2026 NPPES data Neurological Surgery Physician NPI 1699752048 M.D.
Verify on CMS →

KHALID SETHI, M.D.

Neurological Surgery Physician in VESTAL, New York. 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
726
Medicare Part D claims · 406 beneficiaries · Neurological Surgery Physician avg: 181
Generic prescribing
98%
generic claims · 2% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
90.3495/100
▲ 7 pts above national avg 83.1 · [object Object]
Industry payments
$974.68
35 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

KHALID SETHI, M.D. reported a CMS MIPS final score of 90.3495/100 — above the 83.1 national average — and filed 726 Medicare Part D claims in 2023.

90.3495/100
MIPS score · +7 vs avg
726
Part D claims, 2023
98%
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.

KHALID SETHI, 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

90 Top 40% higher than 60% 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%). Below this entry. 50–60: 5,882 scored providers (1%). Below this entry. 60–70: 13,906 scored providers (3%). Below this entry. 70–80: 118,074 scored providers (25%). Below this entry. 80–90: 129,887 scored providers (27%). Below this entry. 90–100: 189,403 scored providers (40%). This entry sits in this band. 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)

KHALID SETHI, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 3 hospital affiliations — 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 KHALID SETHI, M.D.?

High performer (top quartile)

NPI registry status

Active

Issued 12/28/2005

NPI 1699752048

Primary specialty

Neurological Surgery Physician

Mid-sized

8,100 US NPIs in this specialty

Medicare Part D claims

726 301% vs specialty avg

2023 prescription claims

Specialty avg: 181

MIPS final score

90.3495/100 7.249500000000012% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in New York

How Neurological Surgery Physician compares to other specialties among New York providers

New York providers

Neurological Surgery Physician share within New York

1. Neurological Surgery Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Neurological Surgery Physician share within New York

Medicare quality performance — MIPS

KHALID SETHI, M.D.'s 2023 MIPS final score plotted against the Neurological Surgery Physician national average

High performer (top quartile)
MIPS Final Score
90.3495/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Neurological Surgery Physician) — 90.3495/100 vs national avg 83.1

0%100%National avg83%90.3%
MIPS final score (Neurological Surgery Physician) — 90.3495/100 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).

KHALID SETHI, M.D. appears in the CMS NPPES registry as a Neurological Surgery Physician provider holding M.D. credentials at 1020 VESTAL PKWY E, VESTAL, NY, 13850, with a listed phone of (607) 444-6868. NPI 1699752048 was issued on 12/28/2005. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what SETHI 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 726 prescription claims written by this provider, covering 406 Medicare beneficiaries and totaling roughly $12K in drug spend, split 2% brand-name and 98% generic by claim count, with an opioid prescribing rate of 13.4%. 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 90.3495/100 for the 2023 performance year (Quality 80.699), compared with the national average of 83.1.

Neurological Surgery Physician is a mid-sized specialty nationwide, with 8,100 enrolled providers across 53 states and an average of 181 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

1020 VESTAL PKWY E
VESTAL, NY 13850

Provider Details

NPI 1699752048
Specialty Neurological Surgery Physician
Credentials M.D.
Gender Male
NPI Issued 12/28/2005

CMS Quality Score (MIPS)

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

90.3495
Final Score
Avg: 83.1
80.699
Quality
100
Promoting Interoperability

Reporting: Alternative Payment Model

Hospital and facility affiliations

Facilities where KHALID SETHI, 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.

GUTHRIE MEDICAL GROUP PC
SAYRE, PA
NEUROSCIENCES HEALTHCARE MEDICINE, PC
VESTAL, NY
OUR LADY OF LOURDES MEMORIAL HOSPITAL INC
BINGHAMTON, NY

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 KHALID SETHI, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$975

Largest payer

Intrinsic Therapeutics

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 — New York NYSBPMC 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 ~100K New York medical licensees in 2023 — they are NOT specific to KHALID SETHI, M.D.. To verify KHALID SETHI, M.D.'s current license status, search the NYSBPMC public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

312
Total board actions, New York 2023
Across 302 cases
3.12
Actions per 1,000 licensees
New York statewide rate
probation
Most common action type
89 cases

NYSBPMC 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 New York disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Generic-heavy

KHALID SETHI, M.D. — brand share 2.0%
Specialty average (est.)

2% brand-name claims vs 98% generic, on 726 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.

726
Total Claims
$12K
Total Drug Cost
406
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
770
Total Day Supply
14,056
Brand vs Generic
2% brand / 98% generic
Brand Drug Cost
$5K
Generic Drug Cost
$7K
Opioid Claims
97 (13.4% rate)
Antibiotic Claims
80

Patient Demographics

Average Patient Age
68.9 years
Avg HCC Risk Score
1.25
Gender Split
53% female / 47% male
Age Distribution
<65: 105, 65-74: 169, 75-84: 108, 85+: 24

Top Prescribed Drugs (Medicare Part D)

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

What KHALID SETHI, 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
Gabapentin
157
Dexamethasone
86
Methylprednisolone
65
Doxycycline Hyclate
62
Nortriptyline Hcl
42
Oxycodone-Acetaminophen
Oxycodone Hcl/Acetaminophen
35
Tizanidine Hcl
34
Tramadol Hcl
26
Cyclobenzaprine Hcl
23
Diclofenac Sodium
23

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

Neurological Surgery Physician Overview

How KHALID SETHI, M.D. fits within the Neurological Surgery Physician landscape nationally.

8,100
Neurological Surgery Physician Providers in US
53
States with Neurological Surgery Physician
181
Avg Claims per Provider

KHALID SETHI, M.D.'s 726 claims are above the specialty average of 181.

Nearby Neurological Surgery Physician Providers in New York

Other clinicians with the same primary specialty enrolled in New York, drawn from the same CMS NPPES roster as SETHI.

Compare Neurological Surgery Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is KHALID SETHI, M.D.'s specialty?
KHALID SETHI, M.D. specializes in Neurological Surgery Physician and practices in VESTAL, New York. Credentials: M.D..
How much does KHALID SETHI, M.D. prescribe under Medicare Part D?
In 2023, KHALID SETHI, M.D. wrote 726 Medicare Part D claims totaling $12K in drug costs for 406 beneficiaries.
What is KHALID SETHI, M.D.'s Medicare quality score?
KHALID SETHI, M.D. has a CMS MIPS Final Score of 90.3495/100 (Quality: 80.699). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is KHALID SETHI, M.D. located?
KHALID SETHI, M.D. is located at 1020 VESTAL PKWY E, VESTAL, NY, 13850. Phone: (607) 444-6868.
What is KHALID SETHI, M.D.'s NPI number?
KHALID SETHI, M.D.'s National Provider Identifier (NPI) is 1699752048, issued on 12/28/2005.
Does KHALID SETHI, M.D. prescribe more brand-name or generic drugs?
KHALID SETHI, M.D.'s prescribing is 2% brand-name and 98% generic drugs by claim count, with $5K in brand drug costs.
Does KHALID SETHI, M.D. prescribe opioids?
Yes, KHALID SETHI, M.D. had 97 opioid claims in 2023 with an opioid prescribing rate of 13.4%.
How many Neurological Surgery Physician providers are there in the US?
There are 8,100 Neurological Surgery Physician providers across 53 states in the US. The average Neurological Surgery Physician provider writes 181 Medicare Part D claims per year.
What drugs does KHALID SETHI, M.D. prescribe most often?
Based on 2023 Medicare Part D data, KHALID SETHI, M.D.'s most frequently prescribed drugs include Gabapentin, Dexamethasone, Methylprednisolone. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does KHALID SETHI, M.D. accept Medicare?
KHALID SETHI, M.D. appears in CMS Medicare data with 726 Part D claims and 406 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify KHALID SETHI, M.D.'s credentials?
KHALID SETHI, M.D.'s NPI is 1699752048 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