2026 NPPES data Sports Medicine (Orthopaedic Surgery) Physician NPI 1174051254 MD
Verify on CMS →

ERIC PRIDGEN, MD

Sports Medicine (Orthopaedic Surgery) Physician in LEHIGHTON, Pennsylvania. 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
20
Medicare Part D claims · 18 beneficiaries · Sports Medicine (Orthopaedic Surgery) Physician avg: 278
MIPS score
95.6426/100
▲ 13 pts above national avg 83.1 · [object Object]
Industry payments
$208.43
4 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: ERIC PRIDGEN, MD is a Sports Medicine (Orthopaedic Surgery) Physician ([object Object]) practicing in LEHIGHTON, Pennsylvania with a Medicare Part D prescribing footprint of 20 claims across 18 beneficiaries . Their CMS MIPS Final Score of 95.6426/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $208.43 across 4 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: ERIC PRIDGEN, MD reported a CMS MIPS final score of 95.6426 out of 100, above the 83.1 national average, and filed 20 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)

ERIC PRIDGEN, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 2 hospital affiliations — signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).

ERIC PRIDGEN, MD at a glance

High performer (top quartile)

NPI registry status

Active

Issued 06/01/2017

NPI 1174051254

Primary specialty

Sports Medicine (Orthopaedic Surgery) Physician

Niche

2,681 US NPIs in this specialty

Medicare Part D claims

20 93% vs specialty avg

2023 prescription claims

Specialty avg: 278

MIPS final score

95.6426/100 12.542600000000007% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Pennsylvania

How Sports Medicine (Orthopaedic Surgery) Physician compares to other specialties among Pennsylvania providers

Pennsylvania providers

Sports Medicine (Orthopaedic Surgery) Physician share within Pennsylvania

1. Sports Medicine (Orthopaedic Surgery) Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Sports Medicine (Orthopaedic Surgery) Physician share within Pennsylvania

Medicare quality performance — MIPS

ERIC PRIDGEN, MD's 2023 MIPS final score plotted against the Sports Medicine (Orthopaedic Surgery) Physician national average

High performer (top quartile)
MIPS Final Score
95.6426/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Sports Medicine (Orthopaedic Surgery) Physician) — 95.6426/100 vs national avg 83.1

0%100%National avg83%95.6%
MIPS final score (Sports Medicine (Orthopaedic Surgery) Physician) — 95.6426/100 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).

ERIC PRIDGEN, MD is a Sports Medicine (Orthopaedic Surgery) Physician provider practicing in LEHIGHTON, Pennsylvania, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: MD. NPI: 1174051254. 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.

ERIC PRIDGEN, MD appears in the CMS NPPES registry as a Sports Medicine (Orthopaedic Surgery) Physician provider holding MD credentials at 575 S 9TH ST STE 5, LEHIGHTON, PA, 18235, with a listed phone of (484) 526-1735. NPI 1174051254 was issued on 06/01/2017. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what PRIDGEN 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 20 prescription claims written by this provider, covering 18 Medicare beneficiaries and totaling roughly $118 in drug spend. 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 95.6426/100 for the 2023 performance year (Quality 80.5735), compared with the national average of 83.1.

Sports Medicine (Orthopaedic Surgery) Physician is a narrow specialty nationwide, with 2,681 enrolled providers across 53 states and an average of 278 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

575 S 9TH ST STE 5
LEHIGHTON, PA 18235

Provider Details

NPI 1174051254
Specialty Sports Medicine (Orthopaedic Surgery) Physician
Credentials MD
Gender Male
NPI Issued 06/01/2017

CMS Quality Score (MIPS)

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

95.6426
Final Score
Avg: 83.1
80.5735
Quality
100
Promoting Interoperability

Reporting: Alternative Payment Model

Hospital and facility affiliations

Facilities where ERIC PRIDGEN, 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.

GSLPG, INC
ORWIGSBURG, PA
ST LUKES PHYSICIAN GROUP INC
PALMERTON, PA

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 ERIC PRIDGEN, MD. Source: openpaymentsdata.cms.gov.

Total received

$208

Largest payer

Vericel 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.

License & disciplinary context — Pennsylvania PA-BOM 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 ~45K Pennsylvania medical licensees in 2023 — they are NOT specific to ERIC PRIDGEN, MD. To verify ERIC PRIDGEN, MD's current license status, search the PA-BOM public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

133
Total board actions, Pennsylvania 2023
Across 129 cases
2.96
Actions per 1,000 licensees
Pennsylvania statewide rate
probation
Most common action type
48 cases

PA-BOM 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 Pennsylvania disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

20
Total Claims
$118
Total Drug Cost
18
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
22
Total Day Supply
414
Brand Drug Cost
$0
Generic Drug Cost
$118

Patient Demographics

Average Patient Age
69.4 years
Avg HCC Risk Score
0.90

Sports Medicine (Orthopaedic Surgery) Physician Overview

How ERIC PRIDGEN, MD fits within the Sports Medicine (Orthopaedic Surgery) Physician landscape nationally.

2,681
Sports Medicine (Orthopaedic Surgery) Physician Providers in US
53
States with Sports Medicine (Orthopaedic Surgery) Physician
278
Avg Claims per Provider

ERIC PRIDGEN, MD's 20 claims are below the specialty average of 278.

Nearby Sports Medicine (Orthopaedic Surgery) Physician Providers in Pennsylvania

Other clinicians with the same primary specialty enrolled in Pennsylvania, drawn from the same CMS NPPES roster as PRIDGEN.

Compare Sports Medicine (Orthopaedic Surgery) Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is ERIC PRIDGEN, MD's specialty?
ERIC PRIDGEN, MD specializes in Sports Medicine (Orthopaedic Surgery) Physician and practices in LEHIGHTON, Pennsylvania. Credentials: MD.
How much does ERIC PRIDGEN, MD prescribe under Medicare Part D?
In 2023, ERIC PRIDGEN, MD wrote 20 Medicare Part D claims totaling $118 in drug costs for 18 beneficiaries.
What is ERIC PRIDGEN, MD's Medicare quality score?
ERIC PRIDGEN, MD has a CMS MIPS Final Score of 95.6426/100 (Quality: 80.5735). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is ERIC PRIDGEN, MD located?
ERIC PRIDGEN, MD is located at 575 S 9TH ST STE 5, LEHIGHTON, PA, 18235. Phone: (484) 526-1735.
What is ERIC PRIDGEN, MD's NPI number?
ERIC PRIDGEN, MD's National Provider Identifier (NPI) is 1174051254, issued on 06/01/2017.
How many Sports Medicine (Orthopaedic Surgery) Physician providers are there in the US?
There are 2,681 Sports Medicine (Orthopaedic Surgery) Physician providers across 53 states in the US. The average Sports Medicine (Orthopaedic Surgery) Physician provider writes 278 Medicare Part D claims per year.
Does ERIC PRIDGEN, MD accept Medicare?
ERIC PRIDGEN, MD appears in CMS Medicare data with 20 Part D claims and 18 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify ERIC PRIDGEN, MD's credentials?
ERIC PRIDGEN, MD's NPI is 1174051254 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