2026 NPPES data Internal Medicine Physician NPI 1538242037 MD
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Robert Simon, MD

Internal Medicine Physician in Toms River, New Jersey. This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 172,858 in Internal Medicine Physician, and covers specialty classification, practice address, and Medicare Part D prescribing data when reported. According to CMS, every field reflects the provider's official federal registration, see our methodology.

Federal data, no proprietary rating. We show these CMS records as-is - no composite score, no star rating, no editorial opinion layered on top.
Prescribing volume
4K
Medicare Part D claims · 535 beneficiaries · Internal Medicine Physician avg: 3K
Generic prescribing
90%
generic claims · 8% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
80/100
▼ 3 pts below national avg 83.1 · Above neutral
Compiled from official public sources by the PlainDoctor editorial team.

What the federal data shows

Robert Simon, MD reported a CMS MIPS final score of 80/100 - below the 83.1 national average - and filed 3,898 Medicare Part D claims in 2023.

80/100
MIPS score · -3 vs avg
4K
Part D claims, 2023
90%
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.

Robert Simon, MD's MIPS score vs every scored U.S. clinician

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

80 33rd percentile higher than 33% 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%). This entry sits in this band. 90+: 189,403 scored providers (40%). Above this entry. 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

Where Robert Simon, MD sits

This provider among internal medicine physician peers

Across the 36,260 internal medicine physician providers who report both Medicare Part D prescribing and a MIPS quality score, Robert Simon, MD writes more Part D claims than 76% of them and scores higher on MIPS quality than 32% - placing this provider in the high-volume, lower-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.

Part D claim volume vs MIPS quality, by specialty percentile

Lower volume · High qualityHigh volume · High qualityLower volume · Lower qualityHigh volume · Lower quality02550751000255075100Part D claim volume, percentile in specialtyMIPS quality, percentilePart D claim volume, percentile in specialty: 98 · MIPS quality, percentile: 88Part D claim volume, percentile in specialty: 43 · MIPS quality, percentile: 67Part D claim volume, percentile in specialty: 55 · MIPS quality, percentile: 18Part D claim volume, percentile in specialty: 82 · MIPS quality, percentile: 48Part D claim volume, percentile in specialty: 30 · MIPS quality, percentile: 42Part D claim volume, percentile in specialty: 77 · MIPS quality, percentile: 45Part D claim volume, percentile in specialty: 3 · MIPS quality, percentile: 85Part D claim volume, percentile in specialty: 42 · MIPS quality, percentile: 38Part D claim volume, percentile in specialty: 97 · MIPS quality, percentile: 53Part D claim volume, percentile in specialty: 65 · MIPS quality, percentile: 93Part D claim volume, percentile in specialty: 20 · MIPS quality, percentile: 97Part D claim volume, percentile in specialty: 37 · MIPS quality, percentile: 60Part D claim volume, percentile in specialty: 27 · MIPS quality, percentile: 25Part D claim volume, percentile in specialty: 28 · MIPS quality, percentile: 13Part D claim volume, percentile in specialty: 95 · MIPS quality, percentile: 0Part D claim volume, percentile in specialty: 92 · MIPS quality, percentile: 18Part D claim volume, percentile in specialty: 70 · MIPS quality, percentile: 92Part D claim volume, percentile in specialty: 15 · MIPS quality, percentile: 12Part D claim volume, percentile in specialty: 90 · MIPS quality, percentile: 18Part D claim volume, percentile in specialty: 0 · MIPS quality, percentile: 27Part D claim volume, percentile in specialty: 47 · MIPS quality, percentile: 30Part D claim volume, percentile in specialty: 67 · MIPS quality, percentile: 77Part D claim volume, percentile in specialty: 53 · MIPS quality, percentile: 97Part D claim volume, percentile in specialty: 73 · MIPS quality, percentile: 3Part D claim volume, percentile in specialty: 7 · MIPS quality, percentile: 52Part D claim volume, percentile in specialty: 23 · MIPS quality, percentile: 55Part D claim volume, percentile in specialty: 48 · MIPS quality, percentile: 10Part D claim volume, percentile in specialty: 52 · MIPS quality, percentile: 17Part D claim volume, percentile in specialty: 22 · MIPS quality, percentile: 33Part D claim volume, percentile in specialty: 78 · MIPS quality, percentile: 77Part D claim volume, percentile in specialty: 100 · MIPS quality, percentile: 2Part D claim volume, percentile in specialty: 85 · MIPS quality, percentile: 50Part D claim volume, percentile in specialty: 83 · MIPS quality, percentile: 73Part D claim volume, percentile in specialty: 35 · MIPS quality, percentile: 83Part D claim volume, percentile in specialty: 72 · MIPS quality, percentile: 32Part D claim volume, percentile in specialty: 12 · MIPS quality, percentile: 15Part D claim volume, percentile in specialty: 88 · MIPS quality, percentile: 40Part D claim volume, percentile in specialty: 25 · MIPS quality, percentile: 35Part D claim volume, percentile in specialty: 5 · MIPS quality, percentile: 62Part D claim volume, percentile in specialty: 57 · MIPS quality, percentile: 70Part D claim volume, percentile in specialty: 80 · MIPS quality, percentile: 5Part D claim volume, percentile in specialty: 62 · MIPS quality, percentile: 18Part D claim volume, percentile in specialty: 75 · MIPS quality, percentile: 58Part D claim volume, percentile in specialty: 87 · MIPS quality, percentile: 28Part D claim volume, percentile in specialty: 38 · MIPS quality, percentile: 88Part D claim volume, percentile in specialty: 8 · MIPS quality, percentile: 75Part D claim volume, percentile in specialty: 33 · MIPS quality, percentile: 87Part D claim volume, percentile in specialty: 63 · MIPS quality, percentile: 8Part D claim volume, percentile in specialty: 18 · MIPS quality, percentile: 72Part D claim volume, percentile in specialty: 68 · MIPS quality, percentile: 68Part D claim volume, percentile in specialty: 40 · MIPS quality, percentile: 47Part D claim volume, percentile in specialty: 50 · MIPS quality, percentile: 7Part D claim volume, percentile in specialty: 2 · MIPS quality, percentile: 63Part D claim volume, percentile in specialty: 60 · MIPS quality, percentile: 95Part D claim volume, percentile in specialty: 45 · MIPS quality, percentile: 37Part D claim volume, percentile in specialty: 10 · MIPS quality, percentile: 57Part D claim volume, percentile in specialty: 13 · MIPS quality, percentile: 82Part D claim volume, percentile in specialty: 32 · MIPS quality, percentile: 63Part D claim volume, percentile in specialty: 58 · MIPS quality, percentile: 97Part D claim volume, percentile in specialty: 17 · MIPS quality, percentile: 80Robert Simon, MD-Part D claim volume, percentile in specialty: 76 · MIPS quality, percentile: 32
Part D claim volume vs MIPS quality, by specialty percentile

Each dot is one internal medicine physician peer from a representative sample of 60; the gold marker is Robert Simon, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.

Board certification likely (heuristic, not verified)

Robert Simon, 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 Robert Simon, MD?

Near national average

NPI registry status

Active

Issued 10/20/2006

NPI 1538242037

Primary specialty

Internal Medicine Physician

High-volume

172,858 US NPIs in this specialty

Medicare Part D claims

3,898 44% vs specialty avg

2023 prescription claims

Specialty avg: 2,716

MIPS final score

80/100 3.1 pts vs avg

Above neutral band

vs 83.1 national avg

Specialty distribution in New Jersey

How Internal Medicine Physician compares to other specialties among New Jersey providers

New Jersey providers

Largest specialties in New Jersey (% of in-state providers)

Mental Health Counselor - 6.2%Mental Health Counselor6.2%Physical Therapist - 5.9%Physical Therapist5.9%Clinical Social Worker - 5.5%Clinical Social Worker5.5%Student in an Organized Health Care Education/Training Program - 5.4%Student in an Organized Health Care Education/Training Program5.4%Pharmacist - 5%Pharmacist5%Internal Medicine Physician - 3.1%Internal Medicine Physician3.1%
Largest specialties in New Jersey (% of in-state providers)

Medicare quality performance, MIPS

Robert Simon, MD's 2023 MIPS final score plotted against the Internal Medicine Physician national average

Near national average
MIPS Final Score
80/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Internal Medicine Physician) - 80/100 vs national avg 83.1

0%100%National avg83%80%
MIPS final score (Internal Medicine Physician) - 80/100 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).

Robert Simon, MD appears in the CMS NPPES registry as a Internal Medicine Physician provider holding MD credentials at 20 HOSPITAL DR, Toms River, NJ, 08755, with a listed phone of (732) 281-0530. NPI 1538242037 was issued on 10/20/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what Simon 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 3,898 prescription claims written by this provider, covering 535 Medicare beneficiaries and totaling roughly $329K in drug spend, split 8% brand-name and 90% 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 80/100 for the 2023 performance year (Quality 50.1, Cost 83), compared with the national average of 83.1.

Internal Medicine Physician is a high-volume specialty nationwide, with 172,858 enrolled providers across 56 states and an average of 2,716 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

20 HOSPITAL DR
Toms River, NJ 08755

Provider Details

NPI 1538242037
Specialty Internal Medicine Physician
Credentials MD
Gender Male
NPI Issued 10/20/2006

CMS Quality Score (MIPS)

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

80.0415
Final Score
Avg: 83.1
50.1122
Quality
83.004
Cost
89
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where Robert Simon, 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.

Deborah Cardiovascular Group, P.C.
Browns Mills, NJ

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 · Generic-heavy

Robert Simon, MD - brand share 8.0%
Internal Medicine Physician average

8% brand-name claims vs 90% generic, on 3,898 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.

3,898
Total Claims
$329K
Total Drug Cost
535
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
10,069
Total Day Supply
295,951
Brand vs Generic
8% brand / 90% generic
Brand Drug Cost
$253K
Generic Drug Cost
$75K
Antibiotic Claims
146

Patient Demographics

Average Patient Age
76.7 years
Avg HCC Risk Score
1.01
Gender Split
54% female / 46% male
Age Distribution
<65: 16, 65-74: 203, 75-84: 214, 85+: 102

Top Prescribed Drugs (Medicare Part D)

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

What Robert Simon, MD 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
Atorvastatin Calcium
387
Lisinopril
248
Levothyroxine Sodium
247
Alprazolam
238
Amlodipine Besylate
179
Metformin Hcl
176
Metoprolol Succinate
152
Losartan Potassium
150
Rosuvastatin Calcium
138
Hydrochlorothiazide
134

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

Internal Medicine Physician Overview

How Robert Simon, MD fits within the Internal Medicine Physician landscape nationally.

172,858
Internal Medicine Physician Providers in US
56
States with Internal Medicine Physician
2,716
Avg Claims per Provider

Robert Simon, MD's 3,898 claims are above the specialty average of 2,716.

Nearby Internal Medicine Physician Providers in New Jersey

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

Compare Internal Medicine Physician nationally: see state-by-state distribution →

Before you book an appointment

Use this federal record as your verification checklist, not as a recommendation.

  • Confirm the NPI record is current in the official CMS registry, providers update their own NPPES details, and moves can lag. Verify this NPI
  • Check the active license and any disciplinary history with the New Jersey medical board, federal registration is not a license check. Credential verification guide
  • Weigh a second option: compare this provider with a nearby Internal Medicine Physician peer on Medicare volume and prescribing patterns. Compare providers

Medicare Part D and MIPS figures describe practice patterns in federal programs only, they are not quality ratings, and PlainDoctor does not rate, rank, or recommend providers.

Frequently Asked Questions

What is Robert Simon, MD's specialty?
Robert Simon, MD specializes in Internal Medicine Physician and practices in Toms River, New Jersey. Credentials: MD.
How much does Robert Simon, MD prescribe under Medicare Part D?
In 2023, Robert Simon, MD wrote 3,898 Medicare Part D claims totaling $329K in drug costs for 535 beneficiaries.
What is Robert Simon, MD's Medicare quality score?
Robert Simon, MD has a CMS MIPS Final Score of 80/100 (Quality: 50.1, Cost: 83). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Robert Simon, MD located?
Robert Simon, MD is located at 20 HOSPITAL DR, Toms River, NJ, 08755. Phone: (732) 281-0530.
What is Robert Simon, MD's NPI number?
Robert Simon, MD's National Provider Identifier (NPI) is 1538242037, issued on 10/20/2006.
Does Robert Simon, MD prescribe more brand-name or generic drugs?
Robert Simon, MD's prescribing is 8% brand-name and 90% generic drugs by claim count, with $253K in brand drug costs.
How many Internal Medicine Physician providers are there in the US?
There are 172,858 Internal Medicine Physician providers across 56 states in the US. The average Internal Medicine Physician provider writes 2,716 Medicare Part D claims per year.
What drugs does Robert Simon, MD prescribe most often?
Based on 2023 Medicare Part D data, Robert Simon, MD's most frequently prescribed drugs include Atorvastatin Calcium, Lisinopril, Levothyroxine Sodium. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Robert Simon, MD accept Medicare?
Robert Simon, MD appears in CMS Medicare data with 3,898 Part D claims and 535 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Robert Simon, MD's credentials?
Robert Simon, MD's NPI is 1538242037 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

Compiled from official public sources by the PlainDoctor editorial team.