2026 NPPES data Physical Medicine & Rehabilitation Physician NPI 1427075506 M.D.
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THEODORE NICHOLAS, M.D.

Physical Medicine & Rehabilitation Physician in KILL DEVIL HILLS, North Carolina. 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
9K
Medicare Part D claims · 398 beneficiaries · Physical Medicine & Rehabilitation Physician avg: 781
Generic prescribing
94%
generic claims · 6% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
75/100
▼ 8 pts below national avg 83.1 · [object Object]

What the federal data shows

THEODORE NICHOLAS, M.D. reported a CMS MIPS final score of 75/100 — below the 83.1 national average — and filed 9,238 Medicare Part D claims in 2023.

75/100
MIPS score · -8 vs avg
9K
Part D claims, 2023
94%
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.

THEODORE NICHOLAS, 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

75 15th percentile higher than 15% 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%). This entry sits in this band. 80–90: 129,887 scored providers (27%). Above this entry. 90–100: 189,403 scored providers (40%). Above this entry. 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)

THEODORE NICHOLAS, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting — 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 THEODORE NICHOLAS, M.D.?

Below national average

NPI registry status

Active

Issued 07/16/2006

NPI 1427075506

Primary specialty

Physical Medicine & Rehabilitation Physician

Mid-sized

15,306 US NPIs in this specialty

Medicare Part D claims

9,238 1083% vs specialty avg

2023 prescription claims

Specialty avg: 781

MIPS final score

75/100 8.099999999999994% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in North Carolina

How Physical Medicine & Rehabilitation Physician compares to other specialties among North Carolina providers

North Carolina providers

Physical Medicine & Rehabilitation Physician share within North Carolina

1. Physical Medicine & Rehabilitation Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Physical Medicine & Rehabilitation Physician share within North Carolina

Medicare quality performance — MIPS

THEODORE NICHOLAS, M.D.'s 2023 MIPS final score plotted against the Physical Medicine & Rehabilitation Physician national average

Below national average
MIPS Final Score
75/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Physical Medicine & Rehabilitation Physician) — 75/100 vs national avg 83.1

0%100%National avg83%75%
MIPS final score (Physical Medicine & Rehabilitation Physician) — 75/100 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).

THEODORE NICHOLAS, M.D. appears in the CMS NPPES registry as a Physical Medicine & Rehabilitation Physician provider holding M.D. credentials at 3210 N. CROATAN HWY., KILL DEVIL HILLS, NC, 27948, with a listed phone of (252) 261-5868. NPI 1427075506 was issued on 07/16/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what NICHOLAS 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 9,238 prescription claims written by this provider, covering 398 Medicare beneficiaries and totaling roughly $657K in drug spend, split 6% brand-name and 94% generic by claim count, with an opioid prescribing rate of 50.1%. 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 75/100 for the 2023 performance year, compared with the national average of 83.1.

Physical Medicine & Rehabilitation Physician is a mid-sized specialty nationwide, with 15,306 enrolled providers across 54 states and an average of 781 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

3210 N. CROATAN HWY.
KILL DEVIL HILLS, NC 27948

Provider Details

NPI 1427075506
Specialty Physical Medicine & Rehabilitation Physician
Credentials M.D.
Gender Male
NPI Issued 07/16/2006

CMS Quality Score (MIPS)

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

75
Final Score
Avg: 83.1

Reporting: Group practice

Brand vs generic prescribing mix · Generic-heavy

THEODORE NICHOLAS, M.D. — brand share 6.0%
Specialty average (est.)

6% brand-name claims vs 94% generic, on 9,238 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.

9,238
Total Claims
$657K
Total Drug Cost
398
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
10,015
Total Day Supply
282,851
Brand vs Generic
6% brand / 94% generic
Brand Drug Cost
$384K
Generic Drug Cost
$273K
Opioid Claims
4,627 (50.1% rate)
Antibiotic Claims
23

Patient Demographics

Average Patient Age
68.7 years
Avg HCC Risk Score
1.46
Gender Split
60% female / 40% male
Age Distribution
<65: 101, 65-74: 192, 75-84: 92, 85+: 13

Top Prescribed Drugs (Medicare Part D)

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

What THEODORE NICHOLAS, 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
Oxycodone Hcl
1,936
Hydrocodone-Acetaminophen
Hydrocodone/Acetaminophen
763
Alprazolam
714
Oxycodone-Acetaminophen
Oxycodone Hcl/Acetaminophen
492
Gabapentin
431
Cyclobenzaprine Hcl
373
Diazepam
357
Morphine Sulfate Er
Morphine Sulfate
324
Prednisone
315
Zolpidem Tartrate
265

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

Physical Medicine & Rehabilitation Physician Overview

How THEODORE NICHOLAS, M.D. fits within the Physical Medicine & Rehabilitation Physician landscape nationally.

15,306
Physical Medicine & Rehabilitation Physician Providers in US
54
States with Physical Medicine & Rehabilitation Physician
781
Avg Claims per Provider

THEODORE NICHOLAS, M.D.'s 9,238 claims are above the specialty average of 781.

Nearby Physical Medicine & Rehabilitation Physician Providers in North Carolina

Other clinicians with the same primary specialty enrolled in North Carolina, drawn from the same CMS NPPES roster as NICHOLAS.

Compare Physical Medicine & Rehabilitation Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is THEODORE NICHOLAS, M.D.'s specialty?
THEODORE NICHOLAS, M.D. specializes in Physical Medicine & Rehabilitation Physician and practices in KILL DEVIL HILLS, North Carolina. Credentials: M.D..
How much does THEODORE NICHOLAS, M.D. prescribe under Medicare Part D?
In 2023, THEODORE NICHOLAS, M.D. wrote 9,238 Medicare Part D claims totaling $657K in drug costs for 398 beneficiaries.
What is THEODORE NICHOLAS, M.D.'s Medicare quality score?
THEODORE NICHOLAS, M.D. has a CMS MIPS Final Score of 75/100. The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is THEODORE NICHOLAS, M.D. located?
THEODORE NICHOLAS, M.D. is located at 3210 N. CROATAN HWY., KILL DEVIL HILLS, NC, 27948. Phone: (252) 261-5868.
What is THEODORE NICHOLAS, M.D.'s NPI number?
THEODORE NICHOLAS, M.D.'s National Provider Identifier (NPI) is 1427075506, issued on 07/16/2006.
Does THEODORE NICHOLAS, M.D. prescribe more brand-name or generic drugs?
THEODORE NICHOLAS, M.D.'s prescribing is 6% brand-name and 94% generic drugs by claim count, with $384K in brand drug costs.
Does THEODORE NICHOLAS, M.D. prescribe opioids?
Yes, THEODORE NICHOLAS, M.D. had 4,627 opioid claims in 2023 with an opioid prescribing rate of 50.1%.
How many Physical Medicine & Rehabilitation Physician providers are there in the US?
There are 15,306 Physical Medicine & Rehabilitation Physician providers across 54 states in the US. The average Physical Medicine & Rehabilitation Physician provider writes 781 Medicare Part D claims per year.
What drugs does THEODORE NICHOLAS, M.D. prescribe most often?
Based on 2023 Medicare Part D data, THEODORE NICHOLAS, M.D.'s most frequently prescribed drugs include Oxycodone Hcl, Hydrocodone-Acetaminophen, Alprazolam. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does THEODORE NICHOLAS, M.D. accept Medicare?
THEODORE NICHOLAS, M.D. appears in CMS Medicare data with 9,238 Part D claims and 398 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify THEODORE NICHOLAS, M.D.'s credentials?
THEODORE NICHOLAS, M.D.'s NPI is 1427075506 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