NPI registry status
Active
2026 NPPES data Sports Medicine (Internal Medicine) Physician NPI 1497751242 M.D.
Verify on CMS → Andrew Nelson, M.D.
Sports Medicine (Internal Medicine) Physician in Toms River, New Jersey.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 295 in Sports Medicine (Internal Medicine) Physician, and covers specialty classification, practice address, and Medicare Part D prescribing data when reported. According to CMS, every field reflects the provider's official federal registration, see our methodology.
Federal data, no proprietary rating.
We show these CMS records as-is - no composite score, no star rating, no editorial opinion layered on top.
Prescribing volume
350
Medicare Part D claims · 137 beneficiaries · Sports Medicine (Internal Medicine) Physician avg: 1K
MIPS score
66.4/100
▼ 17 pts below national avg 83.1 · Mid-tier
Compiled from official public sources by the PlainDoctor editorial team.
What the federal data shows
Andrew Nelson, M.D. reported a CMS MIPS final score of 66.4/100 - below the 83.1 national average - and filed 350 Medicare Part D claims in 2023.
- 66.4/100
- MIPS score · -17 vs avg
- 350
- Part D claims, 2023
- Likely
- board-certified (heuristic)
Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) - no proprietary rating or editorial opinion is applied.
Andrew Nelson, M.D.'s MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
66 7th percentile higher than 7% of 477,587 scored providers
Each bar is a band; taller bars hold more scored providers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.
Source CMS Merit-based Incentive Payment System (MIPS) · 2023
Where Andrew Nelson, M.D. sits
This provider among sports medicine (internal medicine) physician peers
Across the 68 sports medicine (internal medicine) physician providers who report both Medicare Part D prescribing and a MIPS quality score, Andrew Nelson, M.D. writes more Part D claims than 50% of them and scores higher on MIPS quality than 10% - placing this provider in the high-volume, lower-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Part D claim volume vs MIPS quality, by specialty percentile
Each dot is one sports medicine (internal medicine) physician peer from a representative sample of 60; the gold marker is Andrew Nelson, M.D.. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
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).
What does the federal data show about Andrew Nelson, M.D.?
Below national averagePrimary specialty
Sports Medicine (Internal Medicine) Physician
Medicare Part D claims
350 72% vs specialty avg
MIPS final score
66.4/100 16.7 pts vs avg
Specialty distribution in New Jersey
How Sports Medicine (Internal Medicine) Physician compares to other specialties among New Jersey providers
Medicare quality performance, MIPS
Andrew Nelson, M.D.'s 2023 MIPS final score plotted against the Sports Medicine (Internal Medicine) Physician national average
- MIPS Final Score
- 66.4/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Sports Medicine (Internal Medicine) Physician) - 66.4/100 vs national avg 83.1
How MIPS and board certification work
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. 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.
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%. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 66.4/100 for the 2023 performance year (Quality 42.5, Cost 52.1), compared with the national average of 83.1.
Sports Medicine (Internal Medicine) Physician is a narrow specialty nationwide, with 295 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
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.
What Andrew Nelson, M.D. prescribes most
Top Medicare Part D drugs by claim count, 2023
- Meloxicam
Meloxicam
81 claims
- Oxycodone Hcl
Oxycodone Hcl
44 claims
- Methylprednisolone
Methylprednisolone
37 claims
- Morphine Sulfate Er 23
Morphine Sulfate Er
23 claims
- Gabapentin 22
Gabapentin
22 claims
- Prednisone 21
Prednisone
21 claims
- Celecoxib 19
Celecoxib
19 claims
- Hydrocodone-Acetam… 15
Hydrocodone-Acetaminophen
15 claims
| 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.
More Sports Medicine (Internal Medicine) Physician in NJ →
All providers in New Jersey →
Compare specialties →
Sports Medicine (Internal Medicine) Physician Overview
How Andrew Nelson, M.D. fits within the Sports Medicine (Internal Medicine) Physician landscape nationally.
295
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.
Dr. Jodie Bachman
D.O.
Madison, NJ
Dr. Dhimant Balar
D.O.
Freehold, NJ
Dr. Douglas Borkowski
M.D.
Wayne, NJ
Dr. Wazim Buksh
MD
East Hanover, NJ
Dr. Steven Crawford
MD
W Long Branch, NJ
Compare Sports Medicine (Internal Medicine) Physician nationally: see state-by-state distribution →
Before you book an appointment
Use this federal record as your verification checklist, not as a recommendation.
- Confirm the NPI record is current in the official CMS registry, providers update their own NPPES details, and moves can lag. Verify this NPI
- Check the active license and any disciplinary history with the New Jersey medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Sports Medicine (Internal Medicine) Physician peer on Medicare volume and prescribing patterns. Compare providers
Medicare Part D and MIPS figures describe practice patterns in federal programs only, they are not quality ratings, and PlainDoctor does not rate, rank, or recommend providers.
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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 66.4/100 (Quality: 42.5, Cost: 52.1). 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 295 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
View source datasets and methodology notes
- 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
Compiled from official public sources by the PlainDoctor editorial team.
Every figure on PlainDoctor is rendered directly from the federal CMS NPPES registry, Medicare Part D, MIPS, and Open Payments records, no number is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of May 2026.