2026 NPPES data Sports Medicine (Internal Medicine) Physician NPI 1497751242 M.D.
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ANDREW NELSON, M.D.

Sports Medicine (Internal Medicine) Physician in TOMS RIVER, New Jersey. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.

Federal data — no proprietary rating. PlainDoctor publishes the actual CMS NPPES and Medicare records — NPI registration, specialty, practice location, and prescribing data — without a composite score or editorial opinion on top. Every field traces to a federal source.
Prescribing volume
350
Medicare Part D claims · 137 beneficiaries · Sports Medicine (Internal Medicine) Physician avg: 1K
MIPS score
66.3842/100
▼ 17 pts below national avg 83.1 · [object Object]
What the federal data reveals: ANDREW NELSON, M.D. is a Sports Medicine (Internal Medicine) Physician ([object Object]) practicing in TOMS RIVER, New Jersey with a Medicare Part D prescribing footprint of 350 claims across 137 beneficiaries . Their CMS MIPS Final Score of 66.3842/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities .

What stands out: ANDREW NELSON, M.D. reported a CMS MIPS final score of 66.3842 out of 100, below the 83.1 national average, and filed 350 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

Board certification likely (heuristic — not verified)

ANDREW NELSON, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 1 hospital affiliation — signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).

ANDREW NELSON, M.D. at a glance

Below national average

NPI registry status

Active

Issued 06/27/2005

NPI 1497751242

Primary specialty

Sports Medicine (Internal Medicine) Physician

Rare

292 US NPIs in this specialty

Medicare Part D claims

350 72% vs specialty avg

2023 prescription claims

Specialty avg: 1,267

MIPS final score

66.3842/100 16.715799999999987% pts

Mid-tier band

vs 83.1 national avg

Specialty distribution in New Jersey

How Sports Medicine (Internal Medicine) Physician compares to other specialties among New Jersey providers

New Jersey providers

Sports Medicine (Internal Medicine) Physician share within New Jersey

1. Sports Medicine (Internal Medicine) Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Sports Medicine (Internal Medicine) Physician share within New Jersey

Medicare quality performance — MIPS

ANDREW NELSON, M.D.'s 2023 MIPS final score plotted against the Sports Medicine (Internal Medicine) Physician national average

Below national average
MIPS Final Score
66.3842/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Sports Medicine (Internal Medicine) Physician) — 66.3842/100 vs national avg 83.1

0%100%National avg83%66.4%
MIPS final score (Sports Medicine (Internal Medicine) Physician) — 66.3842/100 vs national avg 83.1

The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.

Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).

ANDREW NELSON, M.D. is a Sports Medicine (Internal Medicine) Physician provider practicing in TOMS RIVER, New Jersey, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: M.D.. NPI: 1497751242. This profile includes practice location, specialty classification, and organizational affiliations from the CMS provider registry. Provider information is self-reported to CMS and updated monthly.

ANDREW NELSON, M.D. appears in the CMS NPPES registry as a Sports Medicine (Internal Medicine) Physician provider holding M.D. credentials at 1594 ROUTE 9, TOMS RIVER, NJ, 08755, with a listed phone of (732) 349-8888. NPI 1497751242 was issued on 06/27/2005. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what NELSON most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.

Medicare Part D records for calendar year 2023 show 350 prescription claims written by this provider, covering 137 Medicare beneficiaries and totaling roughly $6K in drug spend, with an opioid prescribing rate of 37.4%. These figures capture only Medicare Part D — commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 66.3842/100 for the 2023 performance year (Quality 42.515, Cost 52.099), compared with the national average of 83.1.

Sports Medicine (Internal Medicine) Physician is a narrow specialty nationwide, with 292 enrolled providers across 43 states and an average of 1,267 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist — always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.

Practice Address

1594 ROUTE 9
TOMS RIVER, NJ 08755

Provider Details

NPI 1497751242
Specialty Sports Medicine (Internal Medicine) Physician
Credentials M.D.
Gender Male
NPI Issued 06/27/2005

CMS Quality Score (MIPS)

Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.

66.3842
Final Score
Avg: 83.1
42.515
Quality
52.099
Cost
92
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where ANDREW NELSON, M.D. bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" — a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.

SEAVIEW ORTHOPAEDICS AND MEDICAL ASSOCIATES LLP
OCEAN, NJ

Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

350
Total Claims
$6K
Total Drug Cost
137
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
350
Total Day Supply
7,742
Generic Drug Cost
$5K
Opioid Claims
131 (37.4% rate)

Patient Demographics

Average Patient Age
72.5 years
Avg HCC Risk Score
0.98
Gender Split
69% female / 31% male
Age Distribution
<65: 12, 65-74: 75, 75-84: 37, 85+: 13

Top Prescribed Drugs (Medicare Part D)

Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.

Drug Claims
Meloxicam
81
Oxycodone Hcl
44
Methylprednisolone
37
Morphine Sulfate Er
Morphine Sulfate
23
Gabapentin
22
Prednisone
21
Celecoxib
19
Hydrocodone-Acetaminophen
Hydrocodone/Acetaminophen
15
Fentanyl
13
Duloxetine Hcl
11

* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.

Sports Medicine (Internal Medicine) Physician Overview

How ANDREW NELSON, M.D. fits within the Sports Medicine (Internal Medicine) Physician landscape nationally.

292
Sports Medicine (Internal Medicine) Physician Providers in US
43
States with Sports Medicine (Internal Medicine) Physician
1,267
Avg Claims per Provider

ANDREW NELSON, M.D.'s 350 claims are below the specialty average of 1,267.

Nearby Sports Medicine (Internal Medicine) Physician Providers in New Jersey

Other clinicians with the same primary specialty enrolled in New Jersey, drawn from the same CMS NPPES roster as NELSON.

Compare Sports Medicine (Internal Medicine) Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is ANDREW NELSON, M.D.'s specialty?
ANDREW NELSON, M.D. specializes in Sports Medicine (Internal Medicine) Physician and practices in TOMS RIVER, New Jersey. Credentials: M.D..
How much does ANDREW NELSON, M.D. prescribe under Medicare Part D?
In 2023, ANDREW NELSON, M.D. wrote 350 Medicare Part D claims totaling $6K in drug costs for 137 beneficiaries.
What is ANDREW NELSON, M.D.'s Medicare quality score?
ANDREW NELSON, M.D. has a CMS MIPS Final Score of 66.3842/100 (Quality: 42.515, Cost: 52.099). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is ANDREW NELSON, M.D. located?
ANDREW NELSON, M.D. is located at 1594 ROUTE 9, TOMS RIVER, NJ, 08755. Phone: (732) 349-8888.
What is ANDREW NELSON, M.D.'s NPI number?
ANDREW NELSON, M.D.'s National Provider Identifier (NPI) is 1497751242, issued on 06/27/2005.
Does ANDREW NELSON, M.D. prescribe opioids?
Yes, ANDREW NELSON, M.D. had 131 opioid claims in 2023 with an opioid prescribing rate of 37.4%.
How many Sports Medicine (Internal Medicine) Physician providers are there in the US?
There are 292 Sports Medicine (Internal Medicine) Physician providers across 43 states in the US. The average Sports Medicine (Internal Medicine) Physician provider writes 1,267 Medicare Part D claims per year.
What drugs does ANDREW NELSON, M.D. prescribe most often?
Based on 2023 Medicare Part D data, ANDREW NELSON, M.D.'s most frequently prescribed drugs include Meloxicam, Oxycodone Hcl, Methylprednisolone. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does ANDREW NELSON, M.D. accept Medicare?
ANDREW NELSON, M.D. appears in CMS Medicare data with 350 Part D claims and 137 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify ANDREW NELSON, M.D.'s credentials?
ANDREW NELSON, M.D.'s NPI is 1497751242 with credentials M.D.. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.

Data Sources

Provider Directory
CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
Specialty Classification
NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
Prescribing Data
CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
Quality Performance
CMS Merit-based Incentive Payment System (MIPS) — 2023 performance year.
Limitations
Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.

See our complete data methodology for details on how we collect and process government data.

Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).

Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology