NPI registry status
Active
2026 NPPES data Retina Specialist (Ophthalmology) Physician NPI 1225481351 MD
Verify on CMS → Sushant Wagley, MD
Retina Specialist (Ophthalmology) Physician in West Des Moines, Iowa.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 913 in Retina Specialist (Ophthalmology) 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
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 · Exceptional
Industry payments
$2.2K
3 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
Sushant Wagley, MD reported a CMS MIPS final score of 100/100 - above the 83.1 national average - and filed 357 Medicare Part D claims in 2023.
- 100/100
- MIPS score · +17 vs avg
- 357
- Part D claims, 2023
- 57%
- 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.
Sushant Wagley, MD'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
Where Sushant Wagley, MD sits
This provider among retina specialist (ophthalmology) physician peers
Across the 583 retina specialist (ophthalmology) physician providers who report both Medicare Part D prescribing and a MIPS quality score, Sushant Wagley, MD writes more Part D claims than 43% of them and scores higher on MIPS quality than 58% - placing this provider in the lower-volume, high-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Part D claim volume vs MIPS quality, by specialty percentile
Each dot is one retina specialist (ophthalmology) physician peer from a representative sample of 60; the gold marker is Sushant Wagley, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
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).
What does the federal data show about Sushant Wagley, MD?
High performer (top quartile)Primary specialty
Retina Specialist (Ophthalmology) Physician
Medicare Part D claims
357 36% vs specialty avg
MIPS final score
100/100 16.9 pts vs avg
Specialty distribution in Iowa
How Retina Specialist (Ophthalmology) Physician compares to other specialties among Iowa providers
Medicare quality performance, MIPS
Sushant Wagley, MD's 2023 MIPS final score plotted against the Retina Specialist (Ophthalmology) Physician national average
- 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
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).
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.
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. 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
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%
Retina Specialist (Ophthalmology) Physician average
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.
What Sushant Wagley, MD prescribes most
Top Medicare Part D drugs by claim count, 2023
- Prednisolone Acetate
Prednisolone Acetate
142 claims
- Tobramycin
Tobramycin
97 claims
- Ketorolac Trometha… 30
Ketorolac Tromethamine
30 claims
- Dorzolamide-Timolol 20
Dorzolamide-Timolol
20 claims
- Erythromycin 11
Erythromycin
11 claims
| 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.
More Retina Specialist (Ophthalmology) Physician in IA →
All providers in Iowa →
Compare specialties →
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.
Dr. Michael Abramoff
MD, PHD
Iowa City, IA
Dr. Timothy Boyce
M.D.
Iowa City, IA
Dr. Beau Fenner
MD
Iowa City, IA
Dr. David Massop
MD
Des Moines, IA
Dr. Taariq Mohammed
MD
Iowa City, IA
Compare Retina Specialist (Ophthalmology) 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 Iowa medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Retina Specialist (Ophthalmology) 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.
Healthcare Guides
Learn more about finding, verifying, and understanding healthcare providers.
How to Find a Doctor
Step-by-step guide to choosing a provider
Verify Credentials
Check NPI, board certification & license status
Medical Specialties Explained
Who treats what and how specialties differ
Understanding Medicare Claims Data
What prescribing data reveals about a provider
In-Network vs Out-of-Network
How insurance networks affect your costs
Telehealth Guide
Virtual care options and coverage in 2026
Explore Iowa
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
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.