2026 NPPES data Pain Medicine (Anesthesiology) Physician NPI 1043625726 M.D.
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NIDHI AGRAWAL, M.D.

Pain Medicine (Anesthesiology) Physician in HORSHAM, 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
435
Medicare Part D claims · 86 beneficiaries · Pain Medicine (Anesthesiology) Physician avg: 2K
Generic prescribing
95%
generic claims · 5% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
91.75/100
▲ 9 pts above national avg 83.1 · [object Object]
What the federal data reveals: NIDHI AGRAWAL, M.D. is a Pain Medicine (Anesthesiology) Physician ([object Object]) practicing in HORSHAM, Pennsylvania with a Medicare Part D prescribing footprint of 435 claims across 86 beneficiaries — 5% brand-name prescribing . Their CMS MIPS Final Score of 91.75/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities .

What stands out: NIDHI AGRAWAL, M.D. reported a CMS MIPS final score of 91.75 out of 100, above the 83.1 national average, and filed 435 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)

NIDHI AGRAWAL, 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).

NIDHI AGRAWAL, M.D. at a glance

High performer (top quartile)

NPI registry status

Active

Issued 06/21/2014

NPI 1043625726

Primary specialty

Pain Medicine (Anesthesiology) Physician

Niche

4,020 US NPIs in this specialty

Medicare Part D claims

435 74% vs specialty avg

2023 prescription claims

Specialty avg: 1,657

MIPS final score

91.75/100 8.650000000000006% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Pennsylvania

How Pain Medicine (Anesthesiology) Physician compares to other specialties among Pennsylvania providers

Pennsylvania providers

Pain Medicine (Anesthesiology) Physician share within Pennsylvania

1. Pain Medicine (Anesthesiology) Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Pain Medicine (Anesthesiology) Physician share within Pennsylvania

Medicare quality performance — MIPS

NIDHI AGRAWAL, M.D.'s 2023 MIPS final score plotted against the Pain Medicine (Anesthesiology) Physician national average

High performer (top quartile)
MIPS Final Score
91.75/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Pain Medicine (Anesthesiology) Physician) — 91.75/100 vs national avg 83.1

0%100%National avg83%91.8%
MIPS final score (Pain Medicine (Anesthesiology) Physician) — 91.75/100 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).

NIDHI AGRAWAL, M.D. is a Pain Medicine (Anesthesiology) Physician provider practicing in HORSHAM, Pennsylvania, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: M.D.. NPI: 1043625726. 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.

NIDHI AGRAWAL, M.D. appears in the CMS NPPES registry as a Pain Medicine (Anesthesiology) Physician provider holding M.D. credentials at 300 WELSH RD BLDG 2, HORSHAM, PA, 19044, with a listed phone of (844) 365-7246. NPI 1043625726 was issued on 06/21/2014. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what AGRAWAL 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 435 prescription claims written by this provider, covering 86 Medicare beneficiaries and totaling roughly $28K in drug spend, split 5% brand-name and 95% generic by claim count, with an opioid prescribing rate of 32.4%. 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 91.75/100 for the 2023 performance year, compared with the national average of 83.1.

Pain Medicine (Anesthesiology) Physician is a narrow specialty nationwide, with 4,020 enrolled providers across 53 states and an average of 1,657 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

300 WELSH RD BLDG 2
HORSHAM, PA 19044

Provider Details

NPI 1043625726
Specialty Pain Medicine (Anesthesiology) Physician
Credentials M.D.
Gender Female
NPI Issued 06/21/2014

CMS Quality Score (MIPS)

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

91.75
Final Score
Avg: 83.1
89
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where NIDHI AGRAWAL, 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.

SMG ANESTHESIA SPECIALISTS LLC
VIRGINIA BEACH, VA

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 NIDHI AGRAWAL, M.D.. To verify NIDHI AGRAWAL, M.D.'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.

Brand vs generic prescribing mix · Generic-heavy

NIDHI AGRAWAL, M.D. — brand share 5.0%
Specialty average (est.)

5% brand-name claims vs 95% generic, on 435 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.

435
Total Claims
$28K
Total Drug Cost
86
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
557
Total Day Supply
15,319
Brand vs Generic
5% brand / 95% generic
Brand Drug Cost
$19K
Generic Drug Cost
$8K
Opioid Claims
141 (32.4% rate)

Patient Demographics

Average Patient Age
73.1 years
Avg HCC Risk Score
1.17
Gender Split
59% female / 41% 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
Gabapentin
103
Oxycodone Hcl
34
Oxycodone-Acetaminophen
Oxycodone Hcl/Acetaminophen
29
Trazodone Hcl
27
Hydrocodone-Acetaminophen
Hydrocodone/Acetaminophen
23
Diclofenac Sodium
22
Tramadol Hcl
21
Diclofenac Sodium Er
Diclofenac Sodium
18
Duloxetine Hcl
15
Methadone Hcl
15

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

Pain Medicine (Anesthesiology) Physician Overview

How NIDHI AGRAWAL, M.D. fits within the Pain Medicine (Anesthesiology) Physician landscape nationally.

4,020
Pain Medicine (Anesthesiology) Physician Providers in US
53
States with Pain Medicine (Anesthesiology) Physician
1,657
Avg Claims per Provider

NIDHI AGRAWAL, M.D.'s 435 claims are below the specialty average of 1,657.

Nearby Pain Medicine (Anesthesiology) Physician Providers in Pennsylvania

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

Compare Pain Medicine (Anesthesiology) Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is NIDHI AGRAWAL, M.D.'s specialty?
NIDHI AGRAWAL, M.D. specializes in Pain Medicine (Anesthesiology) Physician and practices in HORSHAM, Pennsylvania. Credentials: M.D..
How much does NIDHI AGRAWAL, M.D. prescribe under Medicare Part D?
In 2023, NIDHI AGRAWAL, M.D. wrote 435 Medicare Part D claims totaling $28K in drug costs for 86 beneficiaries.
What is NIDHI AGRAWAL, M.D.'s Medicare quality score?
NIDHI AGRAWAL, M.D. has a CMS MIPS Final Score of 91.75/100. The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is NIDHI AGRAWAL, M.D. located?
NIDHI AGRAWAL, M.D. is located at 300 WELSH RD BLDG 2, HORSHAM, PA, 19044. Phone: (844) 365-7246.
What is NIDHI AGRAWAL, M.D.'s NPI number?
NIDHI AGRAWAL, M.D.'s National Provider Identifier (NPI) is 1043625726, issued on 06/21/2014.
Does NIDHI AGRAWAL, M.D. prescribe more brand-name or generic drugs?
NIDHI AGRAWAL, M.D.'s prescribing is 5% brand-name and 95% generic drugs by claim count, with $19K in brand drug costs.
Does NIDHI AGRAWAL, M.D. prescribe opioids?
Yes, NIDHI AGRAWAL, M.D. had 141 opioid claims in 2023 with an opioid prescribing rate of 32.4%.
How many Pain Medicine (Anesthesiology) Physician providers are there in the US?
There are 4,020 Pain Medicine (Anesthesiology) Physician providers across 53 states in the US. The average Pain Medicine (Anesthesiology) Physician provider writes 1,657 Medicare Part D claims per year.
What drugs does NIDHI AGRAWAL, M.D. prescribe most often?
Based on 2023 Medicare Part D data, NIDHI AGRAWAL, M.D.'s most frequently prescribed drugs include Gabapentin, Oxycodone Hcl, Oxycodone-Acetaminophen. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does NIDHI AGRAWAL, M.D. accept Medicare?
NIDHI AGRAWAL, M.D. appears in CMS Medicare data with 435 Part D claims and 86 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify NIDHI AGRAWAL, M.D.'s credentials?
NIDHI AGRAWAL, M.D.'s NPI is 1043625726 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