2026 NPPES data Ophthalmology Physician NPI 1003981804 MD
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ELENA JIMENEZ, MD

Ophthalmology Physician in SAN JUAN, Puerto Rico. 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 · 368 beneficiaries · Ophthalmology Physician avg: 1K
Generic prescribing
49%
generic claims · 51% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
30/100
▼ 53 pts below national avg 83.1 · [object Object]
Industry payments
$155.23
5 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: ELENA JIMENEZ, MD is a Ophthalmology Physician ([object Object]) practicing in SAN JUAN, Puerto Rico with a Medicare Part D prescribing footprint of 1K claims across 368 beneficiaries — 51% brand-name prescribing . Their CMS MIPS Final Score of 30/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $155.23 across 5 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: ELENA JIMENEZ, MD reported a CMS MIPS final score of 30 out of 100, below the 83.1 national average, and filed 1,325 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)

ELENA JIMENEZ, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting — signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).

ELENA JIMENEZ, MD at a glance

Below national average

NPI registry status

Active

Issued 11/21/2006

NPI 1003981804

Primary specialty

Ophthalmology Physician

Mid-sized

22,090 US NPIs in this specialty

Medicare Part D claims

1,325 7% vs specialty avg

2023 prescription claims

Specialty avg: 1,420

MIPS final score

30/100 53.099999999999994% pts

Below average band

vs 83.1 national avg

Specialty distribution in Puerto Rico

How Ophthalmology Physician compares to other specialties among Puerto Rico providers

Puerto Rico providers

Ophthalmology Physician share within Puerto Rico

1. Ophthalmology Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Ophthalmology Physician share within Puerto Rico

Medicare quality performance — MIPS

ELENA JIMENEZ, MD's 2023 MIPS final score plotted against the Ophthalmology Physician national average

Below national average
MIPS Final Score
30/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Ophthalmology Physician) — 30/100 vs national avg 83.1

0%100%National avg83%30%
MIPS final score (Ophthalmology Physician) — 30/100 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).

ELENA JIMENEZ, MD is a Ophthalmology Physician provider practicing in SAN JUAN, Puerto Rico, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: MD. NPI: 1003981804. 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.

ELENA JIMENEZ, MD appears in the CMS NPPES registry as a Ophthalmology Physician provider holding MD credentials at 735 AVE PONCE DE LEON STE 503, SAN JUAN, PR, 00917, with a listed phone of (787) 510-7880. NPI 1003981804 was issued on 11/21/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what JIMENEZ 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 1,325 prescription claims written by this provider, covering 368 Medicare beneficiaries and totaling roughly $116K in drug spend, split 51% brand-name and 49% 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 30/100 for the 2023 performance year (Quality 0, Cost 100), compared with the national average of 83.1.

Ophthalmology Physician is a mid-sized specialty nationwide, with 22,090 enrolled providers across 56 states and an average of 1,420 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

735 AVE PONCE DE LEON STE 503
SAN JUAN, PR 00917

Provider Details

NPI 1003981804
Specialty Ophthalmology Physician
Credentials MD
Gender Female
NPI Issued 11/21/2006

CMS Quality Score (MIPS)

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

30
Final Score
Avg: 83.1
0
Quality
100
Cost

Reporting: Individual

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 ELENA JIMENEZ, MD. Source: openpaymentsdata.cms.gov.

Total received

$155

Largest payer

Amgen 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.

Brand vs generic prescribing mix · Brand-heavy

ELENA JIMENEZ, MD — brand share 51.0%
Specialty average (est.)

51% brand-name claims vs 49% generic, on 1,325 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.

1,325
Total Claims
$116K
Total Drug Cost
368
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
1,491
Total Day Supply
37,575
Brand vs Generic
51% brand / 49% generic
Brand Drug Cost
$94K
Generic Drug Cost
$22K

Patient Demographics

Average Patient Age
74.8 years
Avg HCC Risk Score
1.41
Gender Split
68% female / 32% male
Age Distribution
<65: 19, 65-74: 159, 75-84: 159, 85+: 31

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Prednisolone Acetate
327
Ofloxacin
231
Latanoprost
183
Lumigan
Bimatoprost
123
Brimonidine Tartrate-Timolol
Brimonidine Tartrate/Timolol
86
Alphagan P
Brimonidine Tartrate
63
Brimonidine Tartrate
62
Tobramycin-Dexamethasone
Tobramycin/Dexamethasone
56
Timolol Maleate
37
Combigan
Brimonidine Tartrate/Timolol
31

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

Ophthalmology Physician Overview

How ELENA JIMENEZ, MD fits within the Ophthalmology Physician landscape nationally.

22,090
Ophthalmology Physician Providers in US
56
States with Ophthalmology Physician
1,420
Avg Claims per Provider

ELENA JIMENEZ, MD's 1,325 claims are below the specialty average of 1,420.

Nearby Ophthalmology Physician Providers in Puerto Rico

Other clinicians with the same primary specialty enrolled in Puerto Rico, drawn from the same CMS NPPES roster as JIMENEZ.

Compare Ophthalmology Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is ELENA JIMENEZ, MD's specialty?
ELENA JIMENEZ, MD specializes in Ophthalmology Physician and practices in SAN JUAN, Puerto Rico. Credentials: MD.
How much does ELENA JIMENEZ, MD prescribe under Medicare Part D?
In 2023, ELENA JIMENEZ, MD wrote 1,325 Medicare Part D claims totaling $116K in drug costs for 368 beneficiaries.
What is ELENA JIMENEZ, MD's Medicare quality score?
ELENA JIMENEZ, MD has a CMS MIPS Final Score of 30/100 (Quality: 0, Cost: 100). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is ELENA JIMENEZ, MD located?
ELENA JIMENEZ, MD is located at 735 AVE PONCE DE LEON STE 503, SAN JUAN, PR, 00917. Phone: (787) 510-7880.
What is ELENA JIMENEZ, MD's NPI number?
ELENA JIMENEZ, MD's National Provider Identifier (NPI) is 1003981804, issued on 11/21/2006.
Does ELENA JIMENEZ, MD prescribe more brand-name or generic drugs?
ELENA JIMENEZ, MD's prescribing is 51% brand-name and 49% generic drugs by claim count, with $94K in brand drug costs.
How many Ophthalmology Physician providers are there in the US?
There are 22,090 Ophthalmology Physician providers across 56 states in the US. The average Ophthalmology Physician provider writes 1,420 Medicare Part D claims per year.
What drugs does ELENA JIMENEZ, MD prescribe most often?
Based on 2023 Medicare Part D data, ELENA JIMENEZ, MD's most frequently prescribed drugs include Prednisolone Acetate, Ofloxacin, Latanoprost. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does ELENA JIMENEZ, MD accept Medicare?
ELENA JIMENEZ, MD appears in CMS Medicare data with 1,325 Part D claims and 368 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify ELENA JIMENEZ, MD's credentials?
ELENA JIMENEZ, MD's NPI is 1003981804 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

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