2026 NPPES data Ophthalmology Physician NPI 1487008181
Verify on CMS →

NATHANIEL SIMMONS

Ophthalmology Physician in ORCHARD PARK, 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
2K
Medicare Part D claims · 447 beneficiaries · Ophthalmology Physician avg: 1K
Generic prescribing
61%
generic claims · 39% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
100/100
▲ 17 pts above national avg 83.1 · [object Object]
Industry payments
$1.4K
59 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

NATHANIEL SIMMONS reported a CMS MIPS final score of 100/100 — above the 83.1 national average — and filed 1,619 Medicare Part D claims in 2023.

100/100
MIPS score · +17 vs avg
2K
Part D claims, 2023
61%
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.

NATHANIEL SIMMONS's MIPS score vs every scored U.S. clinician

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

100 Top 7% higher than 93% 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)

NATHANIEL SIMMONS 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).

What does the federal data show about NATHANIEL SIMMONS?

High performer (top quartile)

NPI registry status

Active

Issued 04/19/2016

NPI 1487008181

Primary specialty

Ophthalmology Physician

Mid-sized

22,090 US NPIs in this specialty

Medicare Part D claims

1,619 14% vs specialty avg

2023 prescription claims

Specialty avg: 1,420

MIPS final score

100/100 16.900000000000006% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in New York

How Ophthalmology Physician compares to other specialties among New York providers

New York providers

Ophthalmology Physician share within New York

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

Medicare quality performance — MIPS

NATHANIEL SIMMONS's 2023 MIPS final score plotted against the Ophthalmology Physician national average

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

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

0%100%National avg83%99%
MIPS final score (Ophthalmology Physician) — 100/100 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).

NATHANIEL SIMMONS appears in the CMS NPPES registry as a Ophthalmology Physician provider at 3151 SOUTHWESTER BLVD, ORCHARD PARK, NY, 14127, with a listed phone of (716) 674-6030. NPI 1487008181 was issued on 04/19/2016. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what SIMMONS 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 1,619 prescription claims written by this provider, covering 447 Medicare beneficiaries and totaling roughly $302K in drug spend, split 39% brand-name and 61% 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 100/100 for the 2023 performance year (Quality 100, Cost 100), compared with the national average of 83.1.

Ophthalmology Physician is a mid-sized specialty nationwide, with 22,090 enrolled providers across 56 states and an average of 1,420 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

3151 SOUTHWESTER BLVD
ORCHARD PARK, NY 14127

Provider Details

NPI 1487008181
Specialty Ophthalmology Physician
Gender Male
NPI Issued 04/19/2016

CMS Quality Score (MIPS)

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

100
Final Score
Avg: 83.1
100
Quality
100
Cost

Reporting: Group practice

Hospital and facility affiliations

Facilities where NATHANIEL SIMMONS 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.

SOUTHTOWNS OPHTHALMOLOGY PC
ORCHARD PARK, 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 NATHANIEL SIMMONS. Source: openpaymentsdata.cms.gov.

Total received

$1.4K

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.

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 NATHANIEL SIMMONS. To verify NATHANIEL SIMMONS'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 · Above average

NATHANIEL SIMMONS — brand share 39.0%
Specialty average (est.)

39% brand-name claims vs 61% generic, on 1,619 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.

1,619
Total Claims
$302K
Total Drug Cost
447
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
3,055
Total Day Supply
86,848
Brand vs Generic
39% brand / 61% generic
Brand Drug Cost
$242K
Generic Drug Cost
$60K

Patient Demographics

Average Patient Age
76.5 years
Avg HCC Risk Score
1.19
Gender Split
58% female / 42% male
Age Distribution
<65: 16, 65-74: 171, 75-84: 187, 85+: 73

Top Prescribed Drugs (Medicare Part D)

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

What NATHANIEL SIMMONS 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
Latanoprost
453
Dorzolamide-Timolol
Dorzolamide Hcl/Timolol Maleat
209
Prednisolone Acetate
144
Timolol Maleate
124
Lumigan
Bimatoprost
111
Cyclosporine
66
Erythromycin
Erythromycin Base
52
Brimonidine Tartrate
51
Brimonidine Tartrate-Timolol
Brimonidine Tartrate/Timolol
51
Xiidra
Lifitegrast
43

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

Ophthalmology Physician Overview

How NATHANIEL SIMMONS fits within the Ophthalmology Physician landscape nationally.

22,090
Ophthalmology Physician Providers in US
56
States with Ophthalmology Physician
1,420
Avg Claims per Provider

NATHANIEL SIMMONS's 1,619 claims are above the specialty average of 1,420.

Nearby Ophthalmology Physician Providers in New York

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

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

Frequently Asked Questions

What is NATHANIEL SIMMONS's specialty?
NATHANIEL SIMMONS specializes in Ophthalmology Physician and practices in ORCHARD PARK, New York.
How much does NATHANIEL SIMMONS prescribe under Medicare Part D?
In 2023, NATHANIEL SIMMONS wrote 1,619 Medicare Part D claims totaling $302K in drug costs for 447 beneficiaries.
What is NATHANIEL SIMMONS's Medicare quality score?
NATHANIEL SIMMONS has a CMS MIPS Final Score of 100/100 (Quality: 100, Cost: 100). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is NATHANIEL SIMMONS located?
NATHANIEL SIMMONS is located at 3151 SOUTHWESTER BLVD, ORCHARD PARK, NY, 14127. Phone: (716) 674-6030.
What is NATHANIEL SIMMONS's NPI number?
NATHANIEL SIMMONS's National Provider Identifier (NPI) is 1487008181, issued on 04/19/2016.
Does NATHANIEL SIMMONS prescribe more brand-name or generic drugs?
NATHANIEL SIMMONS's prescribing is 39% brand-name and 61% generic drugs by claim count, with $242K in brand drug costs.
How many Ophthalmology Physician providers are there in the US?
There are 22,090 Ophthalmology Physician providers across 56 states in the US. The average Ophthalmology Physician provider writes 1,420 Medicare Part D claims per year.
What drugs does NATHANIEL SIMMONS prescribe most often?
Based on 2023 Medicare Part D data, NATHANIEL SIMMONS's most frequently prescribed drugs include Latanoprost, Dorzolamide-Timolol, Prednisolone Acetate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does NATHANIEL SIMMONS accept Medicare?
NATHANIEL SIMMONS appears in CMS Medicare data with 1,619 Part D claims and 447 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify NATHANIEL SIMMONS's credentials?
NATHANIEL SIMMONS's NPI is 1487008181. 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