2026 NPPES data Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician NPI 1164670287 M.D.
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SETH COHEN, M.D.

Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician in IRVINE, California. 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
1K
Medicare Part D claims · 445 beneficiaries · Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician avg: 1K
MIPS score
99.1275/100
▲ 16 pts above national avg 83.1 · [object Object]
Industry payments
$3.8K
11 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

SETH COHEN, M.D. reported a CMS MIPS final score of 99.1275/100 — above the 83.1 national average — and filed 1,383 Medicare Part D claims in 2023.

99.1275/100
MIPS score · +16 vs avg
1K
Part D claims, 2023
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.

SETH COHEN, 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

99 Top 9% higher than 91% 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

Board certification likely (heuristic — not verified)

SETH COHEN, 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 SETH COHEN, M.D.?

High performer (top quartile)

NPI registry status

Active

Issued 09/03/2008

NPI 1164670287

Primary specialty

Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician

Rare

109 US NPIs in this specialty

Medicare Part D claims

1,383 25% vs specialty avg

2023 prescription claims

Specialty avg: 1,103

MIPS final score

99.1275/100 16.027500000000003% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in California

How Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician compares to other specialties among California providers

California providers

Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician share within California

1. Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician share within California

Medicare quality performance — MIPS

SETH COHEN, M.D.'s 2023 MIPS final score plotted against the Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician national average

High performer (top quartile)
MIPS Final Score
99.1275/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician) — 99.1275/100 vs national avg 83.1

0%100%National avg83%99%
MIPS final score (Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician) — 99.1275/100 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).

SETH COHEN, M.D. appears in the CMS NPPES registry as a Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician provider holding M.D. credentials at 1000 FIVEPOINT, IRVINE, CA, 92618, with a listed phone of (949) 671-4673. NPI 1164670287 was issued on 09/03/2008. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what COHEN 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 1,383 prescription claims written by this provider, covering 445 Medicare beneficiaries and totaling roughly $323K in drug spend, with an opioid prescribing rate of 4.0%. 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 99.1275/100 for the 2023 performance year (Quality 85.2396), compared with the national average of 83.1.

Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician is a narrow specialty nationwide, with 109 enrolled providers across 28 states and an average of 1,103 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

1000 FIVEPOINT
IRVINE, CA 92618

Provider Details

NPI 1164670287
Specialty Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
Credentials M.D.
Gender Male
NPI Issued 09/03/2008

CMS Quality Score (MIPS)

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

99.1275
Final Score
Avg: 83.1
85.2396
Quality
100
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where SETH COHEN, 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.

CITY OF HOPE MEDICAL FOUNDATION
NEWPORT BEACH, CA

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 SETH COHEN, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$3.8K

Largest payer

INTUITIVE SURGICAL, 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 — California MBC 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 ~150K California medical licensees in 2023 — they are NOT specific to SETH COHEN, M.D.. To verify SETH COHEN, M.D.'s current license status, search the MBC public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

576
Total board actions, California 2023
Across 556 cases
3.84
Actions per 1,000 licensees
California statewide rate
probation
Most common action type
186 cases

MBC 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 California disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

1,383
Total Claims
$323K
Total Drug Cost
445
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
2,537
Total Day Supply
62,013
Generic Drug Cost
$52K
Opioid Claims
56 (4.0% rate)
Antibiotic Claims
422

Patient Demographics

Average Patient Age
74.9 years
Avg HCC Risk Score
1.59
Gender Split
91% female / 9% male
Age Distribution
<65: 27, 65-74: 192, 75-84: 171, 85+: 55

Top Prescribed Drugs (Medicare Part D)

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

What SETH COHEN, M.D. 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
Nitrofurantoin Mono-Macro
Nitrofurantoin Monohyd/M-Cryst
231
Trospium Chloride
201
Estradiol
196
Myrbetriq
Mirabegron
153
Gemtesa
Vibegron
85
Ciprofloxacin Hcl
83
Cephalexin
79
Methenamine Hippurate
78
Ibuprofen
47
Tamsulosin Hcl
34

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

Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician Overview

How SETH COHEN, M.D. fits within the Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician landscape nationally.

109
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician Providers in US
28
States with Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
1,103
Avg Claims per Provider

SETH COHEN, M.D.'s 1,383 claims are above the specialty average of 1,103.

Nearby Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician Providers in California

Other clinicians with the same primary specialty enrolled in California, drawn from the same CMS NPPES roster as COHEN.

Compare Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is SETH COHEN, M.D.'s specialty?
SETH COHEN, M.D. specializes in Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician and practices in IRVINE, California. Credentials: M.D..
How much does SETH COHEN, M.D. prescribe under Medicare Part D?
In 2023, SETH COHEN, M.D. wrote 1,383 Medicare Part D claims totaling $323K in drug costs for 445 beneficiaries.
What is SETH COHEN, M.D.'s Medicare quality score?
SETH COHEN, M.D. has a CMS MIPS Final Score of 99.1275/100 (Quality: 85.2396). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is SETH COHEN, M.D. located?
SETH COHEN, M.D. is located at 1000 FIVEPOINT, IRVINE, CA, 92618. Phone: (949) 671-4673.
What is SETH COHEN, M.D.'s NPI number?
SETH COHEN, M.D.'s National Provider Identifier (NPI) is 1164670287, issued on 09/03/2008.
Does SETH COHEN, M.D. prescribe opioids?
Yes, SETH COHEN, M.D. had 56 opioid claims in 2023 with an opioid prescribing rate of 4.0%.
How many Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician providers are there in the US?
There are 109 Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician providers across 28 states in the US. The average Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician provider writes 1,103 Medicare Part D claims per year.
What drugs does SETH COHEN, M.D. prescribe most often?
Based on 2023 Medicare Part D data, SETH COHEN, M.D.'s most frequently prescribed drugs include Nitrofurantoin Mono-Macro, Trospium Chloride, Estradiol. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does SETH COHEN, M.D. accept Medicare?
SETH COHEN, M.D. appears in CMS Medicare data with 1,383 Part D claims and 445 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify SETH COHEN, M.D.'s credentials?
SETH COHEN, M.D.'s NPI is 1164670287 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

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