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2026 NPPES data Sleep Medicine (Internal Medicine) Physician NPI 1376768739 M.D.
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James Nelson, M.D.

Sleep Medicine (Internal Medicine) Physician in St Thomas, Virgin Islands.

This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 932 in Sleep Medicine (Internal Medicine) 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 · 325 beneficiaries · Sleep Medicine (Internal Medicine) Physician avg: 1K
Generic prescribing
85%
generic claims · 14% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
30/100
▼ 54 pts below national avg 83.5 · Below average
Industry payments
$21.15
1 payments · CMS Open Payments (Sunshine Act)
Verify NPI on CMS Methodology
Compiled from official public sources by the editorial process.

What the federal data shows

James Nelson, M.D. reported a CMS MIPS final score of 30/100 - below the 83.5 national average - and filed 5,400 Medicare Part D claims in 2024.

30/100
MIPS score · -53 vs avg
5K
Part D claims, 2024
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.

Federal trust snapshot

What official records show about James Nelson, M.D.

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 1376768739), first enumerated 04/13/2007.

    Source: CMS NPPES

  • Reported

    Medicare Part D participation

    Filed 5,400 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 30/100 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.

    Source: NUCC taxonomy + CMS participation heuristic

  • Reported

    Industry payment transparency

    $21.15 in reported industry payments (1 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 1376768739 · Sleep Medicine (Internal Medicine) Physician

NPI-10 · ENUM-MID · TAX-NARROW · MIPS-LOW · RX-MID · BOOK-THIN · PHOTO-FINISH

  • NPI-10 1376768739
  • ENUM-MID 2007
  • TAX-NARROW 932
  • MIPS-LOW 30/100
  • RX-MID 5,400
  • BOOK-THIN 1 in Virgin Islands
  • PHOTO-FINISH Jaime Avecillas, MD · ±0.2

MIPS final-score neighbourhood

Same-specialty nationwide peers by CMS final score, not geographic proximity

MIPS pts

What this shows Nearest measured MIPS peers for this NUCC specialty (2023 performance year).

Source CMS Quality Payment Program (MIPS) As of 2023

James Nelson, M.D.'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.

30 ≥ 3rd percentile 3% of 454,083 measured providers are in lower value bands

0–10: 8,684 measured providers (2%). Below this entry. 10–20: 3,008 measured providers (1%). Below this entry. 20–30: 3,069 measured providers (1%). Below this entry. 30–40: 2,746 measured providers (1%). This entry sits in this band. 40–50: 2,928 measured providers (1%). Above this entry. 50–60: 5,882 measured providers (1%). Above this entry. 60–70: 13,906 measured providers (3%). Above this entry. 70–80: 94,570 measured providers (21%). Above this entry. 80–90: 129,887 measured providers (29%). Above this entry. 90+: 189,403 measured providers (42%). Above this entry. This provider 0 100 every measured MIPS clinician, bucketed by value

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 James Nelson, M.D. sits

This provider among sleep medicine (internal medicine) physician peers

Across the 274 sleep medicine (internal medicine) physician providers who report both Medicare Part D prescribing and a MIPS quality score, James Nelson, M.D. writes more Part D claims than 95% of them and scores higher on MIPS quality than 5% - placing this provider in the high-volume, lower-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.

Lower volume · High qualityHigh volume · High qualityLower volume · Lower qualityHigh volume · Lower quality02550751000255075100Part D claim volume, percentile in specialtyMIPS quality, percentilePoint, Part D claim volume, percentile in specialty: 57 · MIPS quality, percentile: 100Point, Part D claim volume, percentile in specialty: 72 · MIPS quality, percentile: 47Point, Part D claim volume, percentile in specialty: 97 · MIPS quality, percentile: 15Point, Part D claim volume, percentile in specialty: 70 · MIPS quality, percentile: 72Point, Part D claim volume, percentile in specialty: 23 · MIPS quality, percentile: 37Point, Part D claim volume, percentile in specialty: 87 · MIPS quality, percentile: 17Point, Part D claim volume, percentile in specialty: 98 · MIPS quality, percentile: 62Point, Part D claim volume, percentile in specialty: 28 · MIPS quality, percentile: 80Point, Part D claim volume, percentile in specialty: 2 · MIPS quality, percentile: 23Point, Part D claim volume, percentile in specialty: 73 · MIPS quality, percentile: 48Point, Part D claim volume, percentile in specialty: 88 · MIPS quality, percentile: 57Point, Part D claim volume, percentile in specialty: 15 · MIPS quality, percentile: 78Point, Part D claim volume, percentile in specialty: 62 · MIPS quality, percentile: 63Point, Part D claim volume, percentile in specialty: 53 · MIPS quality, percentile: 90Point, Part D claim volume, percentile in specialty: 42 · MIPS quality, percentile: 33Point, Part D claim volume, percentile in specialty: 47 · MIPS quality, percentile: 95Point, Part D claim volume, percentile in specialty: 60 · MIPS quality, percentile: 10Point, Part D claim volume, percentile in specialty: 18 · MIPS quality, percentile: 75Point, Part D claim volume, percentile in specialty: 77 · MIPS quality, percentile: 88Point, Part D claim volume, percentile in specialty: 45 · MIPS quality, percentile: 65Point, Part D claim volume, percentile in specialty: 63 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 68 · MIPS quality, percentile: 68Point, Part D claim volume, percentile in specialty: 38 · MIPS quality, percentile: 8Point, Part D claim volume, percentile in specialty: 83 · MIPS quality, percentile: 42Point, Part D claim volume, percentile in specialty: 30 · MIPS quality, percentile: 58Point, Part D claim volume, percentile in specialty: 37 · MIPS quality, percentile: 28Point, Part D claim volume, percentile in specialty: 75 · MIPS quality, percentile: 22Point, Part D claim volume, percentile in specialty: 65 · MIPS quality, percentile: 38Point, Part D claim volume, percentile in specialty: 52 · MIPS quality, percentile: 30Point, Part D claim volume, percentile in specialty: 78 · MIPS quality, percentile: 45Point, Part D claim volume, percentile in specialty: 12 · MIPS quality, percentile: 27Point, Part D claim volume, percentile in specialty: 82 · MIPS quality, percentile: 53Point, Part D claim volume, percentile in specialty: 10 · MIPS quality, percentile: 60Point, Part D claim volume, percentile in specialty: 43 · MIPS quality, percentile: 92Point, Part D claim volume, percentile in specialty: 25 · MIPS quality, percentile: 83Point, Part D claim volume, percentile in specialty: 90 · MIPS quality, percentile: 18Point, Part D claim volume, percentile in specialty: 50 · MIPS quality, percentile: 3Point, Part D claim volume, percentile in specialty: 85 · MIPS quality, percentile: 20Point, Part D claim volume, percentile in specialty: 7 · MIPS quality, percentile: 13Point, Part D claim volume, percentile in specialty: 95 · MIPS quality, percentile: 92Point, Part D claim volume, percentile in specialty: 55 · MIPS quality, percentile: 98Point, Part D claim volume, percentile in specialty: 80 · MIPS quality, percentile: 75Point, Part D claim volume, percentile in specialty: 17 · MIPS quality, percentile: 5Point, Part D claim volume, percentile in specialty: 67 · MIPS quality, percentile: 2Point, Part D claim volume, percentile in specialty: 32 · MIPS quality, percentile: 97Point, Part D claim volume, percentile in specialty: 40 · MIPS quality, percentile: 12Point, Part D claim volume, percentile in specialty: 48 · MIPS quality, percentile: 23Point, Part D claim volume, percentile in specialty: 20 · MIPS quality, percentile: 38Point, Part D claim volume, percentile in specialty: 0 · MIPS quality, percentile: 87Point, Part D claim volume, percentile in specialty: 100 · MIPS quality, percentile: 55Point, Part D claim volume, percentile in specialty: 58 · MIPS quality, percentile: 73Point, Part D claim volume, percentile in specialty: 8 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 92 · MIPS quality, percentile: 43Point, Part D claim volume, percentile in specialty: 5 · MIPS quality, percentile: 70Point, Part D claim volume, percentile in specialty: 33 · MIPS quality, percentile: 35Point, Part D claim volume, percentile in specialty: 22 · MIPS quality, percentile: 82Point, Part D claim volume, percentile in specialty: 3 · MIPS quality, percentile: 50Point, Part D claim volume, percentile in specialty: 13 · MIPS quality, percentile: 32Point, Part D claim volume, percentile in specialty: 27 · MIPS quality, percentile: 85Point, Part D claim volume, percentile in specialty: 35 · MIPS quality, percentile: 52James Nelson, M.D., Part D claim volume, percentile in specialty: 95 · MIPS quality, percentile: 5
Part D claim volume vs MIPS quality, by specialty percentile

Each dot is one sleep medicine (internal medicine) physician peer from a representative sample of 60; the gold marker is James Nelson, M.D.. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.

✓
Board certification likely (heuristic, not verified)

James Nelson, M.D. 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).

What does the federal data show about James Nelson, M.D.?

Below national average

NPI registry status

Active

Issued 04/13/2007

NPI 1376768739

Primary specialty

Sleep Medicine (Internal Medicine) Physician

Niche

932 US NPIs in this specialty

Medicare Part D claims

5,400 319% vs specialty avg

2024 prescription claims

Specialty avg: 1,288

MIPS final score

30/100 53.5 pts vs avg

Below average band

vs 83.5 national avg

Specialty distribution in Virgin Islands

How Sleep Medicine (Internal Medicine) Physician compares to other specialties among Virgin Islands providers

Virgin Islands providers
Behavior Technician8.7%Physical Therapist5.7%Clinical Social Worker3.6%Pharmacist3.5%Physician Assistant3.2%Chiropractor3.1%Sleep Medicine (Internal Med…0.1%
Largest specialties in Virgin Islands (% of in-state providers)

Medicare quality performance, MIPS

James Nelson, M.D.'s 2023 MIPS final score plotted against the Sleep Medicine (Internal Medicine) Physician national average

Below national average
MIPS Final Score
30/100
vs 83.5 national avg · 2023 performance year
0%100%National avg84%30%
MIPS final score (Sleep Medicine (Internal Medicine) Physician) - 30/100 vs national avg 83.5
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

9003 HAVENSIGHT SHOPP CTR STE 305
St Thomas, VI 00802
(340) 774-3633

Provider Details

NPI 1376768739
Specialty Sleep Medicine (Internal Medicine) Physician
Credentials M.D.
Gender Male
NPI Issued 04/13/2007

CMS Quality Score (MIPS)

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

30
Final Score
Measured-score avg: 83.5
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 James Nelson, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$21

Largest payer

Alexion Pharmaceuticals, 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 · Typical

James Nelson, M.D. - brand share 14.0%
Sleep Medicine (Internal Medicine) Physician average

14% brand-name claims vs 85% generic, on 5,400 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.

5,400
Total Claims
$808K
Total Drug Cost
325
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
8,025.167
Total Day Supply
233,972
Brand vs Generic
14% brand / 85% generic
Brand Drug Cost
$649K
Generic Drug Cost
$157K
Opioid Claims
91 (1.7% rate)
Antibiotic Claims
52

Patient Demographics

Average Patient Age
75.7 years
Avg HCC Risk Score
0.97
Gender Split
63% female / 37% male
Age Distribution
<65: 30, 65-74: 112, 75-84: 135, 85+: 48

Top Prescribed Drugs (Medicare Part D)

Top drugs by claim count for calendar year 2024. Based on Medicare Part D data only.

What James Nelson, M.D. prescribes most

Top Medicare Part D drugs by claim count, 2024

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2024
Drug Claims
Rosuvastatin Calcium
 514
Nifedipine Er
Nifedipine
223
Metoprolol Succinate
 222
Olmesartan-Hydrochlorothiazide
Olmesartan/Hydrochlorothiazide
197
Amlodipine Besylate
 158
Losartan Potassium
 153
Losartan-Hydrochlorothiazide
Losartan/Hydrochlorothiazide
141
Trulicity
Dulaglutide
137
Xarelto
Rivaroxaban
121
Metformin Hcl
 118

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

More Sleep Medicine (Internal Medicine) Physician in VI → All providers in Virgin Islands → Compare specialties →

Sleep Medicine (Internal Medicine) Physician Overview

How James Nelson, M.D. fits within the Sleep Medicine (Internal Medicine) Physician landscape nationally.

932
Sleep Medicine (Internal Medicine) Physician Providers in US
52
States with Sleep Medicine (Internal Medicine) Physician
1,288
Avg Claims per Provider

James Nelson, M.D.'s 5,400 claims are above the specialty average of 1,288.

Nationwide Sleep Medicine (Internal Medicine) Physician peers with similar MIPS or enrollment year

Two federal-record peer sets for Nelson, both outside Virgin Islands so the neighborhoods are not geographic containment.

Similar MIPS final score

Nearest same-specialty clinicians by CMS MIPS final score (30 here).

Jaime Avecillas 30.2 FL Jose Alvarez 26.4 FL Sever Surdulescu 34.5 NC Jagjeet Kalra 23.2 CA

Same NPPES enumeration year (2007)

Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.

Lili Poon Charlotte, NC Allen Denys Warren, MI Jose Jimenez Casso Bayamon, PR Charles Gensmer Coon Rapids, MN

Frequently Asked Questions

What is James Nelson, M.D.'s specialty? ▼
James Nelson, M.D. specializes in Sleep Medicine (Internal Medicine) Physician and practices in St Thomas, Virgin Islands. Credentials: M.D..
How much does James Nelson, M.D. prescribe under Medicare Part D? ▼
In 2024, James Nelson, M.D. wrote 5,400 Medicare Part D claims totaling $808K in drug costs for 325 beneficiaries.
What is James Nelson, M.D.'s Medicare quality score? ▼
James Nelson, M.D. has a CMS MIPS Final Score of 30/100 (Quality: 0, Cost: 100). 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 James Nelson, M.D. located? ▼
James Nelson, M.D. is located at 9003 HAVENSIGHT SHOPP CTR STE 305, St Thomas, VI, 00802. Phone: (340) 774-3633.
What is James Nelson, M.D.'s NPI number? ▼
James Nelson, M.D.'s National Provider Identifier (NPI) is 1376768739, issued on 04/13/2007.
Does James Nelson, M.D. prescribe more brand-name or generic drugs? ▼
James Nelson, M.D.'s prescribing is 14% brand-name and 85% generic drugs by claim count, with $649K in brand drug costs.
Does James Nelson, M.D. prescribe opioids? ▼
Yes, James Nelson, M.D. had 91 opioid claims in 2024 with an opioid prescribing rate of 1.7%.
How many Sleep Medicine (Internal Medicine) Physician providers are there in the US? ▼
There are 932 Sleep Medicine (Internal Medicine) Physician providers across 52 states in the US. The average Sleep Medicine (Internal Medicine) Physician provider writes 1,288 Medicare Part D claims per year.
What drugs does James Nelson, M.D. prescribe most often? ▼
Based on 2024 Medicare Part D data, James Nelson, M.D.'s most frequently prescribed drugs include Rosuvastatin Calcium, Nifedipine Er, Metoprolol Succinate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does James Nelson, M.D. accept Medicare? ▼
James Nelson, M.D. appears in CMS Medicare data with 5,400 Part D claims and 325 Medicare beneficiaries in 2024. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify James Nelson, M.D.'s credentials? ▼
James Nelson, M.D.'s NPI is 1376768739 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

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

Compiled from official public sources by the editorial process.

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.