NPI registry status
Active
2026 NPPES data Hematology (Internal Medicine) Physician NPI 1003990995 M.D.
Verify on CMS → Thomas Ortel, M.D.
Hematology (Internal Medicine) Physician in Durham, North Carolina.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 1,436 in Hematology (Internal Medicine) 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
660
Medicare Part D claims · 162 beneficiaries · Hematology (Internal Medicine) Physician avg: 693
Generic prescribing
45%
generic claims · 55% brand-name · higher generic rates reduce patient out-of-pocket costs
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
Thomas Ortel, M.D. filed 660 Medicare Part D claims in 2023 as a Hematology (Internal Medicine) Physician in Durham, North Carolina, prescribing 45% generic.
- 660
- Part D claims, 2023
- 45%
- 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.
Thomas Ortel, M.D.'s Medicare Part D volume vs every U.S. prescriber
Total Medicare Part D claims, 2023, across all CMS prescribers nationally
660 Top 31% higher than 69% of 1,370,886 prescribers
Each bar is a band; taller bars hold more prescribers. 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 Medicare Part D Prescriber Public Use File · 2023
✓
Board certification likely (heuristic, not verified)
Thomas Ortel, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + 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 Thomas Ortel, M.D.?
Quality data not reportedPrimary specialty
Hematology (Internal Medicine) Physician
Medicare Part D claims
660 5% vs specialty avg
Specialty distribution in North Carolina
How Hematology (Internal Medicine) Physician compares to other specialties among North Carolina providers
Board certification
Not published by CMS
CMS does not publish a per-provider board-certification field in NPPES. PlainDoctor does not have a reliable per-specialty certification rate to show for Hematology (Internal Medicine) Physician. Verify directly:
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).
Thomas Ortel, M.D. appears in the CMS NPPES registry as a Hematology (Internal Medicine) Physician provider holding M.D. credentials at ERWIN RD, Durham, NC, 27710, with a listed phone of (919) 620-4467. NPI 1003990995 was issued on 10/25/2006.
Medicare Part D records for calendar year 2023 show 660 prescription claims written by this provider, covering 162 Medicare beneficiaries and totaling roughly $460K in drug spend, split 55% brand-name and 45% generic by claim count, with an opioid prescribing rate of 2.1%.
Hematology (Internal Medicine) Physician is a narrow specialty nationwide, with 1,436 enrolled providers across 50 states and an average of 693 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 | 1003990995 |
|---|---|
| Specialty | Hematology (Internal Medicine) Physician |
| Credentials | M.D. |
| Gender | Male |
| NPI Issued | 10/25/2006 |
Hospital and facility affiliations
Facilities where Thomas Ortel, 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.
Duke Health Integrated Practice Inc
Cary, NC
Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).
Brand vs generic prescribing mix · Brand-heavy
Thomas Ortel, M.D. - brand share 55.0%
Hematology (Internal Medicine) Physician average
55% brand-name claims vs 45% generic, on 660 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.
660
Total Claims
$460K
Total Drug Cost
162
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 1,172
- Total Day Supply
- 34,503
- Brand vs Generic
- 55% brand / 45% generic
- Brand Drug Cost
- $399K
- Generic Drug Cost
- $60K
- Opioid Claims
- 14 (2.1% rate)
Patient Demographics
- Average Patient Age
- 67.4 years
- Avg HCC Risk Score
- 2.35
- Gender Split
- 59% female / 41% male
- Age Distribution
- <65: 50, 65-74: 67, 75-84: N/A, 85+: N/A
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Thomas Ortel, M.D. prescribes most
Top Medicare Part D drugs by claim count, 2023
- Eliquis
Eliquis
251 claims
- Warfarin Sodium
Warfarin Sodium
114 claims
- Xarelto 81
Xarelto
81 claims
- Jantoven 74
Jantoven
74 claims
- Enoxaparin Sodium 45
Enoxaparin Sodium
45 claims
- Oxycodone Hcl 14
Oxycodone Hcl
14 claims
- Droxia 13
Droxia
13 claims
- Fondaparinux Sodium 12
Fondaparinux Sodium
12 claims
| Drug | Claims |
|---|---|
| Eliquis Apixaban | 251 |
| Warfarin Sodium | 114 |
| Xarelto Rivaroxaban | 81 |
| Jantoven Warfarin Sodium | 74 |
| Enoxaparin Sodium | 45 |
| Oxycodone Hcl | 14 |
| Droxia Hydroxyurea | 13 |
| Fondaparinux Sodium | 12 |
| Sirolimus | 11 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
More Hematology (Internal Medicine) Physician in NC →
All providers in North Carolina →
Compare specialties →
Hematology (Internal Medicine) Physician Overview
How Thomas Ortel, M.D. fits within the Hematology (Internal Medicine) Physician landscape nationally.
1,436
Hematology (Internal Medicine) Physician Providers in US
50
States with Hematology (Internal Medicine) Physician
693
Avg Claims per Provider
Thomas Ortel, M.D.'s 660 claims are below the specialty average of 693.
Nearby Hematology (Internal Medicine) Physician Providers in North Carolina
Other clinicians with the same primary specialty enrolled in North Carolina, drawn from the same CMS NPPES roster as Ortel.
Dr. Charles Agbemabiese
M.D.
Thomasville, NC
Dr. Gowthami Arepally
MD
Durham, NC
Dr. Swetha Arshanapally
M.D.
Salisbury, NC
Dr. Trevor Austin
MD
Asheville, NC
Dr. Andrew Beardsley
M.D.
Asheville, NC
Compare Hematology (Internal Medicine) 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 North Carolina medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Hematology (Internal Medicine) 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
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Medical Specialties Explained
Who treats what and how specialties differ
Understanding Medicare Claims Data
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How insurance networks affect your costs
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Explore North Carolina
Frequently Asked Questions
What is Thomas Ortel, M.D.'s specialty? ▼
Thomas Ortel, M.D. specializes in Hematology (Internal Medicine) Physician and practices in Durham, North Carolina. Credentials: M.D..
How much does Thomas Ortel, M.D. prescribe under Medicare Part D? ▼
In 2023, Thomas Ortel, M.D. wrote 660 Medicare Part D claims totaling $460K in drug costs for 162 beneficiaries.
Where is Thomas Ortel, M.D. located? ▼
Thomas Ortel, M.D. is located at ERWIN RD, Durham, NC, 27710. Phone: (919) 620-4467.
What is Thomas Ortel, M.D.'s NPI number? ▼
Thomas Ortel, M.D.'s National Provider Identifier (NPI) is 1003990995, issued on 10/25/2006.
Does Thomas Ortel, M.D. prescribe more brand-name or generic drugs? ▼
Thomas Ortel, M.D.'s prescribing is 55% brand-name and 45% generic drugs by claim count, with $399K in brand drug costs.
Does Thomas Ortel, M.D. prescribe opioids? ▼
Yes, Thomas Ortel, M.D. had 14 opioid claims in 2023 with an opioid prescribing rate of 2.1%.
How many Hematology (Internal Medicine) Physician providers are there in the US? ▼
There are 1,436 Hematology (Internal Medicine) Physician providers across 50 states in the US. The average Hematology (Internal Medicine) Physician provider writes 693 Medicare Part D claims per year.
What drugs does Thomas Ortel, M.D. prescribe most often? ▼
Based on 2023 Medicare Part D data, Thomas Ortel, M.D.'s most frequently prescribed drugs include Eliquis, Warfarin Sodium, Xarelto. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Thomas Ortel, M.D. accept Medicare? ▼
Thomas Ortel, M.D. appears in CMS Medicare data with 660 Part D claims and 162 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Thomas Ortel, M.D.'s credentials? ▼
Thomas Ortel, M.D.'s NPI is 1003990995 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
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.
- 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.