Mariely Castellanos Nouel, MD
Internal Medicine · Hickory, NCNPI 1649506494
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 99.2% of the total across 629 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. It is spread thinly across 44 manufacturers, the largest accounting for just 21.1% — the pattern of someone who eats at a lot of different presentations. Among internal medicine clinicians in NC with any reported payments, this total sits in the top 5% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 629 payments — averaging $15.54 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AbbVie$2K
- Novo Nordisk$929
- AstraZeneca$713
- GSK$627
- Lilly USA, LLC$612
- Pfizer$555
- plus $4K from 38 others
What the payments were for
- Food & beverage$9,69899%
- Education$771%
Most of this is food and beverage — typically meals provided during product presentations at a clinic or hospital. Nationally that is the single largest category of reported payments by count.
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.
How this compares
$9,776 in reported general payments places this provider in the 95th percentile of 3,302 internal medicine providers in North Carolina.
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 |
|---|---|---|
| MounjaroTirzepatide | 131 | $178,764 |
| JardianceEmpagliflozin | 120 | $147,934 |
| OzempicSemaglutide | 73 | $88,446 |
| FarxigaDapagliflozin Propanediol | 62 | $82,885 |
| JanuviaSitagliptin Phosphate | 73 | $75,100 |
| LinzessLinaclotide | 41 | $55,868 |
| EliquisApixaban | 57 | $48,773 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 30 | $33,691 |
| KerendiaFinerenone | 17 | $31,319 |
| Tresiba Flextouch U-200Insulin Degludec | 30 | $30,043 |
| ZenpepLipase/Protease/Amylase | 12 | $25,624 |
| VraylarCariprazine Hcl | 15 | $21,858 |
| EntrestoSacubitril/Valsartan | 17 | $18,541 |
| VoqueznaVonoprazan Fumarate | 23 | $14,930 |
| VascepaIcosapent Ethyl | 15 | $14,353 |
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 |
|---|---|---|
| Lilly USA, LLCMounjaro, Humulin N | $612 | $180,617145 claims |
| Boehringer IngelheimJardiance | $142 | $147,934120 claims |
| AstraZenecaFarxiga, Breztri Aerosphere | $713 | $116,57692 claims |
| Novo NordiskOzempic | $929 | $88,44673 claims |
| MerckJanuvia, Janumet Xr | $81 | $81,29191 claims |
| AbbVieLinzess, Vraylar, Synthroid | $2,065 | $80,33977 claims |
| PfizerEliquis | $555 | $48,77357 claims |
| BayerKerendia | $455 | $31,31917 claims |
| Aimmune Therapeutics, Inc.Zenpep | $23 | $25,62412 claims |
| NovartisEntresto | $181 | $18,54117 claims |
| Phathom Pharmaceuticals, Inc.Voquezna | $82 | $14,93023 claims |
| GSKTrelegy Ellipta | $627 | $10,23012 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 95th percentile of 3,302 internal medicine providers in North Carolina.
Other internal medicine in Hickory
- Nirmish ShahDurham$862K
- Eugene WrightFayetteville$839K
- Saad UsmaniCharlotte$551K
- Bhakti PaulRaleigh$536K
- Mary KlotmanDurham$478K
- Manesh PatelDurham$435K
- Millie LongChapel Hill$374K
- Marc JohnsonCharlotte$342K
- Christina CraterRaleigh$330K
- Jamy ArdWinston Salem$293K
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.