2026 NPPES data Medical Physician Assistant NPI 1316431315 MD
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LORENA MONTALVO-TOLEDO, MD

Medical Physician Assistant in ARECIBO, 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
637
Medicare Part D claims · 291 beneficiaries · Medical Physician Assistant avg: 1K
Generic prescribing
44%
generic claims · 56% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
76.1517/100
▼ 7 pts below national avg 83.1 · [object Object]
Industry payments
$83.14
2 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: LORENA MONTALVO-TOLEDO, MD is a Medical Physician Assistant ([object Object]) practicing in ARECIBO, Puerto Rico with a Medicare Part D prescribing footprint of 637 claims across 291 beneficiaries — 56% brand-name prescribing . Their CMS MIPS Final Score of 76.1517/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $83.14 across 2 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: LORENA MONTALVO-TOLEDO, MD reported a CMS MIPS final score of 76.1517 out of 100, below the 83.1 national average, and filed 637 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

LORENA MONTALVO-TOLEDO, MD at a glance

Below national average

NPI registry status

Active

Issued 06/21/2018

NPI 1316431315

Primary specialty

Medical Physician Assistant

Mid-sized

40,527 US NPIs in this specialty

Medicare Part D claims

637 41% vs specialty avg

2023 prescription claims

Specialty avg: 1,077

MIPS final score

76.1517/100 6.948299999999989% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in Puerto Rico

How Medical Physician Assistant compares to other specialties among Puerto Rico providers

Puerto Rico providers

Medical Physician Assistant share within Puerto Rico

1. Medical Physician Assistant42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Medical Physician Assistant share within Puerto Rico

Medicare quality performance — MIPS

LORENA MONTALVO-TOLEDO, MD's 2023 MIPS final score plotted against the Medical Physician Assistant national average

Below national average
MIPS Final Score
76.1517/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Medical Physician Assistant) — 76.1517/100 vs national avg 83.1

0%100%National avg83%76.2%
MIPS final score (Medical Physician Assistant) — 76.1517/100 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).

LORENA MONTALVO-TOLEDO, MD is a Medical Physician Assistant provider practicing in ARECIBO, Puerto Rico, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: MD. NPI: 1316431315. 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.

LORENA MONTALVO-TOLEDO, MD appears in the CMS NPPES registry as a Medical Physician Assistant provider holding MD credentials at 404 AVE JOSE DE DIEGO, ARECIBO, PR, 00612, with a listed phone of (787) 878-2758. NPI 1316431315 was issued on 06/21/2018. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what MONTALVO-TOLEDO 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 637 prescription claims written by this provider, covering 291 Medicare beneficiaries and totaling roughly $64K in drug spend, split 56% brand-name and 44% 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 76.1517/100 for the 2023 performance year (Quality 71.0267, Cost 33.955), compared with the national average of 83.1.

Medical Physician Assistant is a mid-sized specialty nationwide, with 40,527 enrolled providers across 55 states and an average of 1,077 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

404 AVE JOSE DE DIEGO
ARECIBO, PR 00612

Provider Details

NPI 1316431315
Specialty Medical Physician Assistant
Credentials MD
Gender Female
NPI Issued 06/21/2018

CMS Quality Score (MIPS)

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

76.1517
Final Score
Avg: 83.1
71.0267
Quality
33.955
Cost
100
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where LORENA MONTALVO-TOLEDO, 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.

RECINTO DE CIENCIAS MEDICAS
RIO PIEDRAS, PR

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 LORENA MONTALVO-TOLEDO, MD. Source: openpaymentsdata.cms.gov.

Total received

$83

Largest payer

Alcon Vision LLC

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 · Brand-heavy

LORENA MONTALVO-TOLEDO, MD — brand share 56.0%
Specialty average (est.)

56% brand-name claims vs 44% generic, on 637 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.

637
Total Claims
$64K
Total Drug Cost
291
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
799
Total Day Supply
20,204
Brand vs Generic
56% brand / 44% generic
Brand Drug Cost
$53K
Generic Drug Cost
$11K
Antibiotic Claims
15

Patient Demographics

Average Patient Age
73.2 years
Avg HCC Risk Score
1.94
Gender Split
56% female / 44% male
Age Distribution
<65: 37, 65-74: 121, 75-84: 95, 85+: 38

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
133
Fluorometholone
72
Neomycin-Polymyxin-Dexameth
Neomycin/Polymyxin B/Dexametha
49
Moxifloxacin
Moxifloxacin Hcl
38
Latanoprost
32
Lumigan
Bimatoprost
28
Timolol Maleate
28
Restasis
Cyclosporine
24
Alphagan P
Brimonidine Tartrate
22
Valacyclovir
Valacyclovir Hcl
18

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

Medical Physician Assistant Overview

How LORENA MONTALVO-TOLEDO, MD fits within the Medical Physician Assistant landscape nationally.

40,527
Medical Physician Assistant Providers in US
55
States with Medical Physician Assistant
1,077
Avg Claims per Provider

LORENA MONTALVO-TOLEDO, MD's 637 claims are below the specialty average of 1,077.

Nearby Medical Physician Assistant Providers in Puerto Rico

Other clinicians with the same primary specialty enrolled in Puerto Rico, drawn from the same CMS NPPES roster as MONTALVO-TOLEDO.

Compare Medical Physician Assistant nationally: see state-by-state distribution →

Frequently Asked Questions

What is LORENA MONTALVO-TOLEDO, MD's specialty?
LORENA MONTALVO-TOLEDO, MD specializes in Medical Physician Assistant and practices in ARECIBO, Puerto Rico. Credentials: MD.
How much does LORENA MONTALVO-TOLEDO, MD prescribe under Medicare Part D?
In 2023, LORENA MONTALVO-TOLEDO, MD wrote 637 Medicare Part D claims totaling $64K in drug costs for 291 beneficiaries.
What is LORENA MONTALVO-TOLEDO, MD's Medicare quality score?
LORENA MONTALVO-TOLEDO, MD has a CMS MIPS Final Score of 76.1517/100 (Quality: 71.0267, Cost: 33.955). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is LORENA MONTALVO-TOLEDO, MD located?
LORENA MONTALVO-TOLEDO, MD is located at 404 AVE JOSE DE DIEGO, ARECIBO, PR, 00612. Phone: (787) 878-2758.
What is LORENA MONTALVO-TOLEDO, MD's NPI number?
LORENA MONTALVO-TOLEDO, MD's National Provider Identifier (NPI) is 1316431315, issued on 06/21/2018.
Does LORENA MONTALVO-TOLEDO, MD prescribe more brand-name or generic drugs?
LORENA MONTALVO-TOLEDO, MD's prescribing is 56% brand-name and 44% generic drugs by claim count, with $53K in brand drug costs.
How many Medical Physician Assistant providers are there in the US?
There are 40,527 Medical Physician Assistant providers across 55 states in the US. The average Medical Physician Assistant provider writes 1,077 Medicare Part D claims per year.
What drugs does LORENA MONTALVO-TOLEDO, MD prescribe most often?
Based on 2023 Medicare Part D data, LORENA MONTALVO-TOLEDO, MD's most frequently prescribed drugs include Prednisolone Acetate, Fluorometholone, Neomycin-Polymyxin-Dexameth. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does LORENA MONTALVO-TOLEDO, MD accept Medicare?
LORENA MONTALVO-TOLEDO, MD appears in CMS Medicare data with 637 Part D claims and 291 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify LORENA MONTALVO-TOLEDO, MD's credentials?
LORENA MONTALVO-TOLEDO, MD's NPI is 1316431315 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