SCOTT MODENA, M.D.
Gastroenterology Physician in MEDFORD, New Jersey. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.
What the federal data shows
SCOTT MODENA, M.D. reported a CMS MIPS final score of 100/100 — above the 83.1 national average — and filed 815 Medicare Part D claims in 2023.
- 100/100
- MIPS score · +17 vs avg
- 815
- Part D claims, 2023
- 85%
- 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.
SCOTT MODENA, M.D.'s MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023 — the federal quality measure
100 Top 7% higher than 93% 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
SCOTT MODENA, 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 SCOTT MODENA, M.D.?
High performer (top quartile)Primary specialty
Medicare Part D claims
MIPS final score
Specialty distribution in New Jersey
How Gastroenterology Physician compares to other specialties among New Jersey providers
Gastroenterology Physician share within New Jersey
Gastroenterology Physician is one of the more visible NUCC categories in New Jersey
Each bar reflects the share of in-state providers whose primary NUCC taxonomy matches the specialty. Long tail of ~690 NUCC codes folded into "Other" to keep the comparison legible.
Medicare quality performance — MIPS
SCOTT MODENA, M.D.'s 2023 MIPS final score plotted against the Gastroenterology Physician national average
- MIPS Final Score
- 100/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Gastroenterology Physician) — 100/100 vs national avg 83.1
Quality benchmarks
- National MIPS avg 2023 reporting year
- Specialty volume Gastroenterology Physician US NPIs
100/100 MIPS final score — 16.9 pts above the 83.1 national average
Quality, Cost, Promoting Interoperability, and Improvement Activities composite score for the 2023 performance year. Specialty: Gastroenterology Physician.
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).
SCOTT MODENA, M.D. appears in the CMS NPPES registry as a Gastroenterology Physician provider holding M.D. credentials at 128 ROUTE 70 STE 1B RIGHT, MEDFORD, NJ, 08055, with a listed phone of (856) 237-8045. NPI 1659339133 was issued on 05/03/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what MODENA 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 815 prescription claims written by this provider, covering 294 Medicare beneficiaries and totaling roughly $130K in drug spend, split 15% brand-name and 85% 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 100/100 for the 2023 performance year, compared with the national average of 83.1.
Gastroenterology Physician is a mid-sized specialty nationwide, with 16,567 enrolled providers across 54 states and an average of 833 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 | 1659339133 |
|---|---|
| Specialty | Gastroenterology Physician |
| Credentials | M.D. |
| Gender | Male |
| NPI Issued | 05/03/2006 |
Verify this provider's license
PlainDoctor pulls this profile from the CMS NPPES public registry. Confirm SCOTT MODENA, M.D.'s current license status, disciplinary history, and board certifications with the New Jersey State Board of Medical Examiners in New Jersey before relying on this page for a clinical or care decision.
How we sourced this profile
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
Reporting: Group practice
Hospital and facility affiliations
Facilities where SCOTT MODENA, 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.
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 SCOTT MODENA, M.D.. Source: openpaymentsdata.cms.gov.
Total received
$532
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 · Typical
15% brand-name claims vs 85% generic, on 815 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.
Prescribing Breakdown
- 30-Day Fills
- 1,285
- Total Day Supply
- 33,748
- Brand vs Generic
- 15% brand / 85% generic
- Brand Drug Cost
- $64K
- Generic Drug Cost
- $65K
- Antibiotic Claims
- 12
Patient Demographics
- Average Patient Age
- 71.4 years
- Avg HCC Risk Score
- 1.08
- Gender Split
- 56% female / 44% male
- Age Distribution
- <65: 40, 65-74: 149, 75-84: 88, 85+: 17
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What SCOTT MODENA, M.D. prescribes most
Top Medicare Part D drugs by claim count, 2023
- Pantoprazole Sodium
Pantoprazole Sodium
171 claims
- Omeprazole
Omeprazole
137 claims
- Dicyclomine Hcl 48
Dicyclomine Hcl
48 claims
- Famotidine 38
Famotidine
38 claims
- Esomeprazole Magne… 36
Esomeprazole Magnesium
36 claims
- Dexlansoprazole Dr 29
Dexlansoprazole Dr
29 claims
- Mesalamine 29
Mesalamine
29 claims
- Colestipol Hcl 27
Colestipol Hcl
27 claims
| Drug | Claims |
|---|---|
| Pantoprazole Sodium | 171 |
| Omeprazole | 137 |
| Dicyclomine Hcl | 48 |
| Famotidine | 38 |
| Esomeprazole Magnesium | 36 |
| Dexlansoprazole Dr Dexlansoprazole | 29 |
| Mesalamine | 29 |
| Colestipol Hcl | 27 |
| Clenpiq Sod Picosulf/Mag Ox/Citric Ac | 26 |
| Linzess Linaclotide | 25 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Gastroenterology Physician Overview
How SCOTT MODENA, M.D. fits within the Gastroenterology Physician landscape nationally.
SCOTT MODENA, M.D.'s 815 claims are below the specialty average of 833.
Nearby Gastroenterology Physician Providers in New Jersey
Other clinicians with the same primary specialty enrolled in New Jersey, drawn from the same CMS NPPES roster as MODENA.
Compare Gastroenterology Physician nationally: see state-by-state distribution →
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Frequently Asked Questions
What is SCOTT MODENA, M.D.'s specialty? ▼
How much does SCOTT MODENA, M.D. prescribe under Medicare Part D? ▼
What is SCOTT MODENA, M.D.'s Medicare quality score? ▼
Where is SCOTT MODENA, M.D. located? ▼
What is SCOTT MODENA, M.D.'s NPI number? ▼
Does SCOTT MODENA, M.D. prescribe more brand-name or generic drugs? ▼
How many Gastroenterology Physician providers are there in the US? ▼
What drugs does SCOTT MODENA, M.D. prescribe most often? ▼
Does SCOTT MODENA, M.D. accept Medicare? ▼
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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