Remote patient monitoring (RPM) relies on low-cost, low-power, wearable sensors for continuous physiological assessment. Photoplethysmographic (PPG) sensors generally require >10 components, occupy an area >300 mm(2), consume >10 mW power, and cost >$20 USD. Although the principle of PPG sensing is straightforward, in practice, a robust implementation requires a careful design including optical alignment, analog circuits, ambient light cancellation, and power management. This paper reports the first use of digital optical proximity sensors (OPS) for "plug-and-play" PPG. OPS have traditionally been used for distance sensing in smartphones and factory automation. Here we show that a digital OPS can perform PPG functions in a single 4×4 mm package which also provides a direct digital interface to a microcontroller. By exploiting its key features, a digital OPS can provide substantial performance advantages over existing state-of-the-art PPGs, including: i) 10X lower power consumption (200 µW) due to pulse operation; ii) high signal to noise ratio (>90), as a result of built-in optical barriers, filters, and ambient light cancellation; iii) 10X lower cost ($2 USD); and iv) 12X smaller area. We show single wavelength PPG measurements in multiple anatomical locations, including fingertips and earlobes. The results suggest that a digital OPS can provide an elegant solution for battery-powered, wearable physiological monitors. To the authors' knowledge, this is the smallest and lowest power PPG sensor reported to date.