Medicare Enrolled
Dr. Richard Nelson, MD
Internal Medicine · Warren, NJ
Practice pattern: Clinical Cardiology
— Primarily office-based clinical cardiology
High
DATA COVERAGE
Data in 3 of 4 federal sources
Measures public federal data availability — not provider quality
Informational, not a quality rating.
This page presents federal public records about Dr. Nelson from CMS (NPPES, Open Payments, Medicare Provider Utilization, PECOS). It is not medical advice, an endorsement, or a judgment of clinical quality. Always consult the provider directly and a licensed clinician for medical decisions. Read methodology →
Are you Dr. Nelson?
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What this data tells you about Dr. Nelson
Dr. Richard Nelson is an internal medicine specialist in Warren, NJ, with 20 years of NPI registration. Based on federal Medicare data, Dr. Nelson performed 6,135 Medicare services in 2023. These records do not provide a deduplicated patient total.
The Data Coverage level for Dr. Nelson is High — reflecting how much public federal data is available about this provider. Patients are encouraged to use this data as one of several factors when choosing a healthcare provider.
✓ 20 years of NPI registration
▲ Top 4% volume in NJ
Medicare Practice Summary — 2023
Medicare Utilization ↗6,135
Medicare services
Top 4% in NJ for internal medicine
Not available
Unique patients (not deduplicated)
$35
Avg. Medicare payment
Medicare patients only (65+ / disabled) · How to read this →
Top procedures by volume
Ranked by number of services performed for Medicare patients. Avg. submitted charge is what the provider billed; avg. Medicare payment is what CMS paid.
| Procedure | Volume | Avg. paid | Avg. submitted |
|---|---|---|---|
| Blood draw (venipuncture) Insertion of a needle into a vein to collect a blood sample. |
722 | $8 | $15 |
| Office visit, established patient (30-39 min) A follow-up office visit for an existing patient lasting between 30 and 39 minutes. The visit involves medical evaluation and management of the patient's condition. |
587 | $99 | $274 |
| Comprehensive metabolic blood panel A blood test that measures a group of chemicals, including glucose, electrolytes, and kidney and liver function markers. |
569 | $10 | $40 |
| Complete blood count (CBC) with differential An automated laboratory test that measures the levels of red blood cells, white blood cells, and platelets in the blood, including a breakdown of the different types of white blood cells. |
411 | $8 | $32 |
| Urinalysis with microscopic exam A urine test performed manually that includes examining the sample under a microscope to check for abnormalities. |
408 | $3 | $13 |
| Thyroid stimulating hormone (TSH) test A blood test that measures the level of thyroid stimulating hormone to evaluate thyroid function. |
364 | $16 | $69 |
| Annual wellness visit, follow-up A follow-up annual wellness visit that includes a personalized prevention plan of service. |
362 | $142 | $236 |
| Lipid panel (cholesterol and triglycerides) A blood test that measures cholesterol and triglyceride levels. |
352 | $13 | $55 |
| Office visit, established patient (20-29 min) An office visit for an existing patient lasting between 20 and 29 minutes. The visit involves medical evaluation and management of the patient's condition. |
340 | $68 | $188 |
| Creatinine test (kidney function) A blood test that measures the amount of creatinine to assess kidney function or detect muscle injury. |
325 | $5 | $22 |
| Urine microalbumin test (kidney screening) A laboratory test that measures the amount of microalbumin, a small protein, in a urine sample. This test is used to detect early signs of kidney damage. |
320 | $6 | $24 |
| Hemoglobin A1c test (diabetes monitoring) A blood test that measures your average blood sugar levels over the past two to three months. |
280 | $9 | $40 |
| Flu vaccine administration This procedure involves the administration of the influenza virus vaccine. It covers the process of delivering the vaccine to the patient. |
126 | $34 | $50 |
| Flu vaccine, high-dose High-dose seasonal influenza vaccine for adults aged 65 and older. Contains four times the antigen of standard-dose flu vaccines (60 mcg per strain), split-virus formulation, preservative-free, single-dose syringe. |
114 | $72 | $118 |
| PSA test (prostate cancer screening) | 111 | $18 | $76 |
| Urine culture, bacterial colony count A laboratory test that measures the number of bacteria growing in a urine sample to help identify infections. |
66 | $8 | $33 |
| Urine culture, bacterial identification A laboratory test that grows and identifies bacteria from a urine sample to detect infections. |
66 | $8 | $34 |
| Immunoglobulin level test A blood test that measures the level of gammaglobulins, which are immune system proteins. |
52 | $9 | $38 |
| Pneumonia vaccine administration This procedure involves the injection of a vaccine to protect against pneumococcal disease. It is administered by a healthcare provider. |
52 | $34 | $50 |
| Pneumococcal conjugate vaccine (PCV15) An intramuscular injection of the 15-valent pneumococcal conjugate vaccine. This vaccine protects against 15 types of pneumococcal bacteria. |
41 | $241 | $444 |
| Basic metabolic blood panel A blood test that measures a group of basic chemicals, including total calcium levels. |
29 | $8 | $35 |
| Vaccine administration The process of giving a vaccine to a patient. This code covers the administration service only and does not include the cost of the vaccine itself. |
29 | $16 | $50 |
| Office visit, established patient, complex (40-54 min) An office or outpatient visit for an existing patient lasting between 40 and 54 minutes. This level of service is determined by the total time spent on the date of the encounter. |
28 | $155 | $366 |
| Transitional care management services, moderate complexity Services provided to coordinate care during the transition from an inpatient or other facility setting back to the community. This includes follow-up and management of a health problem of at least moderate complexity. |
28 | $178 | $416 |
| Vitamin D level test A blood test to measure the amount of Vitamin D-3 in your body. |
25 | $29 | $121 |
| Initial preventive physical examination, new Medicare beneficiary A comprehensive preventive health visit for new Medicare beneficiaries during their first 12 months of enrollment. The service is conducted as a face-to-face visit and is limited to preventive care. |
25 | $181 | $335 |
| Ferritin level test (iron stores) A blood test that measures the level of ferritin, a protein that stores iron in the body. |
24 | $13 | $56 |
| Iron level test | 24 | $6 | $27 |
| Iron binding capacity test A blood test that measures the amount of iron in the blood and the blood's ability to bind and transport iron. |
24 | $9 | $36 |
| Sed rate test (inflammation marker) This automated test measures how quickly red blood cells settle in a tube to detect inflammation in the body. |
24 | $3 | $12 |
| Antibiotic sensitivity test A laboratory test that determines which antibiotics, antifungals, or antivirals are effective against a specific microorganism using microdilution or agar dilution methods. |
24 | $8 | $13 |
| Bacterial culture, aerobic A laboratory test that grows and identifies bacteria capable of surviving in oxygen. The results help determine the presence of specific aerobic microorganisms. |
23 | $8 | $33 |
| Lyme disease antibody test A blood test that checks for antibodies to the bacteria that causes Lyme disease. |
22 | $17 | $70 |
| Fecal immunochemical test (FIT), 1-3 simultaneous A screening test that uses a stool sample to detect hidden blood in the feces, helping to identify potential colorectal cancer. |
21 | $18 | $65 |
| Manual red blood cell count A laboratory test that manually counts the number of red blood cells in a blood sample. |
18 | $4 | $18 |
| Vitamin B-12 level test A blood test that measures the amount of vitamin B-12 in your body. |
17 | $15 | $62 |
| C-reactive protein test (inflammation marker) A blood test that measures the level of C-reactive protein to detect the presence of infection or inflammation in the body. |
17 | $5 | $22 |
| Amylase enzyme level test A blood test that measures the amount of amylase, an enzyme produced by the pancreas and salivary glands, to help evaluate pancreatic health. |
15 | $6 | $27 |
| Lipase level test A blood test that measures the amount of lipase, a fat-digesting enzyme, in your body. |
15 | $7 | $29 |
| Multiplex PCR test for SARS-CoV-2 and influenza A and B A laboratory test that uses a multiplex amplified probe technique to detect the presence of SARS-CoV-2 (COVID-19) and influenza virus types A and B in a single sample. |
12 | $140 | $198 |
| Quadrivalent influenza vaccine, preservative-free A flu shot containing four strains of the influenza virus, formulated without preservatives, administered in a 0.5 ml dose. |
12 | $22 | $30 |
| Pneumococcal vaccine, 23-valent A vaccine that protects against 23 types of pneumococcal bacteria. It is used to prevent infections caused by these bacteria. |
11 | $131 | $189 |
How to read this data: This reflects Medicare patients only (typically 65+). Payment amounts are what Medicare paid the provider, not your out-of-pocket cost. These counts do not measure clinical quality or years of experience.
Geographic Context
Internal medicine physicians in nearby ZIP areas
2,537
County median income
$135,960
Nearest hospital to ZIP centroid (approximate)
MOUNTAINVIEW BEHAVIORAL HOSPITAL
5.6 mi
5.6 mi
Data Sources
| Provider Registry | ✓ NPPES | NPPES snapshot; verify current record |
| Medicare Enrollment | ✓ PECOS | PECOS snapshot |
| Practice Data | ✓ Medicare Util. | Annual (CY lag) |
| Industry Payments | — No payments | N/A |
| Disciplinary History | — Not included | N/A |
This provider has data in 3 of 4 available federal datasets, with a Data Coverage level of High. This reflects how much public data is available about a provider. How we calculate this →
Summary
Dr. Nelson is a clinical cardiology specialist, with above-average Medicare volume (top 4% in NJ), with 20 years of NPI registration.
This summary is auto-generated from federal data, describing data availability and patterns. Read our methodology →
Frequently Asked Questions
Is Dr. Nelson experienced with blood draw (venipuncture)?
Based on Medicare claims data, Dr. Nelson performed 722 blood draw (venipuncture) services. These records cover Medicare fee-for-service activity, including eligible younger beneficiaries; they do not measure total practice volume or clinical quality.
How do Dr. Nelson's costs compare to other internal medicine physicians in Warren?
Dr. Nelson's average Medicare payment per service is $35. Note that these figures represent what Medicare pays, not your out-of-pocket cost, which depends on your specific insurance plan and deductible. Procedure-level data above shows both what was submitted and what Medicare paid for each service type.
What does Data Coverage mean?
Data Coverage (currently High for Dr. Nelson) measures how much public federal data is available about a provider. It is not a quality rating. A "Very High" or "High" level means the provider has data across multiple federal sources (NPPES, PECOS, Medicare Utilization, Open Payments), indicating the presence of registry, enrollment, activity or payment records, not verified experience or clinical quality. A "Low" or "Moderate" level may simply mean the provider is newer, does not see Medicare patients, or has not received any industry payments — none of which are inherently negative. Read our full methodology →
Is this data up to date?
Source publication dates and the snapshots loaded on this site can differ. Rebuilding a page does not refresh its source records. Check the Medicare reporting year and the payment interval shown above; consult the linked official sources for newer releases and current registry details. See our data freshness policy →
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About this page
This page combines public CMS records with calculated summaries and explanatory procedure labels. These transformations are not verbatim federal records. Sources: NPPES ↗, Medicare Provider Utilization ↗, and PECOS. Publication is mandated by the Physician Payments Sunshine Act (§6002 ACA, 42 U.S.C. §1320a-7h) and the Freedom of Information Act.
This page is not medical advice, an endorsement, a recommendation, or a quality rating. Data Coverage reflects data completeness — how much federal information exists for this provider — not clinical performance, patient outcomes, or quality of care. Always verify information directly with the provider and consult a licensed clinician before making medical decisions.
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