Nathaniel Piel, MD
Internal Medicine · Knoxville, TNNPI 1649565755
Payments from drug & device makers
Across 108 payments — averaging $15.53 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Novo Nordisk$322
- Lilly USA, LLC$186
- GSK$158
- Salix Pharmaceuticals, A Division Of Bausch Health US, LLC$127
- Amgen$123
- Pfizer$82
- plus $680 from 20 others
What the payments were for
- Food & beverage$1,669100%
- Education$80%
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.
| Company | Payments | Total |
|---|---|---|
| Novo Nordisk | 18 | $322 |
| Lilly USA, LLC | 17 | $186 |
| GSK | 11 | $158 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 8 | $127 |
| Amgen | 9 | $123 |
| Pfizer | 5 | $82 |
| AstraZeneca | 5 | $76 |
| Boehringer Ingelheim | 5 | $76 |
| Johnson & Johnson(2 entities) | 5 | $71 |
| Astellas Pharma US Inc | 3 | $54 |
| Intuitive Surgical | 1 | $52 |
| Abbott | 3 | $49 |
| Novartis | 3 | $48 |
| E.r. Squibb & Sons, L.L.C. | 2 | $33 |
| Merck | 2 | $25 |
| ARS Pharmaceuticals Operations, Inc. | 1 | $25 |
| Otsuka America Pharmaceutical, Inc. | 1 | $22 |
| Abiomed | 1 | $22 |
| Dexcom, Inc. | 1 | $20 |
| Lundbeck LLC | 1 | $18 |
| Sanofi-aventis U.S. LLC | 1 | $17 |
| Hikma Pharmaceuticals USA | 1 | $17 |
| Nalpropion Pharmaceuticals LLC | 1 | $15 |
| Exact Sciences | 1 | $14 |
| Bayer | 1 | $14 |
| Teva Pharmaceuticals USA, Inc. | 1 | $13 |
How this compares
$1,677 in reported general payments places this provider in the 75th percentile of 2,216 internal medicine 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 |
|---|---|---|
| EliquisApixaban | 117 | $118,263 |
| OzempicSemaglutide | 69 | $82,030 |
| JardianceEmpagliflozin | 36 | $55,244 |
| MounjaroTirzepatide | 32 | $48,110 |
| TrulicityDulaglutide | 25 | $43,108 |
| XareltoRivaroxaban | 17 | $18,807 |
| Stiolto RespimatTiotropium Br/Olodaterol Hcl | 20 | $15,830 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 20 | $14,346 |
| AbrysvoRsv Vacc, Pref A And Pref B/Pf | 29 | $9,286 |
| Anoro ElliptaUmeclidinium Brm/Vilanterol Tr | 12 | $8,671 |
| Novolog FlexpenInsulin Aspart | 12 | $8,444 |
| Diphenhydramine Hcl | 32 | $7,307 |
| Lantus SolostarInsulin Glargine,hum.Rec.Anlog | 44 | $6,737 |
| Promethazine Hcl | 54 | $5,038 |
| Atorvastatin Calcium | 451 | $4,318 |
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 |
|---|---|---|
| PfizerEliquis, Abrysvo | $82 | $127,550146 claims |
| Lilly USA, LLCMounjaro, Trulicity | $186 | $91,21957 claims |
| Novo NordiskOzempic | $322 | $82,03069 claims |
| Boehringer IngelheimJardiance, Stiolto Respimat | $76 | $71,07456 claims |
| GSKTrelegy Ellipta, Anoro Ellipta | $158 | $23,01732 claims |
| Johnson & JohnsonXarelto | $71 | $18,80717 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 75th percentile of 2,216 internal medicine providers in Tennessee.
Other internal medicine in Knoxville
- Amanda Moore MillerKnoxville$2.3M
- George NewmanKnoxville$682K
- Dennis DeruelleKnoxville$263K
- Lewis HagoodKnoxville$143K
- Johnny AltawilKnoxville$23K
- Mark McKenzieChattanooga$11.9M
- Bernard GrunstraBristol$6.4M
- Jewel WhiteKingsport$5.7M
- Judith WhiteKingsport$5.6M
- Obadias MarquezOoltewah$2.8M
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.