2026 NPPES data Ophthalmology Physician NPI 1538120340 MD
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RAMON PORTELA, MD

Ophthalmology Physician in SAN JUAN, Puerto Rico. 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
92
Medicare Part D claims · 59 beneficiaries · Ophthalmology Physician avg: 1K
Generic prescribing
72%
generic claims · 28% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
93.6745/100
▲ 11 pts above national avg 83.1 · [object Object]
Industry payments
$28.14
1 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: RAMON PORTELA, MD is a Ophthalmology Physician ([object Object]) practicing in SAN JUAN, Puerto Rico with a Medicare Part D prescribing footprint of 92 claims across 59 beneficiaries — 28% brand-name prescribing . Their CMS MIPS Final Score of 93.6745/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $28.14 across 1 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: RAMON PORTELA, MD reported a CMS MIPS final score of 93.6745 out of 100, above the 83.1 national average, and filed 92 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)

RAMON PORTELA, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting — signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).

RAMON PORTELA, MD at a glance

High performer (top quartile)

NPI registry status

Active

Issued 03/31/2006

NPI 1538120340

Primary specialty

Ophthalmology Physician

Mid-sized

22,090 US NPIs in this specialty

Medicare Part D claims

92 94% vs specialty avg

2023 prescription claims

Specialty avg: 1,420

MIPS final score

93.6745/100 10.5745% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Puerto Rico

How Ophthalmology Physician compares to other specialties among Puerto Rico providers

Puerto Rico providers

Ophthalmology Physician share within Puerto Rico

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

Medicare quality performance — MIPS

RAMON PORTELA, MD's 2023 MIPS final score plotted against the Ophthalmology Physician national average

High performer (top quartile)
MIPS Final Score
93.6745/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Ophthalmology Physician) — 93.6745/100 vs national avg 83.1

0%100%National avg83%93.7%
MIPS final score (Ophthalmology Physician) — 93.6745/100 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).

RAMON PORTELA, MD is a Ophthalmology Physician provider practicing in SAN JUAN, Puerto Rico, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: MD. NPI: 1538120340. 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.

RAMON PORTELA, MD appears in the CMS NPPES registry as a Ophthalmology Physician provider holding MD credentials at AVE JESUS T PINERO 1250 CAPARRA TERRACE, SAN JUAN, PR, 00921, with a listed phone of (787) 781-2565. NPI 1538120340 was issued on 03/31/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what PORTELA 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 92 prescription claims written by this provider, covering 59 Medicare beneficiaries and totaling roughly $9K in drug spend, split 28% brand-name and 72% 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 93.6745/100 for the 2023 performance year (Quality 100, Cost 78.915), 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

AVE JESUS T PINERO 1250 CAPARRA TERRACE
SAN JUAN, PR 00921

Provider Details

NPI 1538120340
Specialty Ophthalmology Physician
Credentials MD
Gender Male
NPI Issued 03/31/2006

CMS Quality Score (MIPS)

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

93.6745
Final Score
Avg: 83.1
100
Quality
78.915
Cost

Reporting: Group practice

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 RAMON PORTELA, MD. Source: openpaymentsdata.cms.gov.

Total received

$28

Largest payer

ABBVIE 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.

Brand vs generic prescribing mix · Above average

RAMON PORTELA, MD — brand share 28.0%
Specialty average (est.)

28% brand-name claims vs 72% generic, on 92 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.

92
Total Claims
$9K
Total Drug Cost
59
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
96
Total Day Supply
1,422
Brand vs Generic
28% brand / 72% generic
Brand Drug Cost
$8K
Generic Drug Cost
$1K
Antibiotic Claims
20

Patient Demographics

Average Patient Age
74.7 years
Avg HCC Risk Score
1.51
Gender Split
61% female / 39% 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
Bacitracin-Polymyxin
Bacitracin/Polymyxin B Sulfate
18

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

Ophthalmology Physician Overview

How RAMON PORTELA, MD 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

RAMON PORTELA, MD's 92 claims are below the specialty average of 1,420.

Nearby Ophthalmology Physician Providers in Puerto Rico

Other clinicians with the same primary specialty enrolled in Puerto Rico, drawn from the same CMS NPPES roster as PORTELA.

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

Frequently Asked Questions

What is RAMON PORTELA, MD's specialty?
RAMON PORTELA, MD specializes in Ophthalmology Physician and practices in SAN JUAN, Puerto Rico. Credentials: MD.
How much does RAMON PORTELA, MD prescribe under Medicare Part D?
In 2023, RAMON PORTELA, MD wrote 92 Medicare Part D claims totaling $9K in drug costs for 59 beneficiaries.
What is RAMON PORTELA, MD's Medicare quality score?
RAMON PORTELA, MD has a CMS MIPS Final Score of 93.6745/100 (Quality: 100, Cost: 78.915). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is RAMON PORTELA, MD located?
RAMON PORTELA, MD is located at AVE JESUS T PINERO 1250 CAPARRA TERRACE, SAN JUAN, PR, 00921. Phone: (787) 781-2565.
What is RAMON PORTELA, MD's NPI number?
RAMON PORTELA, MD's National Provider Identifier (NPI) is 1538120340, issued on 03/31/2006.
Does RAMON PORTELA, MD prescribe more brand-name or generic drugs?
RAMON PORTELA, MD's prescribing is 28% brand-name and 72% generic drugs by claim count, with $8K 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 RAMON PORTELA, MD prescribe most often?
Based on 2023 Medicare Part D data, RAMON PORTELA, MD's most frequently prescribed drugs include Bacitracin-Polymyxin. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does RAMON PORTELA, MD accept Medicare?
RAMON PORTELA, MD appears in CMS Medicare data with 92 Part D claims and 59 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify RAMON PORTELA, MD's credentials?
RAMON PORTELA, MD's NPI is 1538120340 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