2026 NPPES data Optometrist NPI 1043296213 OD
Verify on CMS →

MICHAEL EDELSTEIN, OD

Optometrist in WALTHAM, Massachusetts. 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
52
Medicare Part D claims · 21 beneficiaries · Optometrist avg: 257
Generic prescribing
31%
generic claims · 69% brand-name · higher generic rates reduce patient out-of-pocket costs
Industry payments
$42
2 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

MICHAEL EDELSTEIN, OD filed 52 Medicare Part D claims in 2023 as a Optometrist in WALTHAM, Massachusetts, prescribing 31% generic.

52
Part D claims, 2023
31%
generic prescribing
$42
industry payments (Sunshine Act)

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.

MICHAEL EDELSTEIN, OD's Medicare Part D volume vs every U.S. prescriber

Total Medicare Part D claims, 2023 — across all CMS prescribers nationally

52 0th percentile higher than 0% of 1,370,886 prescribers

0–200: 670,926 prescribers (49%). This entry sits in this band. 200–400: 182,923 prescribers (13%). Above this entry. 400–600: 90,619 prescribers (7%). Above this entry. 600–800: 56,224 prescribers (4%). Above this entry. 800–1,000: 40,919 prescribers (3%). Above this entry. 1,000–1,200: 31,827 prescribers (2%). Above this entry. 1,200–1,400: 26,224 prescribers (2%). Above this entry. 1,400–1,600: 21,710 prescribers (2%). Above this entry. 1,600–1,800: 19,072 prescribers (1%). Above this entry. 1,800–2,000: 16,451 prescribers (1%). Above this entry. 2,000–2,200: 213,991 prescribers (16%). Above this entry. This provider 0 2K+ every Part D prescriber (claims/yr), bucketed by value

Each bar is a band; taller bars hold more prescribers. 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 Medicare Part D Prescriber Public Use File · 2023

What does the federal data show about MICHAEL EDELSTEIN, OD?

Quality data not reported

NPI registry status

Active

Issued 12/20/2005

NPI 1043296213

Primary specialty

Optometrist

High-volume

60,463 US NPIs in this specialty

Medicare Part D claims

52 80% vs specialty avg

2023 prescription claims

Specialty avg: 257

Specialty distribution in Massachusetts

How Optometrist compares to other specialties among Massachusetts providers

Massachusetts providers

Optometrist share within Massachusetts

1. Optometrist42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Optometrist share within Massachusetts

Specialty board-certification context

Estimated specialty board-certified rate — Optometrist (ABMS / AOA reference)

Quality data not reported
Est. board-certified rate
78%
Optometrist ABMS/AOA estimate

Est. board-certified rate (Optometrist) — ABMS / AOA estimate

0%100%78%
Est. board-certified rate (Optometrist) — ABMS / AOA estimate

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).

MICHAEL EDELSTEIN, OD appears in the CMS NPPES registry as a Optometrist provider holding OD credentials at 446 MOODY ST, WALTHAM, MA, 02453, with a listed phone of (781) 899-3200. NPI 1043296213 was issued on 12/20/2005. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what EDELSTEIN 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 52 prescription claims written by this provider, covering 21 Medicare beneficiaries and totaling roughly $23K in drug spend, split 69% brand-name and 31% 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.

Optometrist is a high-volume specialty nationwide, with 60,463 enrolled providers across 56 states and an average of 257 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

446 MOODY ST
WALTHAM, MA 02453

Provider Details

NPI 1043296213
Specialty Optometrist
Credentials OD
Gender Male
NPI Issued 12/20/2005

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 MICHAEL EDELSTEIN, OD. Source: openpaymentsdata.cms.gov.

Total received

$42

Largest payer

Johnson & Johnson Vision Care, 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.

License & disciplinary context — Massachusetts BORIM 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 ~38K Massachusetts medical licensees in 2023 — they are NOT specific to MICHAEL EDELSTEIN, OD. To verify MICHAEL EDELSTEIN, OD's current license status, search the BORIM public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

80
Total board actions, Massachusetts 2023
Across 78 cases
2.11
Actions per 1,000 licensees
Massachusetts statewide rate
probation
Most common action type
29 cases

BORIM 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 Massachusetts disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Brand-heavy

MICHAEL EDELSTEIN, OD — brand share 69.0%
Specialty average (est.)

69% brand-name claims vs 31% generic, on 52 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.

52
Total Claims
$23K
Total Drug Cost
21
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
56
Total Day Supply
1,450
Brand vs Generic
69% brand / 31% generic
Brand Drug Cost
$21K
Generic Drug Cost
$2K

Patient Demographics

Average Patient Age
71.7 years
Avg HCC Risk Score
0.86

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Restasis
Cyclosporine
20

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

Optometrist Overview

How MICHAEL EDELSTEIN, OD fits within the Optometrist landscape nationally.

60,463
Optometrist Providers in US
56
States with Optometrist
257
Avg Claims per Provider

MICHAEL EDELSTEIN, OD's 52 claims are below the specialty average of 257.

Nearby Optometrist Providers in Massachusetts

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

Compare Optometrist nationally: see state-by-state distribution →

Frequently Asked Questions

What is MICHAEL EDELSTEIN, OD's specialty?
MICHAEL EDELSTEIN, OD specializes in Optometrist and practices in WALTHAM, Massachusetts. Credentials: OD.
How much does MICHAEL EDELSTEIN, OD prescribe under Medicare Part D?
In 2023, MICHAEL EDELSTEIN, OD wrote 52 Medicare Part D claims totaling $23K in drug costs for 21 beneficiaries.
Where is MICHAEL EDELSTEIN, OD located?
MICHAEL EDELSTEIN, OD is located at 446 MOODY ST, WALTHAM, MA, 02453. Phone: (781) 899-3200.
What is MICHAEL EDELSTEIN, OD's NPI number?
MICHAEL EDELSTEIN, OD's National Provider Identifier (NPI) is 1043296213, issued on 12/20/2005.
Does MICHAEL EDELSTEIN, OD prescribe more brand-name or generic drugs?
MICHAEL EDELSTEIN, OD's prescribing is 69% brand-name and 31% generic drugs by claim count, with $21K in brand drug costs.
How many Optometrist providers are there in the US?
There are 60,463 Optometrist providers across 56 states in the US. The average Optometrist provider writes 257 Medicare Part D claims per year.
What drugs does MICHAEL EDELSTEIN, OD prescribe most often?
Based on 2023 Medicare Part D data, MICHAEL EDELSTEIN, OD's most frequently prescribed drugs include Restasis. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does MICHAEL EDELSTEIN, OD accept Medicare?
MICHAEL EDELSTEIN, OD appears in CMS Medicare data with 52 Part D claims and 21 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify MICHAEL EDELSTEIN, OD's credentials?
MICHAEL EDELSTEIN, OD's NPI is 1043296213 with credentials OD. 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.
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