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Midori Nishimura, MD

Family Practice · San Jose

NPI 1861534711

Medicare standing
Clear
Enrolled, allowed to bill and order, not excluded
Plans that list them
Not verified
Not the same as out of network.
Office
1

Offices

1 location · Robert S Nishime MD Inc · 2 clinicians in this group

Looking this up.

Plan participation

Not verified

We could not verify current plan participation for this doctor. This does not mean they are out of network. Call Dr. Nishimura’s office at (408) 293-5864 to ask if they take your plan before you enroll.

Original Medicare doctor bills

$7,092

Medicare paid this office $7,092 for 31 people.

This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.

Largest Original Medicare bills
Return visit (30+ min)17$3,190$103

Who their Medicare patients are

31 Original Medicare patients in 2024. Average age 80 · Under 65 0% · Health risk score 1.00. At or below the middle of the specialty; the typical family practice clinician is at 1.13.

Conditions among them: High blood pressure 68%.

The office billed $12,192, Medicare allowed $9,353 and paid $7,092; for 58 services of 10 kinds.

Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.

Year by year

Original Medicare by year
20243158801.00$12,192$7,092
20232252760.56$11,204$6,005
20223485750.84$14,783$7,466
20213393760.55$15,192$8,729
20203092760.63$14,932$6,606
201934120740.85$19,576$9,661
201832115730.72$19,393$9,169
201746143750.92$25,552$11,754
201640223750.78$33,721$18,002
201542169750.74$27,214$12,251
201441157740.63$28,512$9,980
201342120720.61$20,898$6,896

Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.

See the services billed each year

2023: 2 services

Original Medicare services billed in 2023
Return visit (30+ min)13$2,602$104
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit11$1,715$156

2022: 5 services

Original Medicare services billed in 2022
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit21$3,323$158
Return visit (30+ min)21$1,897$76
Influenza vaccine split virus, preservative free12$822$69
Short return visit (20+ min)11$577$44
Administration of influenza virus vaccine12$447$37

2021: 4 services

Original Medicare services billed in 2021
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit20$3,224$161
Return visit (30+ min)17$2,517$105
Influenza vaccine split virus, preservative free16$1,044$65
Administration of influenza virus vaccine16$346$22

2020: 5 services

Original Medicare services billed in 2020
Return visit (30+ min)19$2,343$73
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit14$1,980$141
Influenza vaccine split virus, preservative free14$909$61
Short return visit (20+ min)11$824$69
Administration of influenza virus vaccine15$334$21

2019: 4 services

Original Medicare services billed in 2019
Return visit (30+ min)27$3,782$86
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit18$2,503$139
Influenza vaccine split virus, preservative free14$873$55
Administration of influenza virus vaccine15$349$21

2018: 4 services

Original Medicare services billed in 2018
Return visit (30+ min)26$3,699$75
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit18$2,382$132
Influenza vaccine split virus, preservative free12$628$52
Administration of influenza virus vaccine13$360$26

2017: 2 services

Original Medicare services billed in 2017
Return visit (30+ min)37$5,323$79
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit16$2,065$129

2016: 7 services

Original Medicare services billed in 2016
Pneumococcal vaccine, 13-valent25$4,606$177
Return visit (30+ min)28$4,414$83
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit15$1,983$132
Short return visit (20+ min)12$1,055$62
Administration of pneumococcal vaccine25$824$32
Administration of influenza virus vaccine20$634$32
Insertion of needle into vein for collection of blood sample11$44$3

2015: 5 services

Original Medicare services billed in 2015
Return visit (30+ min)20$5,098$86
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit18$3,528$196
Short return visit (20+ min)14$1,032$54
Administration of influenza virus vaccine18$636$32
Insertion of needle into vein for collection of blood sample12$59$3

2014: 4 services

Original Medicare services billed in 2014
Return visit (30+ min)34$5,913$84
Short return visit (20+ min)12$1,489$57
Administration of influenza virus vaccine20$622$31
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone)18$212$12

2013: 4 services

Original Medicare services billed in 2013
Return visit (30+ min)30$3,967$76
Short return visit (20+ min)12$1,065$56
Administration of influenza virus vaccine20$643$32
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone)19$224$12

Drugs they prescribed that Part D paid

$20,180

Pharmacies billed $20,180 in 2024.

This is pharmacy cost, not the office bill, and not what patients paid.

Opioids were 0% of their Part D prescriptions (0 of 152) in 2024. At or below the middle of the specialty; the typical family practice clinician is at 2%.

137 generic and 15 brand-name prescriptions · $20,180 in drug cost.

Part D prescriptions only. The opioid rate is opioid prescriptions as a share of all this clinician's Part D prescriptions; surgeons and pain specialists run higher than others, so it is shown against the same specialty.

Largest Part D drug costs
Atorvastatin28$221$8
Amlodipine Besylate16$93$6

Year by year

Part D prescribing by year
2024152320% (0)10%$20,180
2023199260% (0)None$5,576
2022167250% (0)None$2,045
2021178240% (0)None$2,278
2020155240% (0)None$3,376
2019175270% (0)None$4,036
201821026NoneNone$4,562
201723133NoneNone$9,227
201620128NoneNone$7,754
2015243255% (11)7%$10,328
2014191228% (16)14%$9,305
2013194288% (16)12%$7,264

Part D prescriptions only. A drug prescribed to fewer than 11 people in a year is hidden.

See the drugs prescribed each year

2023: 4 drugs

Part D drugs prescribed in 2023
Atorvastatin34$446$13
Metformin15$154$10
Amlodipine Besylate19$119$6
Levothyroxine11$91$8

2022: 4 drugs

Part D drugs prescribed in 2022
Atorvastatin23$151$7
Metformin20$117$6
Amlodipine Besylate18$54$3
Simvastatin14$39$3

2021: 6 drugs

Part D drugs prescribed in 2021
Alendronate14$279$20
Benazepril12$193$16
Atorvastatin27$151$6
Metformin22$122$6
Simvastatin17$60$4
Amlodipine Besylate13$41$3

2020: 5 drugs

Part D drugs prescribed in 2020
Benazepril12$279$23
Alendronate12$239$20
Metformin19$195$10
Simvastatin18$172$10
Atorvastatin13$161$12

2019: 5 drugs

Part D drugs prescribed in 2019
Atorvastatin19$222$12
Alendronate11$209$19
Metformin24$158$7
Benazepril11$134$12
Simvastatin20$105$5

2018: 6 drugs

Part D drugs prescribed in 2018
Atorvastatin17$320$19
Levothyroxine11$307$28
Benazepril18$280$16
Metformin26$203$8
Gabapentin12$108$9
Simvastatin18$95$5

2017: 5 drugs

Part D drugs prescribed in 2017
Atorvastatin20$552$28
Levothyroxine13$455$35
Metformin28$316$11
Benazepril21$265$13
Simvastatin21$208$10

2016: 5 drugs

Part D drugs prescribed in 2016
Levothyroxine17$579$34
Atorvastatin14$311$22
Benazepril19$251$13
Metformin20$250$13
Simvastatin22$181$8

2015: 6 drugs

Part D drugs prescribed in 2015
Atorvastatin24$297$12
Simvastatin21$269$13
Benazepril18$193$11
Metformin25$179$7
Amlodipine Besylate12$109$9
Lisinopril15$49$3

2014: 7 drugs

Part D drugs prescribed in 2014
Hydrocodone-Acetaminophen15$1,405$94
Hydrochlorothiazide14$414$30
Simvastatin21$284$14
Benazepril18$226$13
Amlodipine Besylate17$193$11
Metformin13$192$15
Furosemide13$79$6

2013: 7 drugs

Part D drugs prescribed in 2013
Losartan-Hydrochlorothiazide11$964$88
Simvastatin29$387$13
Benazepril23$307$13
Hydrochlorothiazide16$291$18
Metformin12$239$20
Amlodipine Besylate15$173$12
Hydrocodone-Acetaminophen15$147$10

Money from drug and device companies

$122 in 2025

Industry payments by year
202511None$122
201922None$250

Paid work is consulting, speaking, honoraria and royalties, as opposed to meals and travel.

A payment is not proof that care is biased.

Payments by company
Mayne Pharma CommercialBijuva$122
1 payment
  • Meals for Bijuva · 2025-08-20 · $122
See the published payment
Every published payment
Mayne Pharma CommercialMeals · 2025-08-20Bijuva$122
See earlier years (2019)

2019: $250

Payments by company in 2019
Radius HealthTymlos$125
1 payment
  • Meals for Tymlos · 2019-04-09 · $125
Teva Pharmaceuticals USAAjovy$125
1 payment
  • Meals for Ajovy · 2019-02-08 · $125

Professional record

NPI
1861534711
Licence
CA A061183
Trained
Stanford University School of Medicine, 1995
Gender
Female
More record details
Sole proprietor
No
Taxonomy
Family medicine (207Q00000X)
Mailing address
280 Jackson St, San Jose, CA, 95112
NPI first listed
2007-02-13
NPI last updated
2023-10-04
NPI record certified
2023-10-04

This is when the NPI record was last certified, not a medical board exam.