2026 NPPES data Pediatric Nephrology Physician NPI 1205149036 MD
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NICHOLAS HERRERA, MD

Pediatric Nephrology Physician in KANSAS CITY, Kansas. 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 · 142 beneficiaries · Pediatric Nephrology Physician avg: 97
Generic prescribing
89%
generic claims · 11% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
91.8902/100
▲ 9 pts above national avg 83.1 · [object Object]

What the federal data shows

NICHOLAS HERRERA, MD reported a CMS MIPS final score of 91.8902/100 — above the 83.1 national average — and filed 1,627 Medicare Part D claims in 2023.

91.8902/100
MIPS score · +9 vs avg
2K
Part D claims, 2023
89%
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.

NICHOLAS HERRERA, MD's MIPS score vs every scored U.S. clinician

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

92 Top 37% higher than 63% 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)

NICHOLAS HERRERA, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 2 hospital affiliations — 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 NICHOLAS HERRERA, MD?

High performer (top quartile)

NPI registry status

Active

Issued 07/21/2010

NPI 1205149036

Primary specialty

Pediatric Nephrology Physician

Niche

723 US NPIs in this specialty

Medicare Part D claims

1,627 1577% vs specialty avg

2023 prescription claims

Specialty avg: 97

MIPS final score

91.8902/100 8.790199999999999% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Kansas

How Pediatric Nephrology Physician compares to other specialties among Kansas providers

Kansas providers

Pediatric Nephrology Physician share within Kansas

1. Pediatric Nephrology Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Pediatric Nephrology Physician share within Kansas

Medicare quality performance — MIPS

NICHOLAS HERRERA, MD's 2023 MIPS final score plotted against the Pediatric Nephrology Physician national average

High performer (top quartile)
MIPS Final Score
91.8902/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Pediatric Nephrology Physician) — 91.8902/100 vs national avg 83.1

0%100%National avg83%91.9%
MIPS final score (Pediatric Nephrology Physician) — 91.8902/100 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).

NICHOLAS HERRERA, MD is a Pediatric Nephrology Physician provider practicing in KANSAS CITY, Kansas, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: MD. NPI: 1205149036. 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.

NICHOLAS HERRERA, MD appears in the CMS NPPES registry as a Pediatric Nephrology Physician provider holding MD credentials at 3901 RAINBOW BLVD, KANSAS CITY, KS, 66160, with a listed phone of (913) 588-3961. NPI 1205149036 was issued on 07/21/2010. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what HERRERA 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 1,627 prescription claims written by this provider, covering 142 Medicare beneficiaries and totaling roughly $287K in drug spend, split 11% brand-name and 89% 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 91.8902/100 for the 2023 performance year (Quality 75.1734), compared with the national average of 83.1.

Pediatric Nephrology Physician is a narrow specialty nationwide, with 723 enrolled providers across 50 states and an average of 97 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

3901 RAINBOW BLVD
KANSAS CITY, KS 66160

Provider Details

NPI 1205149036
Specialty Pediatric Nephrology Physician
Credentials MD
Gender Male
NPI Issued 07/21/2010

CMS Quality Score (MIPS)

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

91.8902
Final Score
Avg: 83.1
75.1734
Quality
100
Promoting Interoperability

Reporting: Alternative Payment Model

Hospital and facility affiliations

Facilities where NICHOLAS HERRERA, 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.

KANSAS UNIVERSITY PHYSICIANS INC
KANSAS CITY, KS
THE CHILDRENS MERCY HOSPITAL
KANSAS CITY, MO

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

Brand vs generic prescribing mix · Typical

NICHOLAS HERRERA, MD — brand share 11.0%
Specialty average (est.)

11% brand-name claims vs 89% generic, on 1,627 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.

1,627
Total Claims
$287K
Total Drug Cost
142
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
3,290
Total Day Supply
95,672
Brand vs Generic
11% brand / 89% generic
Brand Drug Cost
$240K
Generic Drug Cost
$44K
Antibiotic Claims
95

Patient Demographics

Average Patient Age
59.6 years
Avg HCC Risk Score
4.84
Gender Split
43% female / 57% male
Age Distribution
<65: 71, 65-74: 60, 75-84: 11, 85+: 0

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Prednisone
191
Losartan Potassium
75
Omeprazole
74
Nifedipine Er
Nifedipine
73
Carvedilol
69
Valganciclovir Hcl
67
Famotidine
64
Atorvastatin Calcium
62
Tamsulosin Hcl
58
Sulfamethoxazole-Trimethoprim
Sulfamethoxazole/Trimethoprim
56

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

Pediatric Nephrology Physician Overview

How NICHOLAS HERRERA, MD fits within the Pediatric Nephrology Physician landscape nationally.

723
Pediatric Nephrology Physician Providers in US
50
States with Pediatric Nephrology Physician
97
Avg Claims per Provider

NICHOLAS HERRERA, MD's 1,627 claims are above the specialty average of 97.

Frequently Asked Questions

What is NICHOLAS HERRERA, MD's specialty?
NICHOLAS HERRERA, MD specializes in Pediatric Nephrology Physician and practices in KANSAS CITY, Kansas. Credentials: MD.
How much does NICHOLAS HERRERA, MD prescribe under Medicare Part D?
In 2023, NICHOLAS HERRERA, MD wrote 1,627 Medicare Part D claims totaling $287K in drug costs for 142 beneficiaries.
What is NICHOLAS HERRERA, MD's Medicare quality score?
NICHOLAS HERRERA, MD has a CMS MIPS Final Score of 91.8902/100 (Quality: 75.1734). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is NICHOLAS HERRERA, MD located?
NICHOLAS HERRERA, MD is located at 3901 RAINBOW BLVD, KANSAS CITY, KS, 66160. Phone: (913) 588-3961.
What is NICHOLAS HERRERA, MD's NPI number?
NICHOLAS HERRERA, MD's National Provider Identifier (NPI) is 1205149036, issued on 07/21/2010.
Does NICHOLAS HERRERA, MD prescribe more brand-name or generic drugs?
NICHOLAS HERRERA, MD's prescribing is 11% brand-name and 89% generic drugs by claim count, with $240K in brand drug costs.
How many Pediatric Nephrology Physician providers are there in the US?
There are 723 Pediatric Nephrology Physician providers across 50 states in the US. The average Pediatric Nephrology Physician provider writes 97 Medicare Part D claims per year.
What drugs does NICHOLAS HERRERA, MD prescribe most often?
Based on 2023 Medicare Part D data, NICHOLAS HERRERA, MD's most frequently prescribed drugs include Prednisone, Losartan Potassium, Omeprazole. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does NICHOLAS HERRERA, MD accept Medicare?
NICHOLAS HERRERA, MD appears in CMS Medicare data with 1,627 Part D claims and 142 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify NICHOLAS HERRERA, MD's credentials?
NICHOLAS HERRERA, MD's NPI is 1205149036 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