Nanette Joyce, DO
Physical Medicine & Rehabilitation · Sacramento, CANPI 1124241302
Payments from drug & device makers
What this record shows
This record is dominated by speaking fees: $36,750 of the $55,798 with a category attached, or 65.9%. Biogen accounts for 99.8% of it on its own, with 1 other manufacturer making up the rest. Reporting peaked in 2019 at $55,468 and has fallen 99.7% since, to $143 in 2024. Among physical medicine & rehabilitation clinicians in CA 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 64 payments — averaging $871.85 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Biogen$56K
- Advanced Respiratory, Inc$123
Across 26 payments — averaging $6981.42 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.
- Novartis$76K
- Novartis Gene Therapies, Inc. (fka Avexis, Inc.)$69K
- Genentech, Inc.$31K
- Tanabe Pharma America, Inc.$6K
What the payments were for
- Consulting fees$8,82016%
- Speaking & faculty fees$36,75066%
- Travel & lodging$9,04716%
- Food & beverage$9212%
- Education$2600%
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.
| Company | Payments | Total |
|---|---|---|
| Biogen | 61 | $55,675 |
| Advanced Respiratory, Inc | 3 | $123 |
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.
- SPINRAZA$54,913
How this compares
$55,798 in reported general payments places this provider in the 95th percentile of 830 physical medicine & rehabilitation providers in California.
See all physical medicine & rehabilitation providers in California →
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 |
|---|---|---|
| EvrysdiRisdiplam | 90 | $2,395,517 |
| Radicava OrsEdaravone | 12 | $158,530 |
| Glycopyrrolate | 11 | $1,635 |
| Baclofen | 12 | $322 |
| Amitriptyline Hcl | 14 | $148 |
Paid to pharmacies, not to this prescriber.
Other physical medicine & rehabilitation in Sacramento
- Brian JovesSacramento$19K
- Nicole WilliamsSacramento$11K
- Lisa WilliamsSacramento$11K
- Jaire SaundersSacramento$10K
- Natalya ShtutmanSacramento$7K
- Ziyad AyyoubParamount$322K
- Pratik GandhiAnaheim$122K
- Mary OatesSanta Maria$115K
- Kevin BarretteSan Francisco$84K
- Steven SampsonLos Angeles$63K
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.