2026 NPPES data Allergy Physician NPI 1013959253 M.D.
Verify on CMS →

MARK SUGAR, M.D.

Allergy Physician in LAGUNA NIGUEL, California. 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
889
Medicare Part D claims · 161 beneficiaries · Allergy Physician avg: 755
Generic prescribing
50%
generic claims · 50% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
80.3266/100
▼ 3 pts below national avg 83.1 · [object Object]
Industry payments
$593.64
23 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: MARK SUGAR, M.D. is a Allergy Physician ([object Object]) practicing in LAGUNA NIGUEL, California with a Medicare Part D prescribing footprint of 889 claims across 161 beneficiaries — 50% brand-name prescribing . Their CMS MIPS Final Score of 80.3266/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $593.64 across 23 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: MARK SUGAR, M.D. reported a CMS MIPS final score of 80.3266 out of 100, below the 83.1 national average, and filed 889 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

Board certification likely (heuristic — not verified)

MARK SUGAR, 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).

MARK SUGAR, M.D. at a glance

Near national average

NPI registry status

Active

Issued 06/12/2006

NPI 1013959253

Primary specialty

Allergy Physician

Niche

1,019 US NPIs in this specialty

Medicare Part D claims

889 18% vs specialty avg

2023 prescription claims

Specialty avg: 755

MIPS final score

80.3266/100 2.773399999999995% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in California

How Allergy Physician compares to other specialties among California providers

California providers

Allergy Physician share within California

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

Medicare quality performance — MIPS

MARK SUGAR, M.D.'s 2023 MIPS final score plotted against the Allergy Physician national average

Near national average
MIPS Final Score
80.3266/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Allergy Physician) — 80.3266/100 vs national avg 83.1

0%100%National avg83%80.3%
MIPS final score (Allergy Physician) — 80.3266/100 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).

MARK SUGAR, M.D. is a Allergy Physician provider practicing in LAGUNA NIGUEL, California, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: M.D.. NPI: 1013959253. 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.

MARK SUGAR, M.D. appears in the CMS NPPES registry as a Allergy Physician provider holding M.D. credentials at 28202 CABOT RD STE 105, LAGUNA NIGUEL, CA, 92677, with a listed phone of (949) 364-2900. NPI 1013959253 was issued on 06/12/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what SUGAR 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 889 prescription claims written by this provider, covering 161 Medicare beneficiaries and totaling roughly $270K in drug spend, split 50% brand-name and 50% 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 80.3266/100 for the 2023 performance year (Quality 100, Cost 34.422), compared with the national average of 83.1.

Allergy Physician is a narrow specialty nationwide, with 1,019 enrolled providers across 49 states and an average of 755 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

28202 CABOT RD STE 105
LAGUNA NIGUEL, CA 92677

Provider Details

NPI 1013959253
Specialty Allergy Physician
Credentials M.D.
Gender Male
NPI Issued 06/12/2006

CMS Quality Score (MIPS)

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

80.3266
Final Score
Avg: 83.1
100
Quality
34.422
Cost

Reporting: Group practice

Hospital and facility affiliations

Facilities where MARK SUGAR, 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.

ALLERGY AND ASTHMA ASSOCIATES OF SOUTHERN CALIF INC
MISSION VIEJO, CA

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 MARK SUGAR, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$594

Largest payer

GENZYME CORPORATION

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 — California MBC 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 ~150K California medical licensees in 2023 — they are NOT specific to MARK SUGAR, M.D.. To verify MARK SUGAR, M.D.'s current license status, search the MBC public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

576
Total board actions, California 2023
Across 556 cases
3.84
Actions per 1,000 licensees
California statewide rate
probation
Most common action type
186 cases

MBC 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 California disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Brand-heavy

MARK SUGAR, M.D. — brand share 50.0%
Specialty average (est.)

50% brand-name claims vs 50% generic, on 889 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.

889
Total Claims
$270K
Total Drug Cost
161
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
1,262
Total Day Supply
35,833
Brand vs Generic
50% brand / 50% generic
Brand Drug Cost
$248K
Generic Drug Cost
$23K
Antibiotic Claims
54

Patient Demographics

Average Patient Age
74.2 years
Avg HCC Risk Score
1.30
Gender Split
62% female / 38% 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
Azelastine Hcl
95
Fluticasone Propionate
81
Advair Hfa
Fluticasone Propion/Salmeterol
74
Albuterol Sulfate Hfa
Albuterol Sulfate
65
Montelukast Sodium
62
Symbicort
Budesonide/Formoterol Fumarate
57
Azelastine-Fluticasone
Azelastine/Fluticasone
44
Fluticasone-Salmeterol
Fluticasone Propion/Salmeterol
35
Flovent Hfa
Fluticasone Propionate
33
Spiriva Respimat
Tiotropium Bromide
29

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

Allergy Physician Overview

How MARK SUGAR, M.D. fits within the Allergy Physician landscape nationally.

1,019
Allergy Physician Providers in US
49
States with Allergy Physician
755
Avg Claims per Provider

MARK SUGAR, M.D.'s 889 claims are above the specialty average of 755.

Nearby Allergy Physician Providers in California

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

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

Frequently Asked Questions

What is MARK SUGAR, M.D.'s specialty?
MARK SUGAR, M.D. specializes in Allergy Physician and practices in LAGUNA NIGUEL, California. Credentials: M.D..
How much does MARK SUGAR, M.D. prescribe under Medicare Part D?
In 2023, MARK SUGAR, M.D. wrote 889 Medicare Part D claims totaling $270K in drug costs for 161 beneficiaries.
What is MARK SUGAR, M.D.'s Medicare quality score?
MARK SUGAR, M.D. has a CMS MIPS Final Score of 80.3266/100 (Quality: 100, Cost: 34.422). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is MARK SUGAR, M.D. located?
MARK SUGAR, M.D. is located at 28202 CABOT RD STE 105, LAGUNA NIGUEL, CA, 92677. Phone: (949) 364-2900.
What is MARK SUGAR, M.D.'s NPI number?
MARK SUGAR, M.D.'s National Provider Identifier (NPI) is 1013959253, issued on 06/12/2006.
Does MARK SUGAR, M.D. prescribe more brand-name or generic drugs?
MARK SUGAR, M.D.'s prescribing is 50% brand-name and 50% generic drugs by claim count, with $248K in brand drug costs.
How many Allergy Physician providers are there in the US?
There are 1,019 Allergy Physician providers across 49 states in the US. The average Allergy Physician provider writes 755 Medicare Part D claims per year.
What drugs does MARK SUGAR, M.D. prescribe most often?
Based on 2023 Medicare Part D data, MARK SUGAR, M.D.'s most frequently prescribed drugs include Azelastine Hcl, Fluticasone Propionate, Advair Hfa. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does MARK SUGAR, M.D. accept Medicare?
MARK SUGAR, M.D. appears in CMS Medicare data with 889 Part D claims and 161 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify MARK SUGAR, M.D.'s credentials?
MARK SUGAR, M.D.'s NPI is 1013959253 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