2026 NPPES data Ophthalmology Physician NPI 1790216778 M.D.
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JUSTIN GAGEL, M.D.

Ophthalmology Physician in LEXINGTON, Kentucky. 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 · 339 beneficiaries · Ophthalmology Physician avg: 1K
Generic prescribing
59%
generic claims · 41% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
47.9647/100
▼ 35 pts below national avg 83.1 · [object Object]
Industry payments
$709.38
33 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

JUSTIN GAGEL, M.D. reported a CMS MIPS final score of 47.9647/100 — below the 83.1 national average — and filed 1,018 Medicare Part D claims in 2023.

47.9647/100
MIPS score · -35 vs avg
1K
Part D claims, 2023
59%
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.

JUSTIN GAGEL, M.D.'s MIPS score vs every scored U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023 — the federal quality measure

48 4th percentile higher than 4% of 477,587 scored providers

0–10: 8,684 scored providers (2%). Below this entry. 10–20: 3,008 scored providers (1%). Below this entry. 20–30: 3,069 scored providers (1%). Below this entry. 30–40: 2,746 scored providers (1%). Below this entry. 40–50: 2,928 scored providers (1%). This entry sits in this band. 50–60: 5,882 scored providers (1%). Above this entry. 60–70: 13,906 scored providers (3%). Above this entry. 70–80: 118,074 scored providers (25%). Above this entry. 80–90: 129,887 scored providers (27%). Above this entry. 90–100: 189,403 scored providers (40%). Above this entry. This provider 0 100 every MIPS-scored clinician, bucketed by value

Each bar is a band; taller bars hold more scored 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.

Source CMS Merit-based Incentive Payment System (MIPS) · 2023

Board certification likely (heuristic — not verified)

JUSTIN GAGEL, 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).

What does the federal data show about JUSTIN GAGEL, M.D.?

Below national average

NPI registry status

Active

Issued 03/22/2017

NPI 1790216778

Primary specialty

Ophthalmology Physician

Mid-sized

22,090 US NPIs in this specialty

Medicare Part D claims

1,018 28% vs specialty avg

2023 prescription claims

Specialty avg: 1,420

MIPS final score

47.9647/100 35.135299999999994% pts

Below average band

vs 83.1 national avg

Specialty distribution in Kentucky

How Ophthalmology Physician compares to other specialties among Kentucky providers

Kentucky providers

Ophthalmology Physician share within Kentucky

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

Medicare quality performance — MIPS

JUSTIN GAGEL, M.D.'s 2023 MIPS final score plotted against the Ophthalmology Physician national average

Below national average
MIPS Final Score
47.9647/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Ophthalmology Physician) — 47.9647/100 vs national avg 83.1

0%100%National avg83%48%
MIPS final score (Ophthalmology Physician) — 47.9647/100 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).

JUSTIN GAGEL, M.D. appears in the CMS NPPES registry as a Ophthalmology Physician provider holding M.D. credentials at 900 S LIMESTONE CTW 304, LEXINGTON, KY, 40536, with a listed phone of (859) 323-9918. NPI 1790216778 was issued on 03/22/2017. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what GAGEL 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 1,018 prescription claims written by this provider, covering 339 Medicare beneficiaries and totaling roughly $151K in drug spend, split 41% brand-name and 59% 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 47.9647/100 for the 2023 performance year (Quality 90.8795, Cost 19.003), 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

900 S LIMESTONE CTW 304
LEXINGTON, KY 40536

Provider Details

NPI 1790216778
Specialty Ophthalmology Physician
Credentials M.D.
Gender Male
NPI Issued 03/22/2017

CMS Quality Score (MIPS)

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

47.9647
Final Score
Avg: 83.1
90.8795
Quality
19.003
Cost
0
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where JUSTIN GAGEL, 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.

UNIVERSITY EYE SPECIALISTS, P.C.
KNOXVILLE, TN

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 JUSTIN GAGEL, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$709

Largest payer

Tarsus 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 · Above average

JUSTIN GAGEL, M.D. — brand share 41.0%
Specialty average (est.)

41% brand-name claims vs 59% generic, on 1,018 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.

1,018
Total Claims
$151K
Total Drug Cost
339
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
1,651
Total Day Supply
44,936
Brand vs Generic
41% brand / 59% generic
Brand Drug Cost
$134K
Generic Drug Cost
$16K
Antibiotic Claims
35

Patient Demographics

Average Patient Age
73.9 years
Avg HCC Risk Score
1.19
Gender Split
59% female / 41% male
Age Distribution
<65: 25, 65-74: 169, 75-84: 115, 85+: 30

Top Prescribed Drugs (Medicare Part D)

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

What JUSTIN GAGEL, M.D. prescribes most

Top Medicare Part D drugs by claim count, 2023

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2023
Drug Claims
Latanoprost
265
Prednisolone Acetate
160
Dorzolamide-Timolol
Dorzolamide Hcl/Timolol Maleat
71
Ketorolac Tromethamine
55
Timolol Maleate
52
Ofloxacin
46
Neomycin-Polymyxin-Dexameth
Neomycin/Polymyxin B/Dexametha
44
Restasis
Cyclosporine
42
Alphagan P
Brimonidine Tartrate
33
Brimonidine Tartrate
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 JUSTIN GAGEL, 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

JUSTIN GAGEL, M.D.'s 1,018 claims are below the specialty average of 1,420.

Nearby Ophthalmology Physician Providers in Kentucky

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

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

Frequently Asked Questions

What is JUSTIN GAGEL, M.D.'s specialty?
JUSTIN GAGEL, M.D. specializes in Ophthalmology Physician and practices in LEXINGTON, Kentucky. Credentials: M.D..
How much does JUSTIN GAGEL, M.D. prescribe under Medicare Part D?
In 2023, JUSTIN GAGEL, M.D. wrote 1,018 Medicare Part D claims totaling $151K in drug costs for 339 beneficiaries.
What is JUSTIN GAGEL, M.D.'s Medicare quality score?
JUSTIN GAGEL, M.D. has a CMS MIPS Final Score of 47.9647/100 (Quality: 90.8795, Cost: 19.003). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is JUSTIN GAGEL, M.D. located?
JUSTIN GAGEL, M.D. is located at 900 S LIMESTONE CTW 304, LEXINGTON, KY, 40536. Phone: (859) 323-9918.
What is JUSTIN GAGEL, M.D.'s NPI number?
JUSTIN GAGEL, M.D.'s National Provider Identifier (NPI) is 1790216778, issued on 03/22/2017.
Does JUSTIN GAGEL, M.D. prescribe more brand-name or generic drugs?
JUSTIN GAGEL, M.D.'s prescribing is 41% brand-name and 59% generic drugs by claim count, with $134K 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 JUSTIN GAGEL, M.D. prescribe most often?
Based on 2023 Medicare Part D data, JUSTIN GAGEL, M.D.'s most frequently prescribed drugs include Latanoprost, Prednisolone Acetate, Dorzolamide-Timolol. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does JUSTIN GAGEL, M.D. accept Medicare?
JUSTIN GAGEL, M.D. appears in CMS Medicare data with 1,018 Part D claims and 339 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify JUSTIN GAGEL, M.D.'s credentials?
JUSTIN GAGEL, M.D.'s NPI is 1790216778 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