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Elaine Elinor Nelson, MD

Emergency Medicine · San Jose

NPI 1962457176

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

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. Nelson’s office at (408) 923-7121 to ask if they take your plan before you enroll.

California Medical Board record

Licence G77615 · Current

Licensed to practise in California · since 1993 · expires 2027-03-31 · Loyola University of Chicago Stritch School of Medicine.

No disciplinary actions, convictions, malpractice judgments or citations in this record.

Original Medicare doctor bills

$43,218

Medicare paid this office $43,218 for 297 people.

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

Largest Original Medicare bills
Emergency department visit with high level of medical decision making171$25,624$143
Critical care, first 30-74 minutes46$8,548$186
Emergency department visit with moderate level of medical decision making61$5,999$98
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only123$913$7

Who their Medicare patients are

297 Original Medicare patients in 2024. Average age 76 · Under 65 11% · 85 and older 27% · Women 55% · Also on Medicaid 33% · Health risk score 1.88. At or below the middle of the specialty; the typical emergency medicine clinician is at 2.01.

Conditions among them: High blood pressure 75% · Coronary heart disease 40% · Chronic kidney disease 40% · Depression 35% · Diabetes 31% · Atrial fibrillation 31% · Heart failure 28% · COPD 24% · Cancer 23% · Stroke 19% · Dementia 18%.

The office billed $371,314, Medicare allowed $55,216 and paid $43,218; for 455 services of 23 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
2024297455761.88$371,314$43,218
2023347531761.77$415,345$51,473
2022392618761.64$444,130$64,815
2021380604751.80$412,609$62,075
2020427674761.89$459,806$68,798
2019210482742.76$221,106$34,834
2018238542733.01$184,381$40,738
2017151385742.88$107,389$33,193
2016165391752.69$103,511$23,738
2015246606732.28$162,943$38,769
2014248571732.23$147,535$34,666
2013247506742.67$143,209$35,113

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: 5 services

Original Medicare services billed in 2023
Emergency department visit with high level of medical decision making210$30,756$146
Critical care, first 30-74 minutes60$11,615$190
Emergency department visit with moderate level of medical decision making67$6,453$96
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only133$904$6
X-ray of chest, 1 view16$129$8

2022: 5 services

Original Medicare services billed in 2022
Emergency department visit with high level of medical decision making212$36,264$167
Critical care, first 30-74 minutes54$12,328$228
Emergency department visit with moderate level of medical decision making86$8,790$101
Emergency department visit with low level of medical decision making38$1,940$51
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only146$1,041$7

2021: 6 services

Original Medicare services billed in 2021
Emergency department visit with high level of medical decision making236$38,983$163
Critical care, first 30-74 minutes46$10,070$219
Emergency department visit with moderate level of medical decision making57$6,011$105
Emergency department visit with low level of medical decision making39$2,335$60
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only131$988$7
X-ray of chest, 1 view19$144$8

2020: 6 services

Original Medicare services billed in 2020
Emergency department visit with high level of medical decision making258$39,988$154
Critical care, first 30-74 minutes71$14,646$206
Emergency department visit with moderate level of medical decision making61$5,717$92
Emergency department visit with low level of medical decision making40$2,197$55
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only124$957$7
X-ray of chest, 1 view34$292$9

2019: 6 services

Original Medicare services billed in 2019
Emergency department visit with high level of medical decision making131$19,735$148
Critical care, first 30-74 minutes39$7,656$196
Emergency department visit with moderate level of medical decision making24$2,462$103
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only121$995$8
X-ray of chest, 1 view80$681$8
Emergency department visit with low level of medical decision making12$596$50

2018: 6 services

Original Medicare services billed in 2018
Emergency department visit with high level of medical decision making141$22,722$161
Critical care, first 30-74 minutes31$7,074$221
Emergency department visit with moderate level of medical decision making29$3,318$114
Emergency department visit with low level of medical decision making28$1,629$56
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only150$1,385$9
X-ray of chest, 1 view81$751$9

2017: 6 services

Original Medicare services billed in 2017
Emergency department visit with high level of medical decision making92$19,424$207
Critical care, first 30-74 minutes17$4,618$272
Emergency department visit with moderate level of medical decision making20$2,786$139
Emergency department visit with low level of medical decision making20$1,406$70
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only99$1,114$11
X-ray of chest, 1 view, front71$856$12

2016: 6 services

Original Medicare services billed in 2016
Emergency department visit with high level of medical decision making100$14,808$147
Critical care, first 30-74 minutes17$3,327$196
Emergency department visit with moderate level of medical decision making18$1,816$101
Emergency department visit with low level of medical decision making28$1,492$53
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only103$858$8
X-ray of chest, 1 view, front79$653$8

2015: 6 services

Original Medicare services billed in 2015
Emergency department visit with high level of medical decision making171$25,658$148
Critical care, first 30-74 minutes22$4,516$196
Emergency department visit with moderate level of medical decision making32$3,237$101
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only162$1,289$8
Emergency department visit with low level of medical decision making23$1,227$53
X-ray of chest, 1 view, front127$1,058$8

2014: 6 services

Original Medicare services billed in 2014
Emergency department visit with high level of medical decision making159$22,672$143
Emergency department visit with moderate level of medical decision making37$3,443$93
Critical care, first 30-74 minutes17$3,323$195
Emergency department visit with low level of medical decision making25$1,272$49
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only155$1,204$8
X-ray of chest, 1 view, front110$916$8

2013: 6 services

Original Medicare services billed in 2013
Emergency department visit with high level of medical decision making158$22,873$143
Critical care, first 30-74 minutes25$4,782$191
Emergency department visit with moderate level of medical decision making36$3,436$95
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only159$1,195$7
Emergency department visit with low level of medical decision making23$1,158$48
X-ray of chest, 1 view, front51$399$8

Medicaid work

$26,061 in 2024

Medicaid paid $26,061 for 289 billed services this clinician did in 2024, up to 42 people in a month for one service.

Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.

Largest Medicaid services in 2024
EMERGENCY DEPT VISIT MOD MDM237$19,495
EMERGENCY DEPARTMENT VISIT HIGH MDM52$6,566
Medicaid work by year
2024289242$26,061
2023441336$21,937
2022176427$5,083
2021120420$4,611
202062319$1,698
20191,140783$44,199
20181,731785$61,390
See the largest Medicaid services in earlier years

2023

Largest Medicaid services in 2023
EMERGENCY DEPT VISIT MOD MDM313$14,493
EMERGENCY DEPARTMENT VISIT HIGH MDM116$7,004
Service12$440

2022

Largest Medicaid services in 2022
EMERGENCY DEPT VISIT LOW MDM122$2,971
EMERGENCY DEPARTMENT VISIT HIGH MDM16$826
EMERGENCY DEPT VISIT MOD MDM25$812
Service13$474

2021

Largest Medicaid services in 2021
EMERGENCY DEPT VISIT LOW MDM68$2,170
EMERGENCY DEPT VISIT MOD MDM28$1,422
EMERGENCY DEPARTMENT VISIT HIGH MDM12$929
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only12$90

2020

Largest Medicaid services in 2020
Service37$1,334
EMERGENCY DEPT VISIT LOW MDM12$332
Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count)13$33

2019

Largest Medicaid services in 2019
EMERGENCY DEPT VISIT LOW MDM404$12,944
Service144$10,803
EMERGENCY DEPT VISIT MOD MDM247$9,722
EMERGENCY DEPARTMENT VISIT HIGH MDM173$8,791
Service31$1,181
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only111$743
Radiologic examination, chest; single view30$15

2018

Largest Medicaid services in 2018
EMERGENCY DEPT VISIT LOW MDM732$25,892
EMERGENCY DEPARTMENT VISIT HIGH MDM236$14,200
EMERGENCY DEPT VISIT MOD MDM325$13,223
Service178$6,453
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only194$1,417
Service13$161
Radiologic examination, chest; single view53$44

Drugs they prescribed that Part D paid

$2,993

Pharmacies billed $2,993 in 2024.

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

Opioids were 12% of their Part D prescriptions (13 of 109) in 2024. Above the middle of the specialty; the typical emergency medicine clinician is at 12%.

100 generic and fewer than 11 brand-name prescriptions · $2,993 in drug cost · 38 antibiotic prescriptions to 36 people.

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
Cephalexin20$150$8
Ondansetron Odt12$82$7

Year by year

Part D prescribing by year
20241098612% (13)None$2,993
202316612517% (28)None$3,146
20221429821% (30)None$3,217
202115010917% (25)None$2,197
20201138710% (11)None$1,223
201924818717% (41)6%$3,637
201828920318% (52)6%$3,174
201727719021% (57)6%$3,518
201634022025% (86)7%$3,712
201545028630% (137)7%$6,404
201449331630% (150)None$6,048
201344029433% (145)None$4,940

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
Cephalexin30$284$9
Prednisone15$114$8
Hydrocodone-Acetaminophen24$108$5
Ondansetron Odt11$85$8

2022: 2 drugs

Part D drugs prescribed in 2022
Cephalexin15$130$9
Hydrocodone-Acetaminophen24$109$5

2021: 3 drugs

Part D drugs prescribed in 2021
Cephalexin18$103$6
Hydrocodone-Acetaminophen20$98$5
Ondansetron Odt11$89$8

2020: 3 drugs

Part D drugs prescribed in 2020
Cephalexin12$106$9
Ondansetron13$64$5
Prednisone11$59$5

2019: 5 drugs

Part D drugs prescribed in 2019
Cephalexin29$194$7
Hydrocodone-Acetaminophen34$127$4
Ondansetron Odt17$96$6
Ibuprofen25$67$3
Prednisone14$55$4

2018: 6 drugs

Part D drugs prescribed in 2018
Cephalexin36$366$10
Ondansetron Odt16$214$13
Hydrocodone-Acetaminophen43$193$4
Ibuprofen22$79$4
Meclizine13$69$5
Prednisone13$56$4

2017: 5 drugs

Part D drugs prescribed in 2017
Cephalexin27$193$7
Hydrocodone-Acetaminophen38$161$4
Ondansetron Odt19$97$5
Ibuprofen23$89$4
Acetaminophen-Codeine11$41$4

2016: 7 drugs

Part D drugs prescribed in 2016
Hydrocodone-Acetaminophen62$291$5
Cephalexin27$210$8
Ibuprofen43$154$4
Ondansetron Odt13$129$10
Azithromycin14$122$9
Prednisone20$91$5
Acetaminophen-Codeine12$48$4

2015: 10 drugs

Part D drugs prescribed in 2015
Hydrocodone-Acetaminophen93$531$6
Ibuprofen43$218$5
Levofloxacin15$187$12
Cephalexin27$186$7
Azithromycin25$181$7
Prednisone21$110$5
Meclizine16$105$7
Acetaminophen-Codeine28$92$3
Ciprofloxacin15$81$5
Ondansetron14$78$6

2014: 8 drugs

Part D drugs prescribed in 2014
Tamiflu11$1,272$116
Hydrocodone-Acetaminophen124$698$6
Cephalexin31$256$8
Ibuprofen36$157$4
Azithromycin20$155$8
Ondansetron Odt11$130$12
Prednisone24$117$5
Ondansetron13$83$6

2013: 10 drugs

Part D drugs prescribed in 2013
Proair Hfa11$518$47
Hydrocodone-Acetaminophen117$506$4
Cephalexin53$462$9
Meclizine14$145$10
Ibuprofen34$130$4
Azithromycin12$125$10
Prednisone19$65$3
Sulfamethoxazole-Trimethoprim11$58$5
Acetaminophen-Codeine12$49$4
Oxycodone-Acetaminophen11$45$4

Checkups this office reported

Medicare did not publish checkup rates for this clinician.

Medicare’s overall office score
94.6 / 100
Scores the office’s reporting and systems. It is not a grade for how the doctor treats you.

Professional record

NPI
1962457176
Licence
CA G77615California G77615: Current · expires 2027-03-31
More record details
Sole proprietor
No
Medicaid ID
CA 00G776150
Taxonomy
Federal specialty code 207P00000X (207P00000X)
Mailing address
2100 Powell St, Ste 920, Emeryville, CA, 94608
NPI first listed
2006-05-24
NPI last updated
2008-07-21

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