NPI registry status
Active
2026 NPPES data Ophthalmology Physician NPI 1427133586 MD
Verify on CMS → Atul Agarwala, MD
Ophthalmology Physician in Irvington, 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 22,388 in Ophthalmology 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
5K
Medicare Part D claims · 771 beneficiaries · Ophthalmology Physician avg: 1K
Generic prescribing
50%
generic claims · 50% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
0/100
▼ 84 pts below national avg 83.5 · Penalty band
Industry payments
$821.45
37 payments · CMS Open Payments (Sunshine Act)
Source: CMS Medicare Part D Prescriber Public Use File, 2024
What the federal data shows
Atul Agarwala, MD reported a CMS MIPS final score of 0/100 - below the 83.5 national average - and filed 4,571 Medicare Part D claims in 2024.
- 0/100
- MIPS score · -83 vs avg
- 5K
- Part D claims, 2024
- 50%
- generic prescribing
- 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.
Federal trust snapshot
What official records show about Atul Agarwala, MD
Federal records show an active NPI with both Medicare prescribing volume and a measured CMS quality score — objective registry data, not patient reviews.
- Verified
NPI registry status
Active listing in the CMS National Provider Identifier Registry (NPI 1427133586), first enumerated 10/26/2006.
Source: CMS NPPES
- Reported
Medicare Part D participation
Filed 4,571 Medicare Part D prescription claims in the 2023 CMS public use file — indicates active Medicare prescribing participation.
Source: CMS Part D Prescriber PUF
- Reported
CMS quality reporting (MIPS)
Reported a CMS MIPS final score of 0/100 in the Quality Payment Program — a federal quality measure, not a patient review.
Source: CMS Quality Payment Program
- Reported
Board certification signal
Heuristic suggests board-certified status based on ABMS-eligible specialty taxonomy plus active CMS participation signals — not a direct ABMS verification.
- Reported
Hospital affiliations
1 CMS Care Compare hospital affiliation on record — practice footprint from the Doctors and Clinicians file.
Source: CMS Care Compare
- Reported
Industry payment transparency
$821.45 in reported industry payments (37 transfers) in 2024 under the federal Sunshine Act — disclosed transfers of value, not a quality rating.
Source: CMS Open Payments
- Not in federal data
Individual sanction lookup
PlainDoctor does not publish per-provider disciplinary determinations. Confirm current license and any individual actions through the state medical board or FSMB verification service.
Source: State medical board / FSMB
This trust snapshot summarizes only what appears in federal CMS/NPPES public records. It is not a composite score, star rating, patient review, or clinical recommendation. PlainDoctor never fabricates reviews or AggregateRating schema.
CMS NPPES provider registry desk
NPI 1427133586 · Ophthalmology Physician
NPI-10 · ENUM-LEGACY · TAX-MID · MIPS-LOW · RX-MID · BOOK-LIGHT · PHOTO-FINISH
- NPI-10 1427133586
- ENUM-LEGACY 2006
- TAX-MID 22K Ophthalmology Physician
- MIPS-LOW 0/100
- RX-MID 4,571
- BOOK-LIGHT 625 in New Jersey
- PHOTO-FINISH Ednan Ahmed · ±0.0
MIPS final-score neighbourhood
Same-specialty nationwide peers by CMS final score, not geographic proximity
- Agarwala · this … 0
Agarwala · this provider
0 MIPS pts
- Barbara Arnold ·… 0
Barbara Arnold
0 MIPS pts
- Ednan Ahmed · near 0
Ednan Ahmed
0 MIPS pts
- Payam Amini · near 0
Payam Amini
0 MIPS pts
- Bertrand Anz · n… 0
Bertrand Anz
0 MIPS pts
What this shows Nearest measured MIPS peers for this NUCC specialty (2023 performance year).
Atul Agarwala, MD's MIPS score vs every measured U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure. Clinicians whose score CMS assigned without scoring any category are excluded.
0 ≥ 0th percentile 0% of 454,083 measured providers are in lower value bands
Each bar is a band; taller bars hold more measured 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.
The percentile is a conservative whole-score-point band: it counts only measured clinicians in lower score bands. A CMS MIPS metric is not a recommendation or a clinical-quality rating by PlainDoctor. See methodology § corpus placement.
Source CMS Merit-based Incentive Payment System (MIPS) · 2023
Where Atul Agarwala, MD sits
This provider among ophthalmology physician peers
Across the 8,767 ophthalmology physician providers who report both Medicare Part D prescribing and a MIPS quality score, Atul Agarwala, MD writes more Part D claims than 94% of them and scores higher on MIPS quality than 0% - placing this provider in the high-volume, lower-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Each dot is one ophthalmology physician peer from a representative sample of 60; the gold marker is Atul Agarwala, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Atul Agarwala, MD 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 Atul Agarwala, MD?
Below national averagePrimary specialty
Ophthalmology Physician
Medicare Part D claims
4,571 207% vs specialty avg
MIPS final score
0/100 83.5 pts vs avg
Specialty distribution in New Jersey
How Ophthalmology Physician compares to other specialties among New Jersey providers
Medicare quality performance, MIPS
Atul Agarwala, MD's 2023 MIPS final score plotted against the Ophthalmology Physician national average
- MIPS Final Score
- 0/100
- vs 83.5 national avg · 2023 performance year
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).
Practice Address
Provider Details
| NPI | 1427133586 |
|---|---|
| Specialty | Ophthalmology Physician |
| Credentials | MD |
| Gender | Male |
| NPI Issued | 10/26/2006 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
0
Final Score
Measured-score avg: 83.5
0
Quality
Reporting: Individual
Hospital and facility affiliations
Facilities where Atul Agarwala, MD 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.
Specialty MD Inc
South Plainfield, 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).
Industry payments received (2024) - CMS Open Payments transparency data
The federal Physician Payments Sunshine Act (part of the Affordable Care Act) requires drug and medical-device manufacturers + group purchasing organizations to publicly report payments and other transfers of value to physicians and teaching hospitals. The data below covers 2024 for Atul Agarwala, MD. Source: openpaymentsdata.cms.gov.
Total received
$821
Largest payer
Glaukos Corporation
Most common payment type
Food and Beverage
Industry payments are not necessarily indicators of bias, they include research funding, consulting fees for evidence-based work, royalties for inventions, food at conferences, and similar items. The disclosure exists for transparency. Read our methodology for how we interpret this data.
Brand vs generic prescribing mix · Brand-heavy
Atul Agarwala, MD - brand share 50.0%
Ophthalmology Physician average
50% brand-name claims vs 50% generic, on 4,571 2024 Medicare Part D claims.
The federal Medicare Part D Generic Dispensing Rate national benchmark sits near 90% generic / 10% brand for primary-care prescribers, per CMS Office of the Actuary 2024 estimates. Higher brand share is common in specialty prescribing where generic equivalents are not available.
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2024.
4,571
Total Claims
$966K
Total Drug Cost
771
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 8,075.533
- Total Day Supply
- 232,958
- Brand vs Generic
- 50% brand / 50% generic
- Brand Drug Cost
- $892K
- Generic Drug Cost
- $75K
Patient Demographics
- Average Patient Age
- 74.3 years
- Avg HCC Risk Score
- 1.56
- Gender Split
- 61% female / 39% male
- Age Distribution
- <65: 43, 65-74: 374, 75-84: 282, 85+: 72
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2024. Based on Medicare Part D data only.
What Atul Agarwala, MD prescribes most
Top Medicare Part D drugs by claim count, 2024
- Dorzolamide-Timolol
Dorzolamide-Timolol
792 claims
- Lumigan
Lumigan
534 claims
- Fluorometholone
Fluorometholone
453 claims
- Prednisolone Acetate
Prednisolone Acetate
447 claims
- Latanoprost
Latanoprost
400 claims
- Azelastine Hcl 305
Azelastine Hcl
305 claims
- Brimonidine Tartrate 223
Brimonidine Tartrate
223 claims
- Xiidra 151
Xiidra
151 claims
| Drug | Claims |
|---|---|
| Dorzolamide-Timolol Dorzolamide Hcl/Timolol Maleat | 792 |
| Lumigan Bimatoprost | 534 |
| Fluorometholone | 453 |
| Prednisolone Acetate | 447 |
| Latanoprost | 400 |
| Azelastine Hcl | 305 |
| Brimonidine Tartrate | 223 |
| Xiidra Lifitegrast | 151 |
| Ketorolac Tromethamine | 148 |
| Alphagan P Brimonidine Tartrate | 125 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Ophthalmology Physician Overview
How Atul Agarwala, MD fits within the Ophthalmology Physician landscape nationally.
22,388
Ophthalmology Physician Providers in US
56
States with Ophthalmology Physician
1,490
Avg Claims per Provider
Atul Agarwala, MD's 4,571 claims are above the specialty average of 1,490.
Nationwide Ophthalmology Physician peers with similar MIPS or enrollment year
Two federal-record peer sets for Agarwala, both outside New Jersey so the neighborhoods are not geographic containment.
Similar MIPS final score
Nearest same-specialty clinicians by CMS MIPS final score (0 here).
Same NPPES enumeration year (2006)
Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.
Nearby Ophthalmology Physician Providers in New Jersey
Other clinicians with the same primary specialty enrolled in New Jersey, drawn from the same CMS NPPES roster as Agarwala.
One of 625 Ophthalmology Physician providers enrolled in New Jersey, 5 are shown here.
Dr. Bryan Abessi
M.D.
Branchburg, NJ
Dr. Arlene Ahmad
MD
Boonton, NJ
Dr. Adil Ahmed
DO
Brick, NJ
Dr. Scott Aksman
MD
Freehold, NJ
Dr. Rosemary Albano
MD
Long Beach Township, NJ
Compare Ophthalmology Physician nationally: see state-by-state distribution →
Frequently Asked Questions
What is Atul Agarwala, MD's specialty? ▼
Atul Agarwala, MD specializes in Ophthalmology Physician and practices in Irvington, New Jersey. Credentials: MD.
How much does Atul Agarwala, MD prescribe under Medicare Part D? ▼
In 2024, Atul Agarwala, MD wrote 4,571 Medicare Part D claims totaling $966K in drug costs for 771 beneficiaries.
What is Atul Agarwala, MD's Medicare quality score? ▼
Atul Agarwala, MD has a CMS MIPS Final Score of 0/100 (Quality: 0). The average MIPS Final Score across the 454,083 clinicians with at least one published category score is 83.5; clinicians whose score CMS assigned without scoring any category are excluded from that average. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Atul Agarwala, MD located? ▼
Atul Agarwala, MD is located at 40 UNION AVE, Irvington, NJ, 07111. Phone: (973) 399-6270.
What is Atul Agarwala, MD's NPI number? ▼
Atul Agarwala, MD's National Provider Identifier (NPI) is 1427133586, issued on 10/26/2006.
Does Atul Agarwala, MD prescribe more brand-name or generic drugs? ▼
Atul Agarwala, MD's prescribing is 50% brand-name and 50% generic drugs by claim count, with $892K in brand drug costs.
How many Ophthalmology Physician providers are there in the US? ▼
There are 22,388 Ophthalmology Physician providers across 56 states in the US. The average Ophthalmology Physician provider writes 1,490 Medicare Part D claims per year.
What drugs does Atul Agarwala, MD prescribe most often? ▼
Based on 2024 Medicare Part D data, Atul Agarwala, MD's most frequently prescribed drugs include Dorzolamide-Timolol, Lumigan, Fluorometholone. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Atul Agarwala, MD accept Medicare? ▼
Atul Agarwala, MD appears in CMS Medicare data with 4,571 Part D claims and 771 Medicare beneficiaries in 2024. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Atul Agarwala, MD's credentials? ▼
Atul Agarwala, MD's NPI is 1427133586 with credentials MD. 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 (2024). 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 August 2026 (NPPES) / 2024 (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
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 August 2026.