Ruben Nieto
Foot & Ankle Surgery · Bakersfield, CANPI 1942615299
Payments from drug & device makers
Across 168 payments — averaging $32.84 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Treace Medical Concepts, Inc.$2K
- Organogenesis Inc.$1K
- Smith+Nephew$1K
- Medtronic$269
- Stryker$233
- AbbVie$103
- plus $916 from 17 others
What the payments were for
- Travel & lodging$1,31924%
- Food & beverage$4,19976%
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 |
|---|---|---|
| Treace Medical Concepts, Inc. | 3 | $1,694 |
| Organogenesis Inc. | 45 | $1,301 |
| Smith+Nephew | 67 | $1,002 |
| Medtronic | 4 | $269 |
| Stryker(2 entities) | 6 | $233 |
| AbbVie | 4 | $103 |
| Bioventus LLC | 3 | $95 |
| Polynovo North America LLC | 3 | $90 |
| Melinta Therapeutics, LLC | 4 | $88 |
| Tactile Systems Technology Inc | 6 | $84 |
| Integra Lifesciences Corporation | 5 | $81 |
| Nevro Corp. | 3 | $79 |
| KCI USA, Inc. | 2 | $72 |
| Vaporox, Inc. | 1 | $61 |
| Orthofix Medical, Inc. | 1 | $55 |
| GRT US Holding, Inc. | 2 | $50 |
| Merck | 3 | $44 |
| Angiodynamics, Inc. | 1 | $39 |
| Davol Inc. | 1 | $18 |
| Paratek Pharmaceuticals, Inc. | 1 | $18 |
| Dynasplint Systems Inc. | 1 | $16 |
| Amgen | 1 | $14 |
| Celularity Inc. | 1 | $12 |
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.
- Lapiplasty System$1,694
- PuraPly$342
- INTELLIS ADAPTIVESTIM$147
- Puraply Antimicrobial$108
- Foot and Ankle$103
How this compares
$5,518 in reported general payments places this provider in the 70th percentile of 1,126 foot & ankle surgery 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 |
|---|---|---|
| Ketoconazole | 428 | $13,311 |
| Betamethasone Dipropionate | 95 | $4,049 |
| Diclofenac Sodium | 147 | $2,498 |
| Linezolid | 14 | $1,398 |
| Nystatin | 72 | $801 |
| Clindamycin Hcl | 92 | $657 |
| SsdSilver Sulfadiazine | 49 | $467 |
| Doxycycline Hyclate | 46 | $441 |
| Cephalexin | 101 | $421 |
| Silver Sulfadiazine | 24 | $379 |
| Levofloxacin | 56 | $342 |
| Nystatin-TriamcinoloneNystatin/Triamcinolone Acet | 11 | $228 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 40 | $225 |
| Amoxicillin-Clavulanate PotassAmoxicillin/Potassium Clav | 15 | $222 |
| Sulfamethoxazole-TrimethoprimSulfamethoxazole/Trimethoprim | 27 | $108 |
Paid to pharmacies, not to this prescriber.
Other foot & ankle surgery in Bakersfield
- John ZimmermanBakersfield$4.6M
- Eric GizaSacramento$3.7M
- Thomas HarrisPasadena$3M
- Felix SigalLos Angeles$2.2M
- Thomas ChangSanta Rosa$2.1M
- Michael CoughlinSan Francisco$1.6M
- Vladimir ZeetserEncino$677K
- Jason NowakRedding$526K
- Candice BradyCamarillo$462K
- Andrew HsuOrange$456K
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.