2026 NPPES data Ophthalmology Physician NPI 1295736452 M.D.
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JOSE MATOS, M.D.

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
3K
Medicare Part D claims · 624 beneficiaries · Ophthalmology Physician avg: 1K
Generic prescribing
61%
generic claims · 39% brand-name · higher generic rates reduce patient out-of-pocket costs
Industry payments
$86.16
2 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: JOSE MATOS, M.D. is a Ophthalmology Physician ([object Object]) practicing in SAN JUAN, Puerto Rico with a Medicare Part D prescribing footprint of 3K claims across 624 beneficiaries — 39% brand-name prescribing . Industry payments of $86.16 across 2 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: JOSE MATOS, M.D. filed 2,945 Medicare Part D claims in 2023 across SAN JUAN, Puerto Rico. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

Board-eligible specialty (heuristic — not verified)

JOSE MATOS, M.D. practices in an ABMS-board-eligible specialty but we don't have enough CMS-participation signals to confirm active board-certified status. Consult CertificationMatters.org (the official ABMS public lookup).

JOSE MATOS, M.D. at a glance

Quality data not reported

NPI registry status

Active

Issued 08/09/2005

NPI 1295736452

Primary specialty

Ophthalmology Physician

Mid-sized

22,090 US NPIs in this specialty

Medicare Part D claims

2,945 107% vs specialty avg

2023 prescription claims

Specialty avg: 1,420

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

Specialty board-certification context

Estimated specialty board-certified rate — Ophthalmology Physician (ABMS / AOA reference)

Quality data not reported
Est. board-certified rate
78%
Ophthalmology Physician ABMS/AOA estimate

Est. board-certified rate (Ophthalmology Physician) — ABMS / AOA estimate

0%100%78%
Est. board-certified rate (Ophthalmology Physician) — ABMS / AOA estimate

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).

JOSE MATOS, M.D. is a Ophthalmology Physician provider practicing in SAN JUAN, Puerto Rico, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: M.D.. NPI: 1295736452. 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.

JOSE MATOS, M.D. appears in the CMS NPPES registry as a Ophthalmology Physician provider holding M.D. credentials at EDIF CAPITAL CENTER I, SAN JUAN, PR, 00918, with a listed phone of (787) 281-0030. NPI 1295736452 was issued on 08/09/2005. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what MATOS 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 2,945 prescription claims written by this provider, covering 624 Medicare beneficiaries and totaling roughly $291K in drug spend, split 39% brand-name and 61% 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.

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

EDIF CAPITAL CENTER I
SAN JUAN, PR 00918

Provider Details

NPI 1295736452
Specialty Ophthalmology Physician
Credentials M.D.
Gender Male
NPI Issued 08/09/2005

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 JOSE MATOS, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$86

Largest payer

RxSight 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 · Above average

JOSE MATOS, M.D. — brand share 39.0%
Specialty average (est.)

39% brand-name claims vs 61% generic, on 2,945 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.

2,945
Total Claims
$291K
Total Drug Cost
624
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
3,540
Total Day Supply
82,244
Brand vs Generic
39% brand / 61% generic
Brand Drug Cost
$223K
Generic Drug Cost
$68K
Antibiotic Claims
94

Patient Demographics

Average Patient Age
75.5 years
Avg HCC Risk Score
1.34
Gender Split
64% female / 36% male
Age Distribution
<65: 15, 65-74: 278, 75-84: 254, 85+: 77

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Latanoprost
536
Tobramycin-Dexamethasone
Tobramycin/Dexamethasone
487
Lumigan
Bimatoprost
332
Erythromycin
Erythromycin Base
237
Acetazolamide
229
Brimonidine Tartrate-Timolol
Brimonidine Tartrate/Timolol
174
Combigan
Brimonidine Tartrate/Timolol
139
Fluorometholone
93
Ketorolac Tromethamine
87
Doxycycline Monohydrate
86

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

Ophthalmology Physician Overview

How JOSE MATOS, M.D. 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

JOSE MATOS, M.D.'s 2,945 claims are above 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 MATOS.

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

Frequently Asked Questions

What is JOSE MATOS, M.D.'s specialty?
JOSE MATOS, M.D. specializes in Ophthalmology Physician and practices in SAN JUAN, Puerto Rico. Credentials: M.D..
How much does JOSE MATOS, M.D. prescribe under Medicare Part D?
In 2023, JOSE MATOS, M.D. wrote 2,945 Medicare Part D claims totaling $291K in drug costs for 624 beneficiaries.
Where is JOSE MATOS, M.D. located?
JOSE MATOS, M.D. is located at EDIF CAPITAL CENTER I, SAN JUAN, PR, 00918. Phone: (787) 281-0030.
What is JOSE MATOS, M.D.'s NPI number?
JOSE MATOS, M.D.'s National Provider Identifier (NPI) is 1295736452, issued on 08/09/2005.
Does JOSE MATOS, M.D. prescribe more brand-name or generic drugs?
JOSE MATOS, M.D.'s prescribing is 39% brand-name and 61% generic drugs by claim count, with $223K 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 JOSE MATOS, M.D. prescribe most often?
Based on 2023 Medicare Part D data, JOSE MATOS, M.D.'s most frequently prescribed drugs include Latanoprost, Tobramycin-Dexamethasone, Lumigan. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does JOSE MATOS, M.D. accept Medicare?
JOSE MATOS, M.D. appears in CMS Medicare data with 2,945 Part D claims and 624 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify JOSE MATOS, M.D.'s credentials?
JOSE MATOS, M.D.'s NPI is 1295736452 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.
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