2026 NPPES data Medical Physician Assistant NPI 1215024898 PA
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SEJAL OTERO, PA

Medical Physician Assistant in JEFFERSON VALLEY, New York. 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
4K
Medicare Part D claims · 373 beneficiaries · Medical Physician Assistant avg: 1K
Generic prescribing
82%
generic claims · 18% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
92.2478/100
▲ 9 pts above national avg 83.1 · [object Object]
Industry payments
$5.8K
265 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

SEJAL OTERO, PA reported a CMS MIPS final score of 92.2478/100 — above the 83.1 national average — and filed 3,593 Medicare Part D claims in 2023.

92.2478/100
MIPS score · +9 vs avg
4K
Part D claims, 2023
82%
generic prescribing
$5.8K
industry payments (Sunshine Act)

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.

SEJAL OTERO, PA'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 32% higher than 68% 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%). Below this entry. 90–100: 189,403 scored providers (40%). This entry sits in this band. 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

What does the federal data show about SEJAL OTERO, PA?

High performer (top quartile)

NPI registry status

Active

Issued 10/06/2006

NPI 1215024898

Primary specialty

Medical Physician Assistant

Mid-sized

40,527 US NPIs in this specialty

Medicare Part D claims

3,593 234% vs specialty avg

2023 prescription claims

Specialty avg: 1,077

MIPS final score

92.2478/100 9.147800000000004% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in New York

How Medical Physician Assistant compares to other specialties among New York providers

New York providers

Medical Physician Assistant share within New York

1. Medical Physician Assistant42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Medical Physician Assistant share within New York

Medicare quality performance — MIPS

SEJAL OTERO, PA's 2023 MIPS final score plotted against the Medical Physician Assistant national average

High performer (top quartile)
MIPS Final Score
92.2478/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Medical Physician Assistant) — 92.2478/100 vs national avg 83.1

0%100%National avg83%92.2%
MIPS final score (Medical Physician Assistant) — 92.2478/100 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).

SEJAL OTERO, PA appears in the CMS NPPES registry as a Medical Physician Assistant provider holding PA credentials at 3630 HILL BLVD, JEFFERSON VALLEY, NY, 10535, with a listed phone of (914) 245-5400. NPI 1215024898 was issued on 10/06/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what OTERO 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 3,593 prescription claims written by this provider, covering 373 Medicare beneficiaries and totaling roughly $793K in drug spend, split 18% brand-name and 82% generic by claim count, with an opioid prescribing rate of 1.1%. 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 92.2478/100 for the 2023 performance year (Quality 84.4957), compared with the national average of 83.1.

Medical Physician Assistant is a mid-sized specialty nationwide, with 40,527 enrolled providers across 55 states and an average of 1,077 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

3630 HILL BLVD
JEFFERSON VALLEY, NY 10535

Provider Details

NPI 1215024898
Specialty Medical Physician Assistant
Credentials PA
Gender Female
NPI Issued 10/06/2006

CMS Quality Score (MIPS)

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

92.2478
Final Score
Avg: 83.1
84.4957
Quality

Reporting: Group practice

Hospital and facility affiliations

Facilities where SEJAL OTERO, PA 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.

WESTCHESTER PUTNAM GASTROENTEROLOGY PC
JEFFERSON VALLEY, NY

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 SEJAL OTERO, PA. Source: openpaymentsdata.cms.gov.

Total received

$5.8K

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.

License & disciplinary context — New York NYSBPMC 2023 annual report

Aggregate state board data only — NOT a determination of any individual provider's status. The figures below describe statewide disciplinary activity across all ~100K New York medical licensees in 2023 — they are NOT specific to SEJAL OTERO, PA. To verify SEJAL OTERO, PA's current license status, search the NYSBPMC public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

312
Total board actions, New York 2023
Across 302 cases
3.12
Actions per 1,000 licensees
New York statewide rate
probation
Most common action type
89 cases

NYSBPMC publishes annual disciplinary statistics as part of public-record reporting under each state's Administrative Procedure Act. See the full breakdown by action type and year on the New York disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Typical

SEJAL OTERO, PA — brand share 18.0%
Specialty average (est.)

18% brand-name claims vs 82% generic, on 3,593 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.

3,593
Total Claims
$793K
Total Drug Cost
373
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
8,117
Total Day Supply
235,661
Brand vs Generic
18% brand / 82% generic
Brand Drug Cost
$660K
Generic Drug Cost
$132K
Opioid Claims
40 (1.1% rate)
Antibiotic Claims
151

Patient Demographics

Average Patient Age
73.2 years
Avg HCC Risk Score
1.01
Gender Split
56% female / 44% male
Age Distribution
<65: 37, 65-74: 173, 75-84: 120, 85+: 43

Top Prescribed Drugs (Medicare Part D)

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

What SEJAL OTERO, PA 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
152
Amlodipine Besylate
144
Losartan Potassium
120
Metoprolol Succinate
109
Omeprazole
107
Levothyroxine Sodium
105
Alprazolam
94
Rosuvastatin Calcium
89
Zolpidem Tartrate
69
Lisinopril
63

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

Medical Physician Assistant Overview

How SEJAL OTERO, PA fits within the Medical Physician Assistant landscape nationally.

40,527
Medical Physician Assistant Providers in US
55
States with Medical Physician Assistant
1,077
Avg Claims per Provider

SEJAL OTERO, PA's 3,593 claims are above the specialty average of 1,077.

Nearby Medical Physician Assistant Providers in New York

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

Compare Medical Physician Assistant nationally: see state-by-state distribution →

Frequently Asked Questions

What is SEJAL OTERO, PA's specialty?
SEJAL OTERO, PA specializes in Medical Physician Assistant and practices in JEFFERSON VALLEY, New York. Credentials: PA.
How much does SEJAL OTERO, PA prescribe under Medicare Part D?
In 2023, SEJAL OTERO, PA wrote 3,593 Medicare Part D claims totaling $793K in drug costs for 373 beneficiaries.
What is SEJAL OTERO, PA's Medicare quality score?
SEJAL OTERO, PA has a CMS MIPS Final Score of 92.2478/100 (Quality: 84.4957). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is SEJAL OTERO, PA located?
SEJAL OTERO, PA is located at 3630 HILL BLVD, JEFFERSON VALLEY, NY, 10535. Phone: (914) 245-5400.
What is SEJAL OTERO, PA's NPI number?
SEJAL OTERO, PA's National Provider Identifier (NPI) is 1215024898, issued on 10/06/2006.
Does SEJAL OTERO, PA prescribe more brand-name or generic drugs?
SEJAL OTERO, PA's prescribing is 18% brand-name and 82% generic drugs by claim count, with $660K in brand drug costs.
Does SEJAL OTERO, PA prescribe opioids?
Yes, SEJAL OTERO, PA had 40 opioid claims in 2023 with an opioid prescribing rate of 1.1%.
How many Medical Physician Assistant providers are there in the US?
There are 40,527 Medical Physician Assistant providers across 55 states in the US. The average Medical Physician Assistant provider writes 1,077 Medicare Part D claims per year.
What drugs does SEJAL OTERO, PA prescribe most often?
Based on 2023 Medicare Part D data, SEJAL OTERO, PA's most frequently prescribed drugs include Atorvastatin Calcium, Amlodipine Besylate, Losartan Potassium. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does SEJAL OTERO, PA accept Medicare?
SEJAL OTERO, PA appears in CMS Medicare data with 3,593 Part D claims and 373 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify SEJAL OTERO, PA's credentials?
SEJAL OTERO, PA's NPI is 1215024898 with credentials PA. 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