2026 NPPES data Clinical Pathology/Laboratory Medicine Physician NPI 1114982329 MD
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NESTOR GARCIA, MD

Clinical Pathology/Laboratory Medicine Physician in WILKES BARRE, Pennsylvania. 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
13
Medicare Part D claims · Clinical Pathology/Laboratory Medicine Physician avg: 149
MIPS score
100/100
▲ 17 pts above national avg 83.1 · [object Object]

What the federal data shows

NESTOR GARCIA, MD reported a CMS MIPS final score of 100/100 — above the 83.1 national average — and filed 13 Medicare Part D claims in 2023.

100/100
MIPS score · +17 vs avg
13
Part D claims, 2023
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.

NESTOR GARCIA, MD'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)

NESTOR GARCIA, MD 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 NESTOR GARCIA, MD?

High performer (top quartile)

NPI registry status

Active

Issued 04/19/2006

NPI 1114982329

Primary specialty

Clinical Pathology/Laboratory Medicine Physician

Niche

1,229 US NPIs in this specialty

Medicare Part D claims

13 91% vs specialty avg

2023 prescription claims

Specialty avg: 149

MIPS final score

100/100 16.900000000000006% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Pennsylvania

How Clinical Pathology/Laboratory Medicine Physician compares to other specialties among Pennsylvania providers

Pennsylvania providers

Clinical Pathology/Laboratory Medicine Physician share within Pennsylvania

1. Clinical Pathology/Laboratory Medicine Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Clinical Pathology/Laboratory Medicine Physician share within Pennsylvania

Medicare quality performance — MIPS

NESTOR GARCIA, MD's 2023 MIPS final score plotted against the Clinical Pathology/Laboratory Medicine Physician national average

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

MIPS final score (Clinical Pathology/Laboratory Medicine Physician) — 100/100 vs national avg 83.1

0%100%National avg83%99%
MIPS final score (Clinical Pathology/Laboratory Medicine 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).

NESTOR GARCIA, MD appears in the CMS NPPES registry as a Clinical Pathology/Laboratory Medicine Physician provider holding MD credentials at 575 N RIVER ST, WILKES BARRE, PA, 18764, with a listed phone of (570) 829-8111. NPI 1114982329 was issued on 04/19/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what GARCIA 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 13 prescription claims written by this provider, covering N/A Medicare beneficiaries and totaling roughly $371 in drug spend. 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), compared with the national average of 83.1.

Clinical Pathology/Laboratory Medicine Physician is a narrow specialty nationwide, with 1,229 enrolled providers across 51 states and an average of 149 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

575 N RIVER ST
WILKES BARRE, PA 18764

Provider Details

NPI 1114982329
Specialty Clinical Pathology/Laboratory Medicine Physician
Credentials MD
Gender Male
NPI Issued 04/19/2006

CMS Quality Score (MIPS)

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

100
Final Score
Avg: 83.1
100
Quality

Reporting: Group practice

Hospital and facility affiliations

Facilities where NESTOR GARCIA, 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.

WYOMING VALLEY PATHOLOGY ASSOCIATES
WILKES BARRE, PA

Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).

License & disciplinary context — Pennsylvania PA-BOM 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 ~45K Pennsylvania medical licensees in 2023 — they are NOT specific to NESTOR GARCIA, MD. To verify NESTOR GARCIA, MD's current license status, search the PA-BOM public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

133
Total board actions, Pennsylvania 2023
Across 129 cases
2.96
Actions per 1,000 licensees
Pennsylvania statewide rate
probation
Most common action type
48 cases

PA-BOM 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 Pennsylvania disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

13
Total Claims
$371
Total Drug Cost
N/A
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
39
Total Day Supply
1,170
Generic Drug Cost
$365

Patient Demographics

Average Patient Age
74.0 years
Avg HCC Risk Score
0.33

Clinical Pathology/Laboratory Medicine Physician Overview

How NESTOR GARCIA, MD fits within the Clinical Pathology/Laboratory Medicine Physician landscape nationally.

1,229
Clinical Pathology/Laboratory Medicine Physician Providers in US
51
States with Clinical Pathology/Laboratory Medicine Physician
149
Avg Claims per Provider

NESTOR GARCIA, MD's 13 claims are below the specialty average of 149.

Nearby Clinical Pathology/Laboratory Medicine Physician Providers in Pennsylvania

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

Compare Clinical Pathology/Laboratory Medicine Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is NESTOR GARCIA, MD's specialty?
NESTOR GARCIA, MD specializes in Clinical Pathology/Laboratory Medicine Physician and practices in WILKES BARRE, Pennsylvania. Credentials: MD.
How much does NESTOR GARCIA, MD prescribe under Medicare Part D?
In 2023, NESTOR GARCIA, MD wrote 13 Medicare Part D claims totaling $371 in drug costs for N/A beneficiaries.
What is NESTOR GARCIA, MD's Medicare quality score?
NESTOR GARCIA, MD has a CMS MIPS Final Score of 100/100 (Quality: 100). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is NESTOR GARCIA, MD located?
NESTOR GARCIA, MD is located at 575 N RIVER ST, WILKES BARRE, PA, 18764. Phone: (570) 829-8111.
What is NESTOR GARCIA, MD's NPI number?
NESTOR GARCIA, MD's National Provider Identifier (NPI) is 1114982329, issued on 04/19/2006.
How many Clinical Pathology/Laboratory Medicine Physician providers are there in the US?
There are 1,229 Clinical Pathology/Laboratory Medicine Physician providers across 51 states in the US. The average Clinical Pathology/Laboratory Medicine Physician provider writes 149 Medicare Part D claims per year.
Does NESTOR GARCIA, MD accept Medicare?
NESTOR GARCIA, MD appears in CMS Medicare data with 13 Part D claims and N/A Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify NESTOR GARCIA, MD's credentials?
NESTOR GARCIA, MD's NPI is 1114982329 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