2026 NPPES data Family Nurse Practitioner NPI 1316480601
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TONYA COX

Family Nurse Practitioner in ALTOONA, Pennsylvania. 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
4K
Medicare Part D claims · 783 beneficiaries · Family Nurse Practitioner avg: 1K
Generic prescribing
54%
generic claims · 46% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
73.6489/100
▼ 9 pts below national avg 83.1 · [object Object]
Industry payments
$890.93
14 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

TONYA COX reported a CMS MIPS final score of 73.6489/100 — below the 83.1 national average — and filed 4,357 Medicare Part D claims in 2023.

73.6489/100
MIPS score · -9 vs avg
4K
Part D claims, 2023
54%
generic prescribing
$890.93
industry payments (Sunshine Act)

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.

TONYA COX's MIPS score vs every scored U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023 — the federal quality measure

74 11th percentile higher than 11% 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

What does the federal data show about TONYA COX?

Below national average

NPI registry status

Active

Issued 11/18/2016

NPI 1316480601

Primary specialty

Family Nurse Practitioner

High-volume

209,817 US NPIs in this specialty

Medicare Part D claims

4,357 257% vs specialty avg

2023 prescription claims

Specialty avg: 1,222

MIPS final score

73.6489/100 9.451099999999997% pts

Mid-tier band

vs 83.1 national avg

Specialty distribution in Pennsylvania

How Family Nurse Practitioner compares to other specialties among Pennsylvania providers

Pennsylvania providers

Family Nurse Practitioner share within Pennsylvania

1. Family Nurse Practitioner42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Family Nurse Practitioner share within Pennsylvania

Medicare quality performance — MIPS

TONYA COX's 2023 MIPS final score plotted against the Family Nurse Practitioner national average

Below national average
MIPS Final Score
73.6489/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Family Nurse Practitioner) — 73.6489/100 vs national avg 83.1

0%100%National avg83%73.6%
MIPS final score (Family Nurse Practitioner) — 73.6489/100 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).

TONYA COX appears in the CMS NPPES registry as a Family Nurse Practitioner provider at 1414 9TH AVE, ALTOONA, PA, 16602, with a listed phone of (814) 946-7593. NPI 1316480601 was issued on 11/18/2016. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what COX 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 4,357 prescription claims written by this provider, covering 783 Medicare beneficiaries and totaling roughly $2.4 million in drug spend, split 46% brand-name and 54% 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 73.6489/100 for the 2023 performance year (Quality 69.8174, Cost 42.3455), compared with the national average of 83.1.

Family Nurse Practitioner is a high-volume specialty nationwide, with 209,817 enrolled providers across 56 states and an average of 1,222 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

1414 9TH AVE
ALTOONA, PA 16602

Provider Details

NPI 1316480601
Specialty Family Nurse Practitioner
Gender Female
NPI Issued 11/18/2016

CMS Quality Score (MIPS)

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

73.6489
Final Score
Avg: 83.1
69.8174
Quality
42.3455
Cost
100
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where TONYA COX 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.

UPMC ALTOONA REGIONAL HEALTH SERVICES, INC.
ALTOONA, PA

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 TONYA COX. Source: openpaymentsdata.cms.gov.

Total received

$891

Largest payer

Novo Nordisk 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 — Pennsylvania PA-BOM 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 ~45K Pennsylvania medical licensees in 2023 — they are NOT specific to TONYA COX. To verify TONYA COX's current license status, search the PA-BOM public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

133
Total board actions, Pennsylvania 2023
Across 129 cases
2.96
Actions per 1,000 licensees
Pennsylvania statewide rate
probation
Most common action type
48 cases

PA-BOM 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 Pennsylvania disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Above average

TONYA COX — brand share 46.0%
Specialty average (est.)

46% brand-name claims vs 54% generic, on 4,357 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.

4,357
Total Claims
$2.4M
Total Drug Cost
783
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
10,340
Total Day Supply
307,522
Brand vs Generic
46% brand / 54% generic
Brand Drug Cost
$2.3M
Generic Drug Cost
$68K

Patient Demographics

Average Patient Age
71.3 years
Avg HCC Risk Score
1.56
Gender Split
65% female / 35% male
Age Distribution
<65: 126, 65-74: 381, 75-84: 220, 85+: 56

Top Prescribed Drugs (Medicare Part D)

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

What TONYA COX 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
Ozempic
Semaglutide
441
Levothyroxine Sodium
336
Metformin Hcl Er
Metformin Hcl
288
Atorvastatin Calcium
232
Synthroid
Levothyroxine Sodium
188
Lisinopril
142
Rosuvastatin Calcium
137
Jardiance
Empagliflozin
131
Metformin Hcl
122
Ezetimibe
105

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

Family Nurse Practitioner Overview

How TONYA COX fits within the Family Nurse Practitioner landscape nationally.

209,817
Family Nurse Practitioner Providers in US
56
States with Family Nurse Practitioner
1,222
Avg Claims per Provider

TONYA COX's 4,357 claims are above the specialty average of 1,222.

Nearby Family Nurse Practitioner Providers in Pennsylvania

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

Compare Family Nurse Practitioner nationally: see state-by-state distribution →

Frequently Asked Questions

What is TONYA COX's specialty?
TONYA COX specializes in Family Nurse Practitioner and practices in ALTOONA, Pennsylvania.
How much does TONYA COX prescribe under Medicare Part D?
In 2023, TONYA COX wrote 4,357 Medicare Part D claims totaling $2.4M in drug costs for 783 beneficiaries.
What is TONYA COX's Medicare quality score?
TONYA COX has a CMS MIPS Final Score of 73.6489/100 (Quality: 69.8174, Cost: 42.3455). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is TONYA COX located?
TONYA COX is located at 1414 9TH AVE, ALTOONA, PA, 16602. Phone: (814) 946-7593.
What is TONYA COX's NPI number?
TONYA COX's National Provider Identifier (NPI) is 1316480601, issued on 11/18/2016.
Does TONYA COX prescribe more brand-name or generic drugs?
TONYA COX's prescribing is 46% brand-name and 54% generic drugs by claim count, with $2.3M in brand drug costs.
How many Family Nurse Practitioner providers are there in the US?
There are 209,817 Family Nurse Practitioner providers across 56 states in the US. The average Family Nurse Practitioner provider writes 1,222 Medicare Part D claims per year.
What drugs does TONYA COX prescribe most often?
Based on 2023 Medicare Part D data, TONYA COX's most frequently prescribed drugs include Ozempic, Levothyroxine Sodium, Metformin Hcl Er. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does TONYA COX accept Medicare?
TONYA COX appears in CMS Medicare data with 4,357 Part D claims and 783 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify TONYA COX's credentials?
TONYA COX's NPI is 1316480601. 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