2026 NPPES data Retina Specialist (Ophthalmology) Physician NPI 1275022535 MD
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KUSH PATEL, MD

Retina Specialist (Ophthalmology) Physician in NEW BRUNSWICK, New Jersey. 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
59
Medicare Part D claims · 36 beneficiaries · Retina Specialist (Ophthalmology) Physician avg: 558
Generic prescribing
75%
generic claims · 25% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
90.9195/100
▲ 8 pts above national avg 83.1 · [object Object]
Industry payments
$322.09
5 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

KUSH PATEL, MD reported a CMS MIPS final score of 90.9195/100 — above the 83.1 national average — and filed 59 Medicare Part D claims in 2023.

90.9195/100
MIPS score · +8 vs avg
59
Part D claims, 2023
75%
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.

KUSH PATEL, MD's MIPS score vs every scored U.S. clinician

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

91 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)

KUSH PATEL, 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).

What does the federal data show about KUSH PATEL, MD?

High performer (top quartile)

NPI registry status

Active

Issued 05/02/2018

NPI 1275022535

Primary specialty

Retina Specialist (Ophthalmology) Physician

Niche

913 US NPIs in this specialty

Medicare Part D claims

59 89% vs specialty avg

2023 prescription claims

Specialty avg: 558

MIPS final score

90.9195/100 7.819500000000005% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in New Jersey

How Retina Specialist (Ophthalmology) Physician compares to other specialties among New Jersey providers

New Jersey providers

Retina Specialist (Ophthalmology) Physician share within New Jersey

1. Retina Specialist (Ophthalmology) Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Retina Specialist (Ophthalmology) Physician share within New Jersey

Medicare quality performance — MIPS

KUSH PATEL, MD's 2023 MIPS final score plotted against the Retina Specialist (Ophthalmology) Physician national average

High performer (top quartile)
MIPS Final Score
90.9195/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Retina Specialist (Ophthalmology) Physician) — 90.9195/100 vs national avg 83.1

0%100%National avg83%90.9%
MIPS final score (Retina Specialist (Ophthalmology) Physician) — 90.9195/100 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).

KUSH PATEL, MD is a Retina Specialist (Ophthalmology) Physician provider practicing in NEW BRUNSWICK, New Jersey, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: MD. NPI: 1275022535. 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.

KUSH PATEL, MD appears in the CMS NPPES registry as a Retina Specialist (Ophthalmology) Physician provider holding MD credentials at 10 PLUM ST STE 600, NEW BRUNSWICK, NJ, 08901, with a listed phone of (732) 220-1600. NPI 1275022535 was issued on 05/02/2018. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what PATEL 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 59 prescription claims written by this provider, covering 36 Medicare beneficiaries and totaling roughly $2K in drug spend, split 25% brand-name and 75% 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 90.9195/100 for the 2023 performance year (Quality 99.4303, Cost 70.776), compared with the national average of 83.1.

Retina Specialist (Ophthalmology) Physician is a narrow specialty nationwide, with 913 enrolled providers across 48 states and an average of 558 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

10 PLUM ST STE 600
NEW BRUNSWICK, NJ 08901

Provider Details

NPI 1275022535
Specialty Retina Specialist (Ophthalmology) Physician
Credentials MD
Gender Male
NPI Issued 05/02/2018

CMS Quality Score (MIPS)

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

90.9195
Final Score
Avg: 83.1
99.4303
Quality
70.776
Cost

Reporting: Group practice

Hospital and facility affiliations

Facilities where KUSH PATEL, 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.

JAMES W MATTERN OD, PLLC
FAIRFAX, VA
VIRGINIA RETINA SPECIALISTS
RESTON, VA

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 KUSH PATEL, MD. Source: openpaymentsdata.cms.gov.

Total received

$322

Largest payer

Astellas Pharma US 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

KUSH PATEL, MD — brand share 25.0%
Specialty average (est.)

25% brand-name claims vs 75% generic, on 59 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.

59
Total Claims
$2K
Total Drug Cost
36
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
80
Total Day Supply
1,820
Brand vs Generic
25% brand / 75% generic
Brand Drug Cost
$1K
Generic Drug Cost
$827

Patient Demographics

Average Patient Age
75.0 years
Avg HCC Risk Score
2.21
Gender Split
44% female / 56% male

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Prednisolone Acetate
13

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

Retina Specialist (Ophthalmology) Physician Overview

How KUSH PATEL, MD fits within the Retina Specialist (Ophthalmology) Physician landscape nationally.

913
Retina Specialist (Ophthalmology) Physician Providers in US
48
States with Retina Specialist (Ophthalmology) Physician
558
Avg Claims per Provider

KUSH PATEL, MD's 59 claims are below the specialty average of 558.

Nearby Retina Specialist (Ophthalmology) Physician Providers in New Jersey

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

Compare Retina Specialist (Ophthalmology) Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is KUSH PATEL, MD's specialty?
KUSH PATEL, MD specializes in Retina Specialist (Ophthalmology) Physician and practices in NEW BRUNSWICK, New Jersey. Credentials: MD.
How much does KUSH PATEL, MD prescribe under Medicare Part D?
In 2023, KUSH PATEL, MD wrote 59 Medicare Part D claims totaling $2K in drug costs for 36 beneficiaries.
What is KUSH PATEL, MD's Medicare quality score?
KUSH PATEL, MD has a CMS MIPS Final Score of 90.9195/100 (Quality: 99.4303, Cost: 70.776). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is KUSH PATEL, MD located?
KUSH PATEL, MD is located at 10 PLUM ST STE 600, NEW BRUNSWICK, NJ, 08901. Phone: (732) 220-1600.
What is KUSH PATEL, MD's NPI number?
KUSH PATEL, MD's National Provider Identifier (NPI) is 1275022535, issued on 05/02/2018.
Does KUSH PATEL, MD prescribe more brand-name or generic drugs?
KUSH PATEL, MD's prescribing is 25% brand-name and 75% generic drugs by claim count, with $1K in brand drug costs.
How many Retina Specialist (Ophthalmology) Physician providers are there in the US?
There are 913 Retina Specialist (Ophthalmology) Physician providers across 48 states in the US. The average Retina Specialist (Ophthalmology) Physician provider writes 558 Medicare Part D claims per year.
What drugs does KUSH PATEL, MD prescribe most often?
Based on 2023 Medicare Part D data, KUSH PATEL, MD's most frequently prescribed drugs include Prednisolone Acetate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does KUSH PATEL, MD accept Medicare?
KUSH PATEL, MD appears in CMS Medicare data with 59 Part D claims and 36 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify KUSH PATEL, MD's credentials?
KUSH PATEL, MD's NPI is 1275022535 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