2026 NPPES data Internal Medicine Physician NPI 1053847152 DO
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EDGARDO FORTUNO, DO

Internal Medicine Physician in SIOUX FALLS, South Dakota. 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
519
Medicare Part D claims · 93 beneficiaries · Internal Medicine Physician avg: 3K
Generic prescribing
85%
generic claims · 15% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
76.6912/100
▼ 6 pts below national avg 83.1 · [object Object]

What the federal data shows

EDGARDO FORTUNO, DO reported a CMS MIPS final score of 76.6912/100 — below the 83.1 national average — and filed 519 Medicare Part D claims in 2023.

76.6912/100
MIPS score · -6 vs avg
519
Part D claims, 2023
85%
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.

EDGARDO FORTUNO, DO's MIPS score vs every scored U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023 — the federal quality measure

77 21st percentile higher than 21% of 477,587 scored providers

0–10: 8,684 scored providers (2%). Below this entry. 10–20: 3,008 scored providers (1%). Below this entry. 20–30: 3,069 scored providers (1%). Below this entry. 30–40: 2,746 scored providers (1%). Below this entry. 40–50: 2,928 scored providers (1%). Below this entry. 50–60: 5,882 scored providers (1%). Below this entry. 60–70: 13,906 scored providers (3%). Below this entry. 70–80: 118,074 scored providers (25%). This entry sits in this band. 80–90: 129,887 scored providers (27%). Above this entry. 90–100: 189,403 scored providers (40%). Above this entry. This provider 0 100 every MIPS-scored clinician, bucketed by value

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

Board certification likely (heuristic — not verified)

EDGARDO FORTUNO, DO 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 EDGARDO FORTUNO, DO?

Below national average

NPI registry status

Active

Issued 05/10/2017

NPI 1053847152

Primary specialty

Internal Medicine Physician

High-volume

172,858 US NPIs in this specialty

Medicare Part D claims

519 81% vs specialty avg

2023 prescription claims

Specialty avg: 2,716

MIPS final score

76.6912/100 6.408799999999999% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in South Dakota

How Internal Medicine Physician compares to other specialties among South Dakota providers

South Dakota providers

Internal Medicine Physician share within South Dakota

1. Internal Medicine Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Internal Medicine Physician share within South Dakota

Medicare quality performance — MIPS

EDGARDO FORTUNO, DO's 2023 MIPS final score plotted against the Internal Medicine Physician national average

Below national average
MIPS Final Score
76.6912/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Internal Medicine Physician) — 76.6912/100 vs national avg 83.1

0%100%National avg83%76.7%
MIPS final score (Internal Medicine Physician) — 76.6912/100 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).

EDGARDO FORTUNO, DO appears in the CMS NPPES registry as a Internal Medicine Physician provider holding DO credentials at 1309 W 17TH ST STE 101, SIOUX FALLS, SD, 57104, with a listed phone of (605) 328-8000. NPI 1053847152 was issued on 05/10/2017. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what FORTUNO 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 519 prescription claims written by this provider, covering 93 Medicare beneficiaries and totaling roughly $24K in drug spend, split 15% brand-name and 85% generic by claim count, with an opioid prescribing rate of 53.0%. 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 76.6912/100 for the 2023 performance year (Quality 78.5693, Cost 44.5681), compared with the national average of 83.1.

Internal Medicine Physician is a high-volume specialty nationwide, with 172,858 enrolled providers across 56 states and an average of 2,716 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

1309 W 17TH ST STE 101
SIOUX FALLS, SD 57104

Provider Details

NPI 1053847152
Specialty Internal Medicine Physician
Credentials DO
Gender Male
NPI Issued 05/10/2017

CMS Quality Score (MIPS)

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

76.6912
Final Score
Avg: 83.1
78.5693
Quality
44.5681
Cost
99
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where EDGARDO FORTUNO, DO 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.

SANFORD MEDICAL CENTER
SIOUX FALLS, SD

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

Brand vs generic prescribing mix · Typical

EDGARDO FORTUNO, DO — brand share 15.0%
Specialty average (est.)

15% brand-name claims vs 85% generic, on 519 2023 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 2023.

519
Total Claims
$24K
Total Drug Cost
93
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
580
Total Day Supply
13,214
Brand vs Generic
15% brand / 85% generic
Brand Drug Cost
$12K
Generic Drug Cost
$12K
Opioid Claims
275 (53.0% rate)

Patient Demographics

Average Patient Age
72.7 years
Avg HCC Risk Score
3.20
Gender Split
53% female / 47% male

Top Prescribed Drugs (Medicare Part D)

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

What EDGARDO FORTUNO, DO prescribes most

Top Medicare Part D drugs by claim count, 2023

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2023
Drug Claims
Methadone Hcl
71
Hydromorphone Hcl
60
Morphine Sulfate Er
Morphine Sulfate
40
Morphine Sulfate
38
Fentanyl
24
Oxycodone Hcl
24
Lorazepam
19
Pregabalin
16
Quetiapine Fumarate
15
Trazodone Hcl
15

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

Internal Medicine Physician Overview

How EDGARDO FORTUNO, DO fits within the Internal Medicine Physician landscape nationally.

172,858
Internal Medicine Physician Providers in US
56
States with Internal Medicine Physician
2,716
Avg Claims per Provider

EDGARDO FORTUNO, DO's 519 claims are below the specialty average of 2,716.

Nearby Internal Medicine Physician Providers in South Dakota

Other clinicians with the same primary specialty enrolled in South Dakota, drawn from the same CMS NPPES roster as FORTUNO.

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

Frequently Asked Questions

What is EDGARDO FORTUNO, DO's specialty?
EDGARDO FORTUNO, DO specializes in Internal Medicine Physician and practices in SIOUX FALLS, South Dakota. Credentials: DO.
How much does EDGARDO FORTUNO, DO prescribe under Medicare Part D?
In 2023, EDGARDO FORTUNO, DO wrote 519 Medicare Part D claims totaling $24K in drug costs for 93 beneficiaries.
What is EDGARDO FORTUNO, DO's Medicare quality score?
EDGARDO FORTUNO, DO has a CMS MIPS Final Score of 76.6912/100 (Quality: 78.5693, Cost: 44.5681). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is EDGARDO FORTUNO, DO located?
EDGARDO FORTUNO, DO is located at 1309 W 17TH ST STE 101, SIOUX FALLS, SD, 57104. Phone: (605) 328-8000.
What is EDGARDO FORTUNO, DO's NPI number?
EDGARDO FORTUNO, DO's National Provider Identifier (NPI) is 1053847152, issued on 05/10/2017.
Does EDGARDO FORTUNO, DO prescribe more brand-name or generic drugs?
EDGARDO FORTUNO, DO's prescribing is 15% brand-name and 85% generic drugs by claim count, with $12K in brand drug costs.
Does EDGARDO FORTUNO, DO prescribe opioids?
Yes, EDGARDO FORTUNO, DO had 275 opioid claims in 2023 with an opioid prescribing rate of 53.0%.
How many Internal Medicine Physician providers are there in the US?
There are 172,858 Internal Medicine Physician providers across 56 states in the US. The average Internal Medicine Physician provider writes 2,716 Medicare Part D claims per year.
What drugs does EDGARDO FORTUNO, DO prescribe most often?
Based on 2023 Medicare Part D data, EDGARDO FORTUNO, DO's most frequently prescribed drugs include Methadone Hcl, Hydromorphone Hcl, Morphine Sulfate Er. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does EDGARDO FORTUNO, DO accept Medicare?
EDGARDO FORTUNO, DO appears in CMS Medicare data with 519 Part D claims and 93 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify EDGARDO FORTUNO, DO's credentials?
EDGARDO FORTUNO, DO's NPI is 1053847152 with credentials DO. 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