(per provider)
$434.2M
Total Medicare Payments
Nurse Practitioner
Top Specialty(670 providers)

How This Compares

#10 of 62
National rank by avg Medicare payment
+19%vs national average
Delaware Medicare Revenue

Top Opportunities

#1
Chronic Care Management (99490)
$5.2M potential
#2
Remote Patient Monitoring (99454)
$3.6M potential
#3
Annual Wellness Visits (G0438/G0439)
$1.8M potential
Peer group: 4,560 providers
Confidence: High
CMS Medicare Public Data 2024
Data year: 2024

How Delaware Compares

#10
of 62 states
+19%
vs national avg

vs Neighboring States

Delaware
$95K
Maryland
$111K
+16%
New Jersey
$105K
+11%
Pennsylvania
$65K
-32%
Strongest Specialty
Nurse Practitioner
670 providers
Biggest Program Gap
CCM (99490)
1.7% adoption vs 11.3% national

Top Revenue Opportunities in Delaware

#1

Chronic Care Management (99490)

$5.2M
estimated annual opportunity

Only 1.7% of providers bill CCM vs 11.3% national average. 435 additional providers could adopt CCM to close this gap.

Current: 1.7%Target: 11.3%
high confidence· 435 providers
#2

Remote Patient Monitoring (99454)

$3.6M
estimated annual opportunity

RPM adoption is 0.5% vs 6.5% nationally. 271 providers could implement RPM programs.

Current: 0.5%Target: 6.5%
high confidence· 271 providers
#3

Annual Wellness Visits (G0438/G0439)

$1.8M
estimated annual opportunity

AWV completion at 10.7% trails the 17.5% national average. 309 additional providers could offer AWV services.

Current: 10.7%Target: 17.5%
high confidence· 309 providers

Market Opportunities by Specialty

Top 50 Providers in Delaware

ProviderPatientsMedicare $
Jamal MislehMD460$6.8M
Delaware Surgery Center, Llc690$4.5M
Lourdes AponteMD906$3.6M
Jinsong ZhangM.D.375$3.5M
Jose PandoMD589$3.2M
Maged HosnyMD892$3.1M
Delaware Diagnostic Labs, Llc1,560$3.1M
Jason KaplanM.D.1,112$2.7M
Ivonne HerreraMD1,068$2.7M
Dhaval ShahMD294$2.5M
Gaetano PastoreM.D.1,314$2.5M
Rockland Surgery Center, L.P.930$2.4M
Gregory MastersMD165$2.3M
Limestone Medical Center, Llc620$2.3M
Egnm Llc603$2.2M
Anthony FureyD.O.1,183$2.0M
St Francis Emergency Medical Services Llc3,108$2.0M
Minimally Invasive Surgical And Neuroscience Llc141$2.0M
Mayda MelendezMD346$2.0M
Carolyn Glazer-HocksteinMD625$1.8M
Christiana Spine Ambulatory Surgical Center, Llc1,344$1.7M
Paula KoMD720$1.7M
Evan LapinskyMD256$1.7M
Mitchell SticklerM.D.2,341$1.5M
Nouman AsifM.D.546$1.5M
C & S Medical, Llc686$1.4M
Newark Endoscopy Asc Llc1,103$1.4M
Yvan Maque AcostaM.D.286$1.3M
Robert MoyerM.D.180$1.3M
First State Surgery Center, Llc199$1.3M
Kathryn O'reillyMD, PHD2,261$1.3M
Lydia ClementsMD308$1.3M
Delaware Eye Surgery Center, Llc662$1.3M
Brian ToussaintMD547$1.2M
Anthony ClayD.O.1,179$1.2M
John RoussalisM.D.PC257$1.2M
Sujung ParkM.D.162$1.2M
Amy Mcghee JezMD208$1.1M
Harry LebowitzM.D.1,301$1.1M
Christopher ContiMD820$1.1M
Rajinder PrasadM.D.1,804$1.1M
Andrew HimelsteinMD312$1.1M
Tyler YerkesPA-C35$1.1M
Curtis AsburyM.D.1,836$1.1M
Sara MoghaddamM.D.674$1.1M
Matthew HansonMD4,378$1.0M
Lab At Seascape3,694$1.0M
Steven DelloseMD1,001$1.0M
Alan MicklinM.D.1,221$989K
Timothy DoyleD.O.1,659$983K

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