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2026 NPPES data Endocrinology, Diabetes & Metabolism Physician NPI 1407995640 M.D.
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Roberto Ortiz, M.D.

Endocrinology, Diabetes & Metabolism Physician in Providence, Rhode Island.

This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 8,078 in Endocrinology, Diabetes & Metabolism 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
12K
Medicare Part D claims · 1K beneficiaries · Endocrinology, Diabetes & Metabolism Physician avg: 3K
Generic prescribing
53%
generic claims · 40% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
82.9/100
▼ 1 pts below national avg 83.5 · Above neutral
Industry payments
$36.85
2 payments · CMS Open Payments (Sunshine Act)
Verify NPI on CMS Methodology
Compiled from official public sources by the editorial process.

What the federal data shows

Roberto Ortiz, M.D. reported a CMS MIPS final score of 82.9/100 - below the 83.5 national average - and filed 12,307 Medicare Part D claims in 2024.

82.9/100
MIPS score · -1 vs avg
12K
Part D claims, 2024
53%
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.

Federal trust snapshot

What official records show about Roberto Ortiz, M.D.

Federal records show an active NPI with both Medicare prescribing volume and a measured CMS quality score — objective registry data, not patient reviews.

  • Verified

    NPI registry status

    Active listing in the CMS National Provider Identifier Registry (NPI 1407995640), first enumerated 02/05/2007.

    Source: CMS NPPES

  • Reported

    Medicare Part D participation

    Filed 12,307 Medicare Part D prescription claims in the 2023 CMS public use file — indicates active Medicare prescribing participation.

    Source: CMS Part D Prescriber PUF

  • Reported

    CMS quality reporting (MIPS)

    Reported a CMS MIPS final score of 82.9/100 in the Quality Payment Program — a federal quality measure, not a patient review.

    Source: CMS Quality Payment Program

  • Reported

    Board certification signal

    Heuristic suggests board-certified status based on ABMS-eligible specialty taxonomy plus active CMS participation signals — not a direct ABMS verification.

    Source: NUCC taxonomy + CMS participation heuristic

  • Reported

    Hospital affiliations

    1 CMS Care Compare hospital affiliation on record — practice footprint from the Doctors and Clinicians file.

    Source: CMS Care Compare

  • Reported

    Industry payment transparency

    $36.85 in reported industry payments (2 transfers) in 2024 under the federal Sunshine Act — disclosed transfers of value, not a quality rating.

    Source: CMS Open Payments

  • Not in federal data

    Individual sanction lookup

    PlainDoctor does not publish per-provider disciplinary determinations. Confirm current license and any individual actions through the state medical board or FSMB verification service.

    Source: State medical board / FSMB

This trust snapshot summarizes only what appears in federal CMS/NPPES public records. It is not a composite score, star rating, patient review, or clinical recommendation. PlainDoctor never fabricates reviews or AggregateRating schema.

CMS NPPES provider registry desk

NPI 1407995640 · Endocrinology, Diabetes & Metabolism Physician

NPI-10 · ENUM-MID · TAX-MID · MIPS-INLINE · RX-HEAVY · BOOK-THIN · PHOTO-FINISH

  • NPI-10 1407995640
  • ENUM-MID 2007
  • TAX-MID 8K Endocrinology, Diabetes
  • MIPS-INLINE 82.9/100
  • RX-HEAVY 12K claims
  • BOOK-THIN 32 in Rhode Island
  • PHOTO-FINISH Moussa Alhaj, M.D. · ±0.0

MIPS final-score neighbourhood

Same-specialty nationwide peers by CMS final score, not geographic proximity

MIPS pts

What this shows Nearest measured MIPS peers for this NUCC specialty (2023 performance year).

Source CMS Quality Payment Program (MIPS) As of 2023

Roberto Ortiz, M.D.'s MIPS score vs every measured U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure. Clinicians whose score CMS assigned without scoring any category are excluded.

83 ≥ 36th percentile 36% of 454,083 measured providers are in lower value bands

0–10: 8,684 measured providers (2%). Below this entry. 10–20: 3,008 measured providers (1%). Below this entry. 20–30: 3,069 measured providers (1%). Below this entry. 30–40: 2,746 measured providers (1%). Below this entry. 40–50: 2,928 measured providers (1%). Below this entry. 50–60: 5,882 measured providers (1%). Below this entry. 60–70: 13,906 measured providers (3%). Below this entry. 70–80: 94,570 measured providers (21%). Below this entry. 80–90: 129,887 measured providers (29%). This entry sits in this band. 90+: 189,403 measured providers (42%). Above this entry. This provider 0 100 every measured MIPS clinician, bucketed by value

Each bar is a band; taller bars hold more measured 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.

The percentile is a conservative whole-score-point band: it counts only measured clinicians in lower score bands. A CMS MIPS metric is not a recommendation or a clinical-quality rating by PlainDoctor. See methodology § corpus placement.

Source CMS Merit-based Incentive Payment System (MIPS) · 2023

Where Roberto Ortiz, M.D. sits

This provider among endocrinology, diabetes & metabolism physician peers

Across the 2,341 endocrinology, diabetes & metabolism physician providers who report both Medicare Part D prescribing and a MIPS quality score, Roberto Ortiz, M.D. writes more Part D claims than 99% of them and scores higher on MIPS quality than 40% - placing this provider in the high-volume, lower-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.

Lower volume · High qualityHigh volume · High qualityLower volume · Lower qualityHigh volume · Lower quality02550751000255075100Part D claim volume, percentile in specialtyMIPS quality, percentilePoint, Part D claim volume, percentile in specialty: 45 · MIPS quality, percentile: 80Point, Part D claim volume, percentile in specialty: 62 · MIPS quality, percentile: 77Point, Part D claim volume, percentile in specialty: 68 · MIPS quality, percentile: 70Point, Part D claim volume, percentile in specialty: 78 · MIPS quality, percentile: 40Point, Part D claim volume, percentile in specialty: 30 · MIPS quality, percentile: 52Point, Part D claim volume, percentile in specialty: 53 · MIPS quality, percentile: 58Point, Part D claim volume, percentile in specialty: 33 · MIPS quality, percentile: 23Point, Part D claim volume, percentile in specialty: 2 · MIPS quality, percentile: 40Point, Part D claim volume, percentile in specialty: 7 · MIPS quality, percentile: 95Point, Part D claim volume, percentile in specialty: 12 · MIPS quality, percentile: 23Point, Part D claim volume, percentile in specialty: 83 · MIPS quality, percentile: 32Point, Part D claim volume, percentile in specialty: 95 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 20 · MIPS quality, percentile: 87Point, Part D claim volume, percentile in specialty: 47 · MIPS quality, percentile: 3Point, Part D claim volume, percentile in specialty: 63 · MIPS quality, percentile: 35Point, Part D claim volume, percentile in specialty: 37 · MIPS quality, percentile: 48Point, Part D claim volume, percentile in specialty: 85 · MIPS quality, percentile: 78Point, Part D claim volume, percentile in specialty: 23 · MIPS quality, percentile: 13Point, Part D claim volume, percentile in specialty: 22 · MIPS quality, percentile: 92Point, Part D claim volume, percentile in specialty: 0 · MIPS quality, percentile: 98Point, Part D claim volume, percentile in specialty: 50 · MIPS quality, percentile: 12Point, Part D claim volume, percentile in specialty: 82 · MIPS quality, percentile: 22Point, Part D claim volume, percentile in specialty: 13 · MIPS quality, percentile: 98Point, Part D claim volume, percentile in specialty: 90 · MIPS quality, percentile: 68Point, Part D claim volume, percentile in specialty: 28 · MIPS quality, percentile: 93Point, Part D claim volume, percentile in specialty: 52 · MIPS quality, percentile: 90Point, Part D claim volume, percentile in specialty: 38 · MIPS quality, percentile: 7Point, Part D claim volume, percentile in specialty: 55 · MIPS quality, percentile: 62Point, Part D claim volume, percentile in specialty: 3 · MIPS quality, percentile: 20Point, Part D claim volume, percentile in specialty: 42 · MIPS quality, percentile: 5Point, Part D claim volume, percentile in specialty: 57 · MIPS quality, percentile: 50Point, Part D claim volume, percentile in specialty: 25 · MIPS quality, percentile: 55Point, Part D claim volume, percentile in specialty: 75 · MIPS quality, percentile: 33Point, Part D claim volume, percentile in specialty: 58 · MIPS quality, percentile: 73Point, Part D claim volume, percentile in specialty: 60 · MIPS quality, percentile: 45Point, Part D claim volume, percentile in specialty: 40 · MIPS quality, percentile: 83Point, Part D claim volume, percentile in specialty: 32 · MIPS quality, percentile: 38Point, Part D claim volume, percentile in specialty: 97 · MIPS quality, percentile: 57Point, Part D claim volume, percentile in specialty: 72 · MIPS quality, percentile: 83Point, Part D claim volume, percentile in specialty: 87 · MIPS quality, percentile: 72Point, Part D claim volume, percentile in specialty: 10 · MIPS quality, percentile: 18Point, Part D claim volume, percentile in specialty: 100 · MIPS quality, percentile: 97Point, Part D claim volume, percentile in specialty: 92 · MIPS quality, percentile: 28Point, Part D claim volume, percentile in specialty: 43 · MIPS quality, percentile: 65Point, Part D claim volume, percentile in specialty: 5 · MIPS quality, percentile: 37Point, Part D claim volume, percentile in specialty: 67 · MIPS quality, percentile: 27Point, Part D claim volume, percentile in specialty: 70 · MIPS quality, percentile: 80Point, Part D claim volume, percentile in specialty: 93 · MIPS quality, percentile: 10Point, Part D claim volume, percentile in specialty: 65 · MIPS quality, percentile: 30Point, Part D claim volume, percentile in specialty: 18 · MIPS quality, percentile: 88Point, Part D claim volume, percentile in specialty: 73 · MIPS quality, percentile: 43Point, Part D claim volume, percentile in specialty: 48 · MIPS quality, percentile: 63Point, Part D claim volume, percentile in specialty: 80 · MIPS quality, percentile: 53Point, Part D claim volume, percentile in specialty: 88 · MIPS quality, percentile: 75Point, Part D claim volume, percentile in specialty: 17 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 77 · MIPS quality, percentile: 2Point, Part D claim volume, percentile in specialty: 35 · MIPS quality, percentile: 60Point, Part D claim volume, percentile in specialty: 8 · MIPS quality, percentile: 17Point, Part D claim volume, percentile in specialty: 27 · MIPS quality, percentile: 8Point, Part D claim volume, percentile in specialty: 15 · MIPS quality, percentile: 15Roberto Ortiz, M.D., Part D claim volume, percentile in specialty: 99 · MIPS quality, percentile: 40
Part D claim volume vs MIPS quality, by specialty percentile

Each dot is one endocrinology, diabetes & metabolism physician peer from a representative sample of 60; the gold marker is Roberto Ortiz, M.D.. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.

✓
Board certification likely (heuristic, not verified)

Roberto Ortiz, 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).

What does the federal data show about Roberto Ortiz, M.D.?

Near national average

NPI registry status

Active

Issued 02/05/2007

NPI 1407995640

Primary specialty

Endocrinology, Diabetes & Metabolism Physician

Mid-sized

8,078 US NPIs in this specialty

Medicare Part D claims

12,307 349% vs specialty avg

2024 prescription claims

Specialty avg: 2,739

MIPS final score

82.9/100 0.6 pts vs avg

Above neutral band

vs 83.5 national avg

Specialty distribution in Rhode Island

How Endocrinology, Diabetes & Metabolism Physician compares to other specialties among Rhode Island providers

Rhode Island providers
Clinical Social Worker8.9%Mental Health Counselor5.3%Physical Therapist4.7%Student in an Organized Heal…4.6%Internal Medicine Physician4.2%Pharmacist4.1%Endocrinology, Diabetes & Me…0.1%
Largest specialties in Rhode Island (% of in-state providers)

Medicare quality performance, MIPS

Roberto Ortiz, M.D.'s 2023 MIPS final score plotted against the Endocrinology, Diabetes & Metabolism Physician national average

Near national average
MIPS Final Score
82.9/100
vs 83.5 national avg · 2023 performance year
0%100%National avg84%82.9%
MIPS final score (Endocrinology, Diabetes & Metabolism Physician) - 82.9/100 vs national avg 83.5
How MIPS and board certification work

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).

Practice Address

100 HIGHLAND AVE
Providence, RI 02906
(401) 351-7100

Provider Details

NPI 1407995640
Specialty Endocrinology, Diabetes & Metabolism Physician
Credentials M.D.
Gender Male
NPI Issued 02/05/2007

CMS Quality Score (MIPS)

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

82.9408
Final Score
Measured-score avg: 83.5
65.8817
Quality

Reporting: Group practice

Hospital and facility affiliations

Facilities where Roberto Ortiz, 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.

Diabetes And Endocrinology Associates, Inc.
Providence, RI

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

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 Roberto Ortiz, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$37

Largest payer

Amgen 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

Roberto Ortiz, M.D. - brand share 40.0%
Endocrinology, Diabetes & Metabolism Physician average

40% brand-name claims vs 53% generic, on 12,307 2024 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 2024.

12,307
Total Claims
$3.7M
Total Drug Cost
1,210
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
26,933.233
Total Day Supply
800,037
Brand vs Generic
40% brand / 53% generic
Brand Drug Cost
$3.4M
Generic Drug Cost
$134K
Antibiotic Claims
18

Patient Demographics

Average Patient Age
72.7 years
Avg HCC Risk Score
1.43
Gender Split
67% female / 33% male
Age Distribution
<65: 140, 65-74: 570, 75-84: 394, 85+: 106

Top Prescribed Drugs (Medicare Part D)

Top drugs by claim count for calendar year 2024. Based on Medicare Part D data only.

What Roberto Ortiz, M.D. prescribes most

Top Medicare Part D drugs by claim count, 2024

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2024
Drug Claims
Levothyroxine Sodium
 1,880
Synthroid
Levothyroxine Sodium
698
Glimepiride
 697
Metformin Hcl Er
Metformin Hcl
539
Jardiance
Empagliflozin
535
Atorvastatin Calcium
 519
Metformin Hcl
 509
Rosuvastatin Calcium
 413
Ozempic
Semaglutide
408
Nano 2nd Gen Pen Needle
Pen Needle, Diabetic
276

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

More Endocrinology, Diabetes & Metabolism Physician in RI → All providers in Rhode Island → Compare specialties →

Endocrinology, Diabetes & Metabolism Physician Overview

How Roberto Ortiz, M.D. fits within the Endocrinology, Diabetes & Metabolism Physician landscape nationally.

8,078
Endocrinology, Diabetes & Metabolism Physician Providers in US
54
States with Endocrinology, Diabetes & Metabolism Physician
2,739
Avg Claims per Provider

Roberto Ortiz, M.D.'s 12,307 claims are above the specialty average of 2,739.

Nationwide Endocrinology, Diabetes & Metabolism Physician peers with similar MIPS or enrollment year

Two federal-record peer sets for Ortiz, both outside Rhode Island so the neighborhoods are not geographic containment.

Similar MIPS final score

Nearest same-specialty clinicians by CMS MIPS final score (82.9 here).

Moussa Alhaj 82.9 KY George Borst 82.9 KY Roberto Mitsui Akagi 82.9 KY Ekatherine Rivera Markelova 82.9 NC

Same NPPES enumeration year (2007)

Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.

Jason Baker New York, NY Tracey McLaughlin Stanford, CA Deepika Reddy Salt Lake City, UT Suzel Vazquez South Miami, FL

Nearby Endocrinology, Diabetes & Metabolism Physician Providers in Rhode Island

Other clinicians with the same primary specialty enrolled in Rhode Island, drawn from the same CMS NPPES roster as Ortiz.

One of 32 Endocrinology, Diabetes & Metabolism Physician providers enrolled in Rhode Island, 5 are shown here.

Dr. Sudhir Bansal
MD
Warwick, RI
Dr. Lucinda Barnard
MD
Johnston, RI
Dr. Harikrashna Bhatt
M.D.
Riverside, RI
Dr. Russell Bratman
M.D.
Riverside, RI
Nathalie Campbell
Warwick, RI

Compare Endocrinology, Diabetes & Metabolism Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is Roberto Ortiz, M.D.'s specialty? ▼
Roberto Ortiz, M.D. specializes in Endocrinology, Diabetes & Metabolism Physician and practices in Providence, Rhode Island. Credentials: M.D..
How much does Roberto Ortiz, M.D. prescribe under Medicare Part D? ▼
In 2024, Roberto Ortiz, M.D. wrote 12,307 Medicare Part D claims totaling $3.7M in drug costs for 1,210 beneficiaries.
What is Roberto Ortiz, M.D.'s Medicare quality score? ▼
Roberto Ortiz, M.D. has a CMS MIPS Final Score of 82.9/100 (Quality: 65.9). The average MIPS Final Score across the 454,083 clinicians with at least one published category score is 83.5; clinicians whose score CMS assigned without scoring any category are excluded from that average. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Roberto Ortiz, M.D. located? ▼
Roberto Ortiz, M.D. is located at 100 HIGHLAND AVE, Providence, RI, 02906. Phone: (401) 351-7100.
What is Roberto Ortiz, M.D.'s NPI number? ▼
Roberto Ortiz, M.D.'s National Provider Identifier (NPI) is 1407995640, issued on 02/05/2007.
Does Roberto Ortiz, M.D. prescribe more brand-name or generic drugs? ▼
Roberto Ortiz, M.D.'s prescribing is 40% brand-name and 53% generic drugs by claim count, with $3.4M in brand drug costs.
How many Endocrinology, Diabetes & Metabolism Physician providers are there in the US? ▼
There are 8,078 Endocrinology, Diabetes & Metabolism Physician providers across 54 states in the US. The average Endocrinology, Diabetes & Metabolism Physician provider writes 2,739 Medicare Part D claims per year.
What drugs does Roberto Ortiz, M.D. prescribe most often? ▼
Based on 2024 Medicare Part D data, Roberto Ortiz, M.D.'s most frequently prescribed drugs include Levothyroxine Sodium, Synthroid, Glimepiride. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Roberto Ortiz, M.D. accept Medicare? ▼
Roberto Ortiz, M.D. appears in CMS Medicare data with 12,307 Part D claims and 1,210 Medicare beneficiaries in 2024. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Roberto Ortiz, M.D.'s credentials? ▼
Roberto Ortiz, M.D.'s NPI is 1407995640 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

View source datasets and methodology notes
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 (2024). 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 August 2026 (NPPES) / 2024 (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 editorial process.

Every figure on PlainDoctor is rendered directly from the federal CMS NPPES registry, Medicare Part D, MIPS, and Open Payments records, no number is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of August 2026.