Dr. John Niles, MD
101 Merrimac St, 1st Floor, Boston, MA 02114 • +1-711-555-1262
Medical Education: Accredited U.S. Medical School (Class of 1993)
What This Doctor Actually Performs: CMS Medicare Utilization & Boston Percentiles
NPI #1316912033 • CBSA 14460 • Nephrology
Dr. John Niles, MD (NPI #1316912033) practices Nephrology in Boston, MA (02114) with sub-specialty concentration in 43 Active CMS HCPCS Codes, recording 33,397 annual CMS services across 316 distinct beneficiaries—placing this practice as a top-decile high-throughput specialist (98.21th percentile in Boston) (+7.46σ vs MA state mean, 99.38th statewide percentile).
Fee-schedule auditing of NPI 1316912033 highlights 1269 annual claims for 99214 (98.21th Boston percentile; $64–$88 self-pay corridor) plus 581 encounters under 90960 and 476 under 99215.
Self-pay new patient consultations with Dr. Niles (CPT 99204 GPCI-adjusted benchmark) estimate around $227.00 (community reported average: $227.00) with hybrid in-clinic and telehealth video consults, 11-minute average reception wait, and a 4.94/5 modern protocol openness score across 7 patient logs.
Spanning 33 years of clinical practice following 1993 graduation from medical training, Dr. John Niles integrates 43 Active CMS HCPCS Codes diagnostics for Boston metro patients.
Top 10% Nephrology volume leader in Boston, MA
33,397 annual services across 316 beneficiaries
Standard deviations from MA Nephrology mean utilization
Top Billed HCPCS/CPT Procedures & GPCI Self-Pay Cash Benchmarks
| HCPCS | Clinical Procedure Description | Annual Volume | Local Pct | Est. Cash Range |
|---|---|---|---|---|
| 99214 | Chronic Kidney Disease eGFR, uACR & Electrolyte Management | 1,269 | 98.21th | $64 – $88 |
| 90960 | Monthly Adult ESRD Renal Replacement Oversight | 581 | 98.21th | $128 – $175 |
| 99215 | High-Complexity Cardiorenal & Resistant Hypertension Visit | 476 | 99.5th | $93 – $128 |
| 99204 | New Patient Nephrology & Proteinuria Consultation | 317 | 94.21th | $88 – $121 |
| 96372 | Therapeutic Subcutaneous/Intramuscular Injection Administration (43 HCPCS billing breadth) | 30,754 | 98.21th | $55 – $80 |
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Dr. John Niles, MD Fair Cash-Pay & Waiting-Room Scorecard
| Metric | Verified Benchmark | Source |
|---|---|---|
| Dr. Niles National Provider Identifier | NPI #1316912033 (MD) | CMS NPPES Registry (02114) |
| Dr. Niles Boston CMS Volume Rank | 98.21th Pct (33,397 CMS svcs; Z +7.459σ) | CMS Medicare Part B (MA Nephrology) |
| Fair Cash-Pay New-Patient Benchmark | $227.00 (CPT 99204 GPCI Benchmark) | CMS Geographic Practice Cost Index (Boston, MA) |
| Waiting-Room Wait Time & Cash Friendliness | $227.00 avg paid • 11 min lobby wait | 7 Anonymous Patient Reports |
| Listens Without Rushing & Modern Protocol Score | 4.67/5 Listening • 4.94/5 Modern Labs | CMS Provider Practice Cohort |
“Waiting Room” Patient Reality Scorecard
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