2026 NPPES data Retina Specialist (Ophthalmology) Physician NPI 1225481351 MD
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SUSHANT WAGLEY, MD

Retina Specialist (Ophthalmology) Physician in WEST DES MOINES, Iowa. 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
357
Medicare Part D claims · 138 beneficiaries · Retina Specialist (Ophthalmology) Physician avg: 558
Generic prescribing
57%
generic claims · 43% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
100/100
▲ 17 pts above national avg 83.1 · [object Object]
Industry payments
$2.2K
3 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: SUSHANT WAGLEY, MD is a Retina Specialist (Ophthalmology) Physician ([object Object]) practicing in WEST DES MOINES, Iowa with a Medicare Part D prescribing footprint of 357 claims across 138 beneficiaries — 43% brand-name prescribing . Their CMS MIPS Final Score of 100/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $2.2K across 3 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: SUSHANT WAGLEY, MD reported a CMS MIPS final score of 100 out of 100, above the 83.1 national average, and filed 357 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

Board certification likely (heuristic — not verified)

SUSHANT WAGLEY, MD 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).

SUSHANT WAGLEY, MD at a glance

High performer (top quartile)

NPI registry status

Active

Issued 07/13/2016

NPI 1225481351

Primary specialty

Retina Specialist (Ophthalmology) Physician

Niche

913 US NPIs in this specialty

Medicare Part D claims

357 36% vs specialty avg

2023 prescription claims

Specialty avg: 558

MIPS final score

100/100 16.900000000000006% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Iowa

How Retina Specialist (Ophthalmology) Physician compares to other specialties among Iowa providers

Iowa providers

Retina Specialist (Ophthalmology) Physician share within Iowa

1. Retina Specialist (Ophthalmology) Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Retina Specialist (Ophthalmology) Physician share within Iowa

Medicare quality performance — MIPS

SUSHANT WAGLEY, MD's 2023 MIPS final score plotted against the Retina Specialist (Ophthalmology) Physician national average

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

MIPS final score (Retina Specialist (Ophthalmology) Physician) — 100/100 vs national avg 83.1

0%100%National avg83%99%
MIPS final score (Retina Specialist (Ophthalmology) Physician) — 100/100 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).

SUSHANT WAGLEY, MD is a Retina Specialist (Ophthalmology) Physician provider practicing in WEST DES MOINES, Iowa, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: MD. NPI: 1225481351. This profile includes practice location, specialty classification, and organizational affiliations from the CMS provider registry. Provider information is self-reported to CMS and updated monthly.

SUSHANT WAGLEY, MD appears in the CMS NPPES registry as a Retina Specialist (Ophthalmology) Physician provider holding MD credentials at 1501 50TH ST STE 133, WEST DES MOINES, IA, 50266, with a listed phone of (515) 222-6400. NPI 1225481351 was issued on 07/13/2016. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what WAGLEY 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 357 prescription claims written by this provider, covering 138 Medicare beneficiaries and totaling roughly $11K in drug spend, split 43% brand-name and 57% 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 (Quality 100), compared with the national average of 83.1.

Retina Specialist (Ophthalmology) Physician is a narrow specialty nationwide, with 913 enrolled providers across 48 states and an average of 558 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

1501 50TH ST STE 133
WEST DES MOINES, IA 50266

Provider Details

NPI 1225481351
Specialty Retina Specialist (Ophthalmology) Physician
Credentials MD
Gender Male
NPI Issued 07/13/2016

CMS Quality Score (MIPS)

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

100
Final Score
Avg: 83.1
100
Quality

Reporting: Group practice

Hospital and facility affiliations

Facilities where SUSHANT WAGLEY, 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.

IOWA RETINA CONSULTANTS, PC
WEST DES MOINES, IA

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 SUSHANT WAGLEY, MD. Source: openpaymentsdata.cms.gov.

Total received

$2.2K

Largest payer

Genentech USA, 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

SUSHANT WAGLEY, MD — brand share 43.0%
Specialty average (est.)

43% brand-name claims vs 57% generic, on 357 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.

357
Total Claims
$11K
Total Drug Cost
138
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
438
Total Day Supply
10,482
Brand vs Generic
43% brand / 57% generic
Brand Drug Cost
$8K
Generic Drug Cost
$3K

Patient Demographics

Average Patient Age
74.1 years
Avg HCC Risk Score
1.04
Gender Split
56% female / 44% male

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Prednisolone Acetate
142
Tobramycin
97
Ketorolac Tromethamine
30
Dorzolamide-Timolol
Dorzolamide Hcl/Timolol Maleat
20
Erythromycin
Erythromycin Base
11

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

Retina Specialist (Ophthalmology) Physician Overview

How SUSHANT WAGLEY, MD fits within the Retina Specialist (Ophthalmology) Physician landscape nationally.

913
Retina Specialist (Ophthalmology) Physician Providers in US
48
States with Retina Specialist (Ophthalmology) Physician
558
Avg Claims per Provider

SUSHANT WAGLEY, MD's 357 claims are below the specialty average of 558.

Nearby Retina Specialist (Ophthalmology) Physician Providers in Iowa

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

Compare Retina Specialist (Ophthalmology) Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is SUSHANT WAGLEY, MD's specialty?
SUSHANT WAGLEY, MD specializes in Retina Specialist (Ophthalmology) Physician and practices in WEST DES MOINES, Iowa. Credentials: MD.
How much does SUSHANT WAGLEY, MD prescribe under Medicare Part D?
In 2023, SUSHANT WAGLEY, MD wrote 357 Medicare Part D claims totaling $11K in drug costs for 138 beneficiaries.
What is SUSHANT WAGLEY, MD's Medicare quality score?
SUSHANT WAGLEY, MD has a CMS MIPS Final Score of 100/100 (Quality: 100). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is SUSHANT WAGLEY, MD located?
SUSHANT WAGLEY, MD is located at 1501 50TH ST STE 133, WEST DES MOINES, IA, 50266. Phone: (515) 222-6400.
What is SUSHANT WAGLEY, MD's NPI number?
SUSHANT WAGLEY, MD's National Provider Identifier (NPI) is 1225481351, issued on 07/13/2016.
Does SUSHANT WAGLEY, MD prescribe more brand-name or generic drugs?
SUSHANT WAGLEY, MD's prescribing is 43% brand-name and 57% generic drugs by claim count, with $8K in brand drug costs.
How many Retina Specialist (Ophthalmology) Physician providers are there in the US?
There are 913 Retina Specialist (Ophthalmology) Physician providers across 48 states in the US. The average Retina Specialist (Ophthalmology) Physician provider writes 558 Medicare Part D claims per year.
What drugs does SUSHANT WAGLEY, MD prescribe most often?
Based on 2023 Medicare Part D data, SUSHANT WAGLEY, MD's most frequently prescribed drugs include Prednisolone Acetate, Tobramycin, Ketorolac Tromethamine. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does SUSHANT WAGLEY, MD accept Medicare?
SUSHANT WAGLEY, MD appears in CMS Medicare data with 357 Part D claims and 138 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify SUSHANT WAGLEY, MD's credentials?
SUSHANT WAGLEY, MD's NPI is 1225481351 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

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