NPI registry status
Active
2026 NPPES data Hematology (Pathology) Physician NPI 1174747323 MD
Verify on CMS → Santhosh Ambika, MD
Hematology (Pathology) Physician in Reno, Nevada.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 745 in Hematology (Pathology) 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
1K
Medicare Part D claims · 233 beneficiaries · Hematology (Pathology) Physician avg: 617
Generic prescribing
64%
generic claims · 36% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
91.6/100
▲ 8 pts above national avg 83.1 · Exceptional
Industry payments
$22.5K
85 payments · CMS Open Payments (Sunshine Act)
Source: CMS Medicare Part D Prescriber Public Use File, 2023
Compiled from official public sources by the PlainDoctor editorial team.
What the federal data shows
Santhosh Ambika, MD reported a CMS MIPS final score of 91.6/100 - above the 83.1 national average - and filed 1,242 Medicare Part D claims in 2023.
- 91.6/100
- MIPS score · +8 vs avg
- 1K
- Part D claims, 2023
- 64%
- 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.
Santhosh Ambika, 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
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)
Santhosh Ambika, 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 Santhosh Ambika, MD?
High performer (top quartile)Primary specialty
Hematology (Pathology) Physician
Medicare Part D claims
1,242 101% vs specialty avg
MIPS final score
91.6/100 8.5 pts vs avg
Specialty distribution in Nevada
How Hematology (Pathology) Physician compares to other specialties among Nevada providers
Medicare quality performance, MIPS
Santhosh Ambika, MD's 2023 MIPS final score plotted against the Hematology (Pathology) Physician national average
- MIPS Final Score
- 91.6/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Hematology (Pathology) Physician) - 91.6/100 vs national avg 83.1
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).
Santhosh Ambika, MD appears in the CMS NPPES registry as a Hematology (Pathology) Physician provider holding MD credentials at 5423 RENO CORPORATE DR., Reno, NV, 89511, with a listed phone of (775) 329-0873. NPI 1174747323 was issued on 04/12/2007.
Medicare Part D records for calendar year 2023 show 1,242 prescription claims written by this provider, covering 233 Medicare beneficiaries and totaling roughly $5.5 million in drug spend, split 36% brand-name and 64% generic by claim count, with an opioid prescribing rate of 4.3%. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 91.6/100 for the 2023 performance year (Quality 85.1), compared with the national average of 83.1.
Hematology (Pathology) Physician is a narrow specialty nationwide, with 745 enrolled providers across 46 states and an average of 617 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
Provider Details
| NPI | 1174747323 |
|---|---|
| Specialty | Hematology (Pathology) Physician |
| Credentials | MD |
| Gender | Male |
| NPI Issued | 04/12/2007 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
91.5901
Final Score
Avg: 83.1
85.0511
Quality
96.8817
Promoting Interoperability
Reporting: Alternative Payment Model
Hospital and facility affiliations
Facilities where Santhosh Ambika, 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.
Humboldt General Hospital
★★☆☆☆ 2/5
Winnemucca, NV
Critical Access Hospitals
CMS CCN: 291308
John A Shields MD And Steven A Schiff MD A Professional Corporation
Reno, NV
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 Santhosh Ambika, MD. Source: openpaymentsdata.cms.gov.
Total received
$22.5K
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
Santhosh Ambika, MD - brand share 36.0%
Hematology (Pathology) Physician average
36% brand-name claims vs 64% generic, on 1,242 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.
1,242
Total Claims
$5.5M
Total Drug Cost
233
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 1,771
- Total Day Supply
- 47,954
- Brand vs Generic
- 36% brand / 64% generic
- Brand Drug Cost
- $5.2M
- Generic Drug Cost
- $266K
- Opioid Claims
- 53 (4.3% rate)
- Antibiotic Claims
- 42
Patient Demographics
- Average Patient Age
- 74.4 years
- Avg HCC Risk Score
- 2.10
- Gender Split
- 54% female / 46% male
- Age Distribution
- <65: 14, 65-74: 100, 75-84: 96, 85+: 23
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Santhosh Ambika, MD prescribes most
Top Medicare Part D drugs by claim count, 2023
- Anastrozole
Anastrozole
103 claims
- Hydroxyurea
Hydroxyurea
74 claims
- Levothyroxine Sodium
Levothyroxine Sodium
64 claims
- Acyclovir
Acyclovir
51 claims
- Brukinsa
Brukinsa
48 claims
- Jakafi
Jakafi
47 claims
- Alendronate Sodium 39
Alendronate Sodium
39 claims
- Hydrocodone-Acetam… 39
Hydrocodone-Acetaminophen
39 claims
| Drug | Claims |
|---|---|
| Anastrozole | 103 |
| Hydroxyurea | 74 |
| Levothyroxine Sodium | 64 |
| Acyclovir | 51 |
| Brukinsa Zanubrutinib | 48 |
| Jakafi Ruxolitinib Phosphate | 47 |
| Alendronate Sodium | 39 |
| Hydrocodone-Acetaminophen Hydrocodone/Acetaminophen | 39 |
| Ibrance Palbociclib | 35 |
| Ondansetron Odt Ondansetron | 35 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Hematology (Pathology) Physician Overview
How Santhosh Ambika, MD fits within the Hematology (Pathology) Physician landscape nationally.
745
Hematology (Pathology) Physician Providers in US
46
States with Hematology (Pathology) Physician
617
Avg Claims per Provider
Santhosh Ambika, MD's 1,242 claims are above the specialty average of 617.
Nearby Hematology (Pathology) Physician Providers in Nevada
Other clinicians with the same primary specialty enrolled in Nevada, drawn from the same CMS NPPES roster as Ambika.
Dr. Diana Garcia
MD
Las Vegas, NV
Dr. Stacey Garry
MD
Las Vegas, NV
Dr. David Marmaduke
MD
Las Vegas, NV
Dr. Michelle McNamara
MD
Las Vegas, NV
Dr. Wansong Qiu
MD PHD
Las Vegas, NV
Compare Hematology (Pathology) 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 Nevada medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Hematology (Pathology) 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.
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Frequently Asked Questions
What is Santhosh Ambika, MD's specialty? ▼
Santhosh Ambika, MD specializes in Hematology (Pathology) Physician and practices in Reno, Nevada. Credentials: MD.
How much does Santhosh Ambika, MD prescribe under Medicare Part D? ▼
In 2023, Santhosh Ambika, MD wrote 1,242 Medicare Part D claims totaling $5.5M in drug costs for 233 beneficiaries.
What is Santhosh Ambika, MD's Medicare quality score? ▼
Santhosh Ambika, MD has a CMS MIPS Final Score of 91.6/100 (Quality: 85.1). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Santhosh Ambika, MD located? ▼
Santhosh Ambika, MD is located at 5423 RENO CORPORATE DR., Reno, NV, 89511. Phone: (775) 329-0873.
What is Santhosh Ambika, MD's NPI number? ▼
Santhosh Ambika, MD's National Provider Identifier (NPI) is 1174747323, issued on 04/12/2007.
Does Santhosh Ambika, MD prescribe more brand-name or generic drugs? ▼
Santhosh Ambika, MD's prescribing is 36% brand-name and 64% generic drugs by claim count, with $5.2M in brand drug costs.
Does Santhosh Ambika, MD prescribe opioids? ▼
Yes, Santhosh Ambika, MD had 53 opioid claims in 2023 with an opioid prescribing rate of 4.3%.
How many Hematology (Pathology) Physician providers are there in the US? ▼
There are 745 Hematology (Pathology) Physician providers across 46 states in the US. The average Hematology (Pathology) Physician provider writes 617 Medicare Part D claims per year.
What drugs does Santhosh Ambika, MD prescribe most often? ▼
Based on 2023 Medicare Part D data, Santhosh Ambika, MD's most frequently prescribed drugs include Anastrozole, Hydroxyurea, Levothyroxine Sodium. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Santhosh Ambika, MD accept Medicare? ▼
Santhosh Ambika, MD appears in CMS Medicare data with 1,242 Part D claims and 233 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Santhosh Ambika, MD's credentials? ▼
Santhosh Ambika, MD's NPI is 1174747323 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
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 (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.