Medicare Enrolled
Dr. Josier Nisnisan, MD
Internal Medicine · Sugar Land, TX
Practice pattern: Mixed Practice
— Diverse clinical practice across multiple procedure types
Low-engagement
Very High
DATA COVERAGE
Data in 4 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. Nisnisan 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 →
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What this data tells you about Dr. Nisnisan
Dr. Josier Nisnisan is an internal medicine specialist in Sugar Land, TX, with 18 years of NPI registration. Based on federal Medicare data, Dr. Nisnisan performed 4,597 Medicare services across 810 unique beneficiaries.
Between the years covered by Open Payments, Dr. Nisnisan received a total of $26,612 from 54 pharmaceutical and/or device companies across 974 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common in internal medicine. Most payments are for meals and travel — low-value interactions common across virtually all practicing physicians. Patients may wish to discuss these relationships with their provider.
The Data Coverage level for Dr. Nisnisan is Very High — reflecting how much public federal data is available about this provider. This is not a quality rating. Patients are encouraged to use this data as one of several factors when choosing a healthcare provider.
✓ 18 years in practice
▲ Top 7% volume in TX
$26,612 industry payments
Medicare Practice Summary
Medicare Utilization ↗4,597
Medicare services
Top 7% in TX for internal medicine
810
Unique beneficiaries
$36
Avg. Medicare payment
Medicare patients only (65+ / disabled) · Not a quality rating · How to read this →
~255 Medicare services per year of practice
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 |
|---|---|---|---|
| Allergen extract preparation and provision A professional service involving the preparation and provision of a single-dose vial of allergen extract. |
2,421 | $13 | $24 |
| Hospital follow-up visit, moderate complexity Follow-up hospital visit for an existing patient involving moderate medical decision making. The visit requires at least 35 minutes of time spent on the date of service. |
681 | $61 | $139 |
| Allergy skin test A diagnostic test performed to identify specific allergies by applying or introducing allergenic extracts to the body. The procedure measures the patient's immune response to various potential allergens. |
560 | $3 | $8 |
| 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. |
212 | $80 | $158 |
| Allergy immunotherapy preparation A professional service involving the preparation and administration of one or more antigens. |
80 | $9 | $23 |
| Hospital discharge day management, 30 minutes or less This service covers the final day of hospital care when the patient is being discharged. It includes coordination of care and instructions for the patient within a time frame of 30 minutes or less. |
70 | $64 | $159 |
| Initial hospital admission, high complexity Initial hospital inpatient or observation care for a new patient involving high-level medical decision making, with at least 75 minutes total time on the date of the encounter. |
65 | $134 | $357 |
| Ultrasound of arm and leg arteries This procedure uses sound waves to create images of the blood vessels in the arms and legs. It allows healthcare providers to examine the structure and blood flow within these arteries. |
41 | $64 | $184 |
| Ultrasound of head and neck blood flow, bilateral An ultrasound exam that uses sound waves to visualize and assess blood flow in the vessels of both the head and the neck. |
39 | $146 | $600 |
| Echocardiogram, transthoracic An ultrasound of the heart that uses color to show blood flow, rate, direction, and valve function. |
38 | $149 | $1,500 |
| Ultrasound of leg arteries or grafts An imaging test that uses sound waves to create pictures of the blood vessels in the legs or any surgical grafts present. |
38 | $182 | $500 |
| Ultrasound of arm or leg veins An ultrasound exam of the veins in the arm or leg. The test uses sound waves to check blood flow and may include compression and other maneuvers. |
38 | $116 | $450 |
| Complete ultrasound of abdomen and pelvis blood flow This procedure uses sound waves to create images of blood flow in the arteries and veins of the abdomen and pelvis. It evaluates the rate and direction of blood movement within these vessels. |
36 | $207 | $500 |
| 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. |
36 | $58 | $103 |
| Complete ultrasound of retroperitoneum An ultrasound examination of the structures located behind the abdominal cavity. |
35 | $84 | $250 |
| Neuropsychological test evaluation, first hour A professional assessment of cognitive and behavioral functioning using standardized tests. This service covers the initial hour of the evaluation process. |
24 | $98 | $155 |
| Psychological test administration, first 30 minutes A technician administers psychological or neuropsychological testing for the first 30 minutes. |
24 | $26 | $60 |
| Psychological test administration, each additional 30 minutes A technician administers psychological or neuropsychological testing. This code covers each additional 30-minute increment of administration time. |
24 | $27 | $60 |
| Auditory brainstem response test A test that measures the brain's response to sound to determine hearing thresholds. The results are interpreted and reported by a medical professional. |
22 | $86 | $175 |
| Electrocardiogram, 1-3 leads with physician review A heart rhythm test using one to three electrodes to record electrical activity, with interpretation by a physician. |
21 | $9 | $30 |
| Awake and drowsy EEG A test that records electrical activity in the brain while the patient is awake and drowsy. |
21 | $297 | $400 |
| Visual evoked potential test A test that measures how quickly electrical signals travel from the eye to the brain in response to visual stimuli. |
21 | $52 | $90 |
| Digital analysis of brain wave activity (EEG) This procedure involves the digital analysis of brain wave activity recorded via an electroencephalogram (EEG). It focuses on the technical interpretation of the digital data rather than the initial recording or supervision. |
21 | $214 | $300 |
| Annual wellness visit, follow-up A follow-up annual wellness visit that includes a personalized prevention plan of service. |
17 | $126 | $185 |
| Home health plan of care certification Certification by a physician or allowed practitioner for Medicare-covered home health services under a home health plan of care. This includes contacting the home health agency and reviewing reports of patient status required by physicians. |
12 | $41 | $105 |
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. A higher procedure volume generally indicates more experience with that procedure.
0.8% high complexity
5.9% medium
93.3% routine
Industry Payment Transparency
Open Payments through 2024 ↗$26,612
Total received (2018-2024)
Avg $3,802/year across 7 years
Top 4% in TX for internal medicine
54
Companies
974
Individual payments
All payments are legal and publicly reported · Not evidence of wrongdoing · How to interpret →
Payment profile
Industry payments classified by relationship type. Not all payments are equal — research and consulting reflect different relationships than speaking programs or meals.
Meals & Travel
Food, beverages, travel, and lodging — typically low-value
$26,612 (100.0%)
Payment trend by year
Annual totals from pharmaceutical and medical device companies.
2024
$3,415
2023
$2,809
2022
$3,515
2021
$3,181
2020
$2,045
2019
$6,650
2018
$4,997
Payments by company (2024)
Consulting
Speaking
Meals & Travel
Research
AstraZeneca Pharmaceuticals LP
$7,102
Novo Nordisk Inc
$2,533
Amgen Inc.
$2,192
Boehringer Ingelheim Pharmaceuticals, Inc.
$1,968
PFIZER INC.
$1,313
Amarin Pharma Inc.
$1,260
Novartis Pharmaceuticals Corporation
$1,062
Lilly USA, LLC
$975
SANOFI-AVENTIS U.S. LLC
$860
GlaxoSmithKline, LLC.
$852
Janssen Pharmaceuticals, Inc
$711
Bayer HealthCare Pharmaceuticals Inc.
$711
ABBVIE INC.
$683
Esperion Therapeutics, Inc.
$541
Merck Sharp & Dohme LLC
$415
Allergan Inc.
$283
Bayer Healthcare Pharmaceuticals Inc.
$281
AbbVie Inc.
$257
E.R. Squibb & Sons, L.L.C.
$220
Astellas Pharma US Inc
$179
Boston Scientific Corporation
$155
Kowa Pharmaceuticals America, Inc.
$155
Allergan, Inc.
$153
Abbott Laboratories
$147
SI-BONE, Inc.
$140
Sunovion Pharmaceuticals Inc.
$137
Relypsa, Inc.
$124
Otsuka America Pharmaceutical, Inc.
$116
Regeneron Pharmaceuticals, Inc.
$112
IBSA Pharma Inc.
$88
Phathom Pharmaceuticals, Inc.
$88
Salix Pharmaceuticals, a division of Bausch Health US, LLC
$83
Corcept Therapeutics
$63
Merck Sharp & Dohme Corporation
$63
ARBOR PHARMACEUTICALS, INC.
$54
Janssen Scientific Affairs, LLC
$49
West-Ward Pharmaceuticals
$45
Regeneron Healthcare Solutions, Inc.
$43
Dexcom, Inc.
$42
Mylan Specialty L.P.
$40
Bardy Diagnostics, Inc.
$40
Lexicon Pharmaceuticals, Inc.
$36
Althera Pharmaceuticals LLC
$30
ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.)
$26
Azurity Pharmaceuticals, Inc.
$24
Radius Health, Inc.
$21
Medtronic MiniMed, Inc.
$21
Biohaven Pharmaceuticals, Inc.
$20
Biohaven Pharmaceutical Holding Company Ltd.
$19
Janssen Biotech, Inc.
$18
Exact Sciences Corporation
$18
Takeda Pharmaceuticals U.S.A., Inc.
$17
Arbor Pharmaceuticals, Inc.
$15
SCILEX PHARMACEUTICALS INC.
$12
Top 3 companies account for 44.4% of total payments
Associated products mentioned in payments ›
AIRSUPRA · ANORO · ANORO ELLIPTA · AREXVY · Aimovig · BELSOMRA · BREO · BREZTRI · BREZTRI AEROSPHERE · BYDUREON · BYSTOLIC · Bidil · CAPLYTA · CHANTIX · Carnation Ambulatory Monitor · Cologuard Collection Kit · Dexcom G6 Transmitter · ELIQUIS · EMGALITY · ENTRESTO · EUCRISA · EVENITY · Edarbi · Edarbyclor · EkoSonic · FARXIGA · FASENRA · FIASP · FREESTYLE LIBRE · FREESTYLE LIBRE 2 · FREESTYLE LIBRE 3 · FreeStyle Libre · HORIZANT · HUMALOG · INVOKANA · Inpefa · JANUVIA · JARDIANCE · Kerendia · Korlym · LATUDA · LEQVIO · LINZESS · LONHALA MAGNAIR · LYRICA · Livalo · MOUNJARO · MYRBETRIQ · Mitigare · Myrbetriq · NEXLETOL · NEXLIZET · NUEDEXTA · NURTEC ODT · Otezla · Ozempic · PRALUENT · PROCLAIM · Prolia · QULIPTA · REXULTI · RYBELSUS · Repatha · Roszet · Rybelsus · SEGLENTIS · SHINGRIX · SIMPONI · SOLIQUA · SOLIQUA 100/33 · SYMBICORT · SYNJARDY · Saxenda · TAVNEOS · TOUJEO · TRADJENTA · TRELEGY ELLIPTA · TRULICITY · Tirosint · Tresiba · Tymlos · UBRELVY · Uloric · Utibron · VERQUVO · VOQUEZNA · VRAYLAR · Vascepa · Veltassa · Veozah · Victoza · Wegovy · XARELTO · XIFAXAN · Xultophy 100/3.6 · Yupelri · ZEPBOUND · ZTLido · iPro2
Should you be concerned? Payments from pharmaceutical and device companies are legal and common — 57% of U.S. physicians receive at least one. They often reflect legitimate consulting, research, or education. What matters is whether a recommended drug or device appears in your doctor's payment records. If so, consider asking your doctor about it. How to interpret this data →
Most payments (100%) are for meals and travel — low-value interactions that are common across virtually all practicing physicians. Total industry engagement is in the top 4% for internal medicine in TX.
Equivalent to $579 per 100 Medicare services performed
Geographic Context
Internal medicine physicians within 10 mi
2,335
Per 100K population
271.6
County median income
$113,409
Nearest hospital
ST LUKE'S SUGAR LAND HOSPITAL
0.0 mi
0.0 mi
Data Sources
| Provider Registry | ✓ NPPES | Weekly updates |
| Medicare Enrollment | ✓ PECOS | Monthly updates |
| Practice Data | ✓ Medicare Util. | Annual (CY lag) |
| Industry Payments | ✓ Open Payments | CY 2024 |
| Disciplinary History | — Not public | N/A |
This provider has data in 4 of 4 available federal datasets, with a Data Coverage level of Very High. This measures how much public data is available about a provider — not how good they are. How we calculate this →
Summary
Dr. Nisnisan is a mixed practice specialist, with above-average Medicare volume (top 7% in TX), with low-engagement industry engagement in the top 4% of TX peers, with 18 years of NPI registration.
This summary is auto-generated from federal data. It describes data availability and patterns — not clinical quality. Read our methodology →
Frequently Asked Questions
Is Dr. Nisnisan experienced with allergen extract preparation and provision?
Based on Medicare claims data, Dr. Nisnisan performed 2,421 allergen extract preparation and provision services. Research suggests that higher procedure volume is often associated with better outcomes, particularly for complex procedures. Note that Medicare data only captures patients aged 65 and older, so the total practice volume across all patients is likely higher.
Does Dr. Nisnisan receive payments from pharmaceutical companies?
Yes. Dr. Nisnisan received a total of $26,612 from 54 companies across 974 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common among physicians — 57% of all U.S. physicians receive at least one industry payment. Patients may wish to ask their doctor about these relationships, especially if a recommended drug or device appears in the payment records.
How do Dr. Nisnisan's costs compare to other internal medicine physicians in Sugar Land?
Dr. Nisnisan's average Medicare payment per service is $36. 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 Very High for Dr. Nisnisan) 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 a long track record of practice, Medicare participation, and industry disclosure. 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?
Each data source has its own update cycle. Provider registry data (NPPES) is updated weekly. Medicare enrollment (PECOS) is updated monthly. Medicare practice data has a ~2 year lag — the most recent available is typically 2 years prior. Industry payment data (Open Payments) is published annually, usually in June, covering the prior calendar year. We display the data date prominently on each section so you always know how current it is. See our data freshness policy →
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About this page
All data on this page is sourced verbatim from public federal records published by the U.S. Centers for Medicare & Medicaid Services (CMS): NPPES ↗, Open Payments ↗, 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. The Transparency Score measures 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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