2026 NPPES data Cornea and External Diseases Specialist Physician NPI 1255481701 M.D.
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EDWARD LAI, M.D.

Cornea and External Diseases Specialist Physician in NEW YORK, New York. 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
1K
Medicare Part D claims · 383 beneficiaries · Cornea and External Diseases Specialist Physician avg: 1K
Generic prescribing
52%
generic claims · 48% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
100/100
▲ 17 pts above national avg 83.1 · [object Object]
Industry payments
$15.87
1 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: EDWARD LAI, M.D. is a Cornea and External Diseases Specialist Physician ([object Object]) practicing in NEW YORK, New York with a Medicare Part D prescribing footprint of 1K claims across 383 beneficiaries — 48% brand-name prescribing . Their CMS MIPS Final Score of 100/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $15.87 across 1 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: EDWARD LAI, M.D. reported a CMS MIPS final score of 100 out of 100, above the 83.1 national average, and filed 1,446 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)

EDWARD LAI, 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).

EDWARD LAI, M.D. at a glance

High performer (top quartile)

NPI registry status

Active

Issued 01/10/2007

NPI 1255481701

Primary specialty

Cornea and External Diseases Specialist Physician

Rare

294 US NPIs in this specialty

Medicare Part D claims

1,446 17% vs specialty avg

2023 prescription claims

Specialty avg: 1,232

MIPS final score

100/100 16.900000000000006% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in New York

How Cornea and External Diseases Specialist Physician compares to other specialties among New York providers

New York providers

Cornea and External Diseases Specialist Physician share within New York

1. Cornea and External Diseases Specialist Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Cornea and External Diseases Specialist Physician share within New York

Medicare quality performance — MIPS

EDWARD LAI, M.D.'s 2023 MIPS final score plotted against the Cornea and External Diseases Specialist Physician national average

High performer (top quartile)
MIPS Final Score
100/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Cornea and External Diseases Specialist Physician) — 100/100 vs national avg 83.1

0%100%National avg83%99%
MIPS final score (Cornea and External Diseases Specialist Physician) — 100/100 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).

EDWARD LAI, M.D. is a Cornea and External Diseases Specialist Physician provider practicing in NEW YORK, New York, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: M.D.. NPI: 1255481701. 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.

EDWARD LAI, M.D. appears in the CMS NPPES registry as a Cornea and External Diseases Specialist Physician provider holding M.D. credentials at 1305 YORK AVE, NEW YORK, NY, 10021, with a listed phone of (646) 962-2020. NPI 1255481701 was issued on 01/10/2007. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what LAI 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 1,446 prescription claims written by this provider, covering 383 Medicare beneficiaries and totaling roughly $428K in drug spend, split 48% brand-name and 52% generic by claim count. 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 100/100 for the 2023 performance year (Quality 86.8066), compared with the national average of 83.1.

Cornea and External Diseases Specialist Physician is a narrow specialty nationwide, with 294 enrolled providers across 43 states and an average of 1,232 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

1305 YORK AVE
NEW YORK, NY 10021

Provider Details

NPI 1255481701
Specialty Cornea and External Diseases Specialist Physician
Credentials M.D.
Gender Male
NPI Issued 01/10/2007

CMS Quality Score (MIPS)

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

100
Final Score
Avg: 83.1
86.8066
Quality
100
Promoting Interoperability

Reporting: Alternative Payment Model

Hospital and facility affiliations

Facilities where EDWARD LAI, 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.

WEILL MEDICAL COLLEGE OF CORNELL
NEW YORK, NY

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 EDWARD LAI, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$16

Largest payer

Ocular Therapeutix, Inc.

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.

License & disciplinary context — New York NYSBPMC 2023 annual report

Aggregate state board data only — NOT a determination of any individual provider's status. The figures below describe statewide disciplinary activity across all ~100K New York medical licensees in 2023 — they are NOT specific to EDWARD LAI, M.D.. To verify EDWARD LAI, M.D.'s current license status, search the NYSBPMC public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

312
Total board actions, New York 2023
Across 302 cases
3.12
Actions per 1,000 licensees
New York statewide rate
probation
Most common action type
89 cases

NYSBPMC publishes annual disciplinary statistics as part of public-record reporting under each state's Administrative Procedure Act. See the full breakdown by action type and year on the New York disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Above average

EDWARD LAI, M.D. — brand share 48.0%
Specialty average (est.)

48% brand-name claims vs 52% generic, on 1,446 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.

1,446
Total Claims
$428K
Total Drug Cost
383
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
1,889
Total Day Supply
47,795
Brand vs Generic
48% brand / 52% generic
Brand Drug Cost
$401K
Generic Drug Cost
$27K
Antibiotic Claims
19

Patient Demographics

Average Patient Age
75.3 years
Avg HCC Risk Score
1.37
Gender Split
73% female / 27% male
Age Distribution
<65: 17, 65-74: 165, 75-84: 159, 85+: 42

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Ketorolac Tromethamine
297
Moxifloxacin
Moxifloxacin Hcl
294
Prednisolone Acetate
278
Restasis
Cyclosporine
221
Xiidra
Lifitegrast
58
Tobramycin-Dexamethasone
Tobramycin/Dexamethasone
42
Olopatadine Hcl
34
Cyclosporine
33
Loteprednol Etabonate
28
Restasis Multidose
Cyclosporine
20

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

Cornea and External Diseases Specialist Physician Overview

How EDWARD LAI, M.D. fits within the Cornea and External Diseases Specialist Physician landscape nationally.

294
Cornea and External Diseases Specialist Physician Providers in US
43
States with Cornea and External Diseases Specialist Physician
1,232
Avg Claims per Provider

EDWARD LAI, M.D.'s 1,446 claims are above the specialty average of 1,232.

Nearby Cornea and External Diseases Specialist Physician Providers in New York

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

Compare Cornea and External Diseases Specialist Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is EDWARD LAI, M.D.'s specialty?
EDWARD LAI, M.D. specializes in Cornea and External Diseases Specialist Physician and practices in NEW YORK, New York. Credentials: M.D..
How much does EDWARD LAI, M.D. prescribe under Medicare Part D?
In 2023, EDWARD LAI, M.D. wrote 1,446 Medicare Part D claims totaling $428K in drug costs for 383 beneficiaries.
What is EDWARD LAI, M.D.'s Medicare quality score?
EDWARD LAI, M.D. has a CMS MIPS Final Score of 100/100 (Quality: 86.8066). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is EDWARD LAI, M.D. located?
EDWARD LAI, M.D. is located at 1305 YORK AVE, NEW YORK, NY, 10021. Phone: (646) 962-2020.
What is EDWARD LAI, M.D.'s NPI number?
EDWARD LAI, M.D.'s National Provider Identifier (NPI) is 1255481701, issued on 01/10/2007.
Does EDWARD LAI, M.D. prescribe more brand-name or generic drugs?
EDWARD LAI, M.D.'s prescribing is 48% brand-name and 52% generic drugs by claim count, with $401K in brand drug costs.
How many Cornea and External Diseases Specialist Physician providers are there in the US?
There are 294 Cornea and External Diseases Specialist Physician providers across 43 states in the US. The average Cornea and External Diseases Specialist Physician provider writes 1,232 Medicare Part D claims per year.
What drugs does EDWARD LAI, M.D. prescribe most often?
Based on 2023 Medicare Part D data, EDWARD LAI, M.D.'s most frequently prescribed drugs include Ketorolac Tromethamine, Moxifloxacin, Prednisolone Acetate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does EDWARD LAI, M.D. accept Medicare?
EDWARD LAI, M.D. appears in CMS Medicare data with 1,446 Part D claims and 383 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify EDWARD LAI, M.D.'s credentials?
EDWARD LAI, M.D.'s NPI is 1255481701 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