David Spigel, MD
Medical Oncology · Nashville, TNNPI 1427074210
Payments from drug & device makers
What this record shows
This record is dominated by consulting fees: $113,718 of the $166,845 with a category attached, or 68.2%. It is spread thinly across 56 manufacturers, the largest accounting for just 15.2%. Reporting peaked in 2019 at $59,860 and has fallen 54.9% since, to $26,969 in 2025. Among medical oncology clinicians in TN with any reported payments, this total sits in the top 10% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 263 payments — averaging $634.39 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$25K
- AbbVie$23K
- E.r. Squibb & Sons, L.L.C.$22K
- Astrazeneca UK Limited$18K
- F. Hoffmann-la Roche AG$17K
- GSK$13K
- plus $49K from 50 others
Across 3,320 payments — averaging $8910.00 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.
- E.r. Squibb & Sons, L.L.C.$5.7M
- Merck$5.2M
- Genentech, Inc.$2.9M
- AstraZeneca$2.9M
- Astrazeneca UK Limited$2.8M
- GSK$1M
- plus $9M from 45 others
What the payments were for
- Consulting fees$113,71868%
- Speaking & faculty fees$13,7158%
- Travel & lodging$32,43019%
- Food & beverage$6,1204%
- Education$8621%
General payments by program year
Who reported the general payments
Companies are grouped under their corporate parent — a single manufacturer often files under several CMS reporting entities. Research and ownership payments are counted separately and are not in this table.
What the payments were tied to
Products named in the reported payments. Only payments of $100 or more are attributed here — the typical reported payment nationally is a meal worth about $16, and listing those product-by-product would be noise.
How this compares
$166,845 in reported general payments places this provider in the 90th percentile of 101 medical oncology providers in Tennessee.
Medicare billing
What this is not: this is the amount Original Medicare Part B allowed for services this provider billed in 2024. It is not their income. It excludes Medicare Advantage — now more than half of all Medicare enrollment — along with Medicaid and all commercial insurance, and it is gross practice revenue before staff, rent, supplies and malpractice premiums. CMS also suppresses any figure covering ten or fewer patients, so low-volume providers appear smaller than they are.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| TagrissoOsimertinib Mesylate | 27 | $422,774 |
| TabrectaCapmatinib Hydrochloride | 11 | $246,312 |
| TepmetkoTepotinib Hcl | 13 | $188,205 |
| EliquisApixaban | 21 | $17,196 |
| Abiraterone Acetate | 12 | $1,578 |
| Fentanyl | 14 | $1,194 |
| Morphine Sulfate ErMorphine Sulfate | 11 | $404 |
| Oxycodone Hcl | 17 | $362 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 17 | $315 |
| Prochlorperazine Maleate | 19 | $217 |
| Levothyroxine Sodium | 24 | $214 |
| Prednisone | 30 | $108 |
| Lactulose | 14 | $83 |
Paid to pharmacies, not to this prescriber.
Companies that both paid and supply prescribed drugs
These companies both reported payments to this provider and make drugs the provider prescribed under Medicare Part D in 2024. For most specialties this overlap is expected — a cardiologist who is paid by a cardiology drugmaker also treats heart disease. It is shown so the reader can see it, not because it implies anything on its own.
| Company | Paid to this provider | Part D cost of their drugs |
|---|---|---|
| AstraZenecaTagrisso | $25,396 | $422,77427 claims |
| NovartisTabrecta | $8,869 | $246,31211 claims |
| EMD Serono, Inc.Tepmetko | $46 | $188,20513 claims |
| PfizerEliquis | $3,901 | $17,19621 claims |
Reading this fairly. The Part D column is what drug plans and patients paid pharmacies — this provider received none of it, and it reflects how many patients they treat and what those drugs cost. Against peers, this provider's reported payments sit in the 90th percentile of 101 medical oncology providers in Tennessee.
Other medical oncology in Nashville
- William PaoNashville$838K
- Dana ThompsonNashville$339K
- Robert RamirezNashville$321K
- Mace RothenbergNashville$318K
- Melissa JohnsonNashville$290K
- Cathy EngNashville$231K
- Michael GibsonNashville$141K
- Jordan BerlinNashville$120K
- Vandana AbramsonNashville$98K
- Leora HornNashville$98K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Billing: Medicare Physician & Other Practitioners, data year 2024. Original Medicare Part B only.
- Identity: NPPES NPI Registry, July 2026.