2026 NPPES data Nephrology Physician NPI 1740228220 MD
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ASHFAQ BALLA, MD

Nephrology Physician in WORCESTER, Massachusetts. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.

Federal data — no proprietary rating. PlainDoctor publishes the actual CMS NPPES and Medicare records — NPI registration, specialty, practice location, and prescribing data — without a composite score or editorial opinion on top. Every field traces to a federal source.
Prescribing volume
633
Medicare Part D claims · 108 beneficiaries · Nephrology Physician avg: 1K
Generic prescribing
83%
generic claims · 17% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
97.0218/100
▲ 14 pts above national avg 83.1 · [object Object]
Industry payments
$13.3
5 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: ASHFAQ BALLA, MD is a Nephrology Physician ([object Object]) practicing in WORCESTER, Massachusetts with a Medicare Part D prescribing footprint of 633 claims across 108 beneficiaries — 17% brand-name prescribing . Their CMS MIPS Final Score of 97.0218/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $13.3 across 5 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: ASHFAQ BALLA, MD reported a CMS MIPS final score of 97.0218 out of 100, above the 83.1 national average, and filed 633 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

Board certification likely (heuristic — not verified)

ASHFAQ BALLA, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 1 hospital affiliation — signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).

ASHFAQ BALLA, MD at a glance

High performer (top quartile)

NPI registry status

Active

Issued 06/04/2006

NPI 1740228220

Primary specialty

Nephrology Physician

Mid-sized

10,534 US NPIs in this specialty

Medicare Part D claims

633 56% vs specialty avg

2023 prescription claims

Specialty avg: 1,454

MIPS final score

97.0218/100 13.921800000000005% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Massachusetts

How Nephrology Physician compares to other specialties among Massachusetts providers

Massachusetts providers

Nephrology Physician share within Massachusetts

1. Nephrology Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Nephrology Physician share within Massachusetts

Medicare quality performance — MIPS

ASHFAQ BALLA, MD's 2023 MIPS final score plotted against the Nephrology Physician national average

High performer (top quartile)
MIPS Final Score
97.0218/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Nephrology Physician) — 97.0218/100 vs national avg 83.1

0%100%National avg83%97%
MIPS final score (Nephrology Physician) — 97.0218/100 vs national avg 83.1

The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.

Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).

ASHFAQ BALLA, MD is a Nephrology Physician provider practicing in WORCESTER, Massachusetts, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: MD. NPI: 1740228220. This profile includes practice location, specialty classification, and organizational affiliations from the CMS provider registry. Provider information is self-reported to CMS and updated monthly.

ASHFAQ BALLA, MD appears in the CMS NPPES registry as a Nephrology Physician provider holding MD credentials at 55 LAKE AVE N, WORCESTER, MA, 01655, with a listed phone of (508) 856-3155. NPI 1740228220 was issued on 06/04/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BALLA most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.

Medicare Part D records for calendar year 2023 show 633 prescription claims written by this provider, covering 108 Medicare beneficiaries and totaling roughly $103K in drug spend, split 17% brand-name and 83% generic by claim count. These figures capture only Medicare Part D — commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 97.0218/100 for the 2023 performance year (Quality 78.0983), compared with the national average of 83.1.

Nephrology Physician is a mid-sized specialty nationwide, with 10,534 enrolled providers across 55 states and an average of 1,454 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist — always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.

Practice Address

55 LAKE AVE N
WORCESTER, MA 01655

Provider Details

NPI 1740228220
Specialty Nephrology Physician
Credentials MD
Gender Male
NPI Issued 06/04/2006

CMS Quality Score (MIPS)

Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.

97.0218
Final Score
Avg: 83.1
78.0983
Quality
100
Promoting Interoperability

Reporting: Alternative Payment Model

Hospital and facility affiliations

Facilities where ASHFAQ BALLA, MD bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" — a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.

UMASS MEMORIAL MEDICAL GROUP INC
WORCESTER, MA

Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).

Industry payments received (2024) — CMS Open Payments transparency data

The federal Physician Payments Sunshine Act (part of the Affordable Care Act) requires drug and medical-device manufacturers + group purchasing organizations to publicly report payments and other transfers of value to physicians and teaching hospitals. The data below covers 2024 for ASHFAQ BALLA, MD. Source: openpaymentsdata.cms.gov.

Total received

$13

Largest payer

Travere Therapeutics, Inc.

Most common payment type

Education

Industry payments are not necessarily indicators of bias — they include research funding, consulting fees for evidence-based work, royalties for inventions, food at conferences, and similar items. The disclosure exists for transparency. Read our methodology for how we interpret this data.

License & disciplinary context — Massachusetts BORIM 2023 annual report

Aggregate state board data only — NOT a determination of any individual provider's status. The figures below describe statewide disciplinary activity across all ~38K Massachusetts medical licensees in 2023 — they are NOT specific to ASHFAQ BALLA, MD. To verify ASHFAQ BALLA, MD's current license status, search the BORIM public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

80
Total board actions, Massachusetts 2023
Across 78 cases
2.11
Actions per 1,000 licensees
Massachusetts statewide rate
probation
Most common action type
29 cases

BORIM publishes annual disciplinary statistics as part of public-record reporting under each state's Administrative Procedure Act. See the full breakdown by action type and year on the Massachusetts disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Typical

ASHFAQ BALLA, MD — brand share 17.0%
Specialty average (est.)

17% brand-name claims vs 83% generic, on 633 2023 Medicare Part D claims.

The federal Medicare Part D Generic Dispensing Rate national benchmark sits near 90% generic / 10% brand for primary-care prescribers, per CMS Office of the Actuary 2024 estimates. Higher brand share is common in specialty prescribing where generic equivalents are not available.

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

633
Total Claims
$103K
Total Drug Cost
108
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
1,445
Total Day Supply
41,653
Brand vs Generic
17% brand / 83% generic
Brand Drug Cost
$86K
Generic Drug Cost
$16K

Patient Demographics

Average Patient Age
73.5 years
Avg HCC Risk Score
3.32
Gender Split
49% female / 51% male
Age Distribution
<65: 16, 65-74: 37, 75-84: 40, 85+: 15

Top Prescribed Drugs (Medicare Part D)

Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.

Drug Claims
Amlodipine Besylate
56
Furosemide
55
Losartan Potassium
49
Lisinopril
40
Metoprolol Succinate
35
Clinolipid
Fat Emulsion/Olive/Soy/Phospho
33
Carvedilol
25
Hydralazine Hcl
24
Sodium Citrate-Citric Acid
Citric Acid/Sodium Citrate
23
Diltiazem 24hr Er (Cd)
Diltiazem Hcl
22

* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.

Nephrology Physician Overview

How ASHFAQ BALLA, MD fits within the Nephrology Physician landscape nationally.

10,534
Nephrology Physician Providers in US
55
States with Nephrology Physician
1,454
Avg Claims per Provider

ASHFAQ BALLA, MD's 633 claims are below the specialty average of 1,454.

Nearby Nephrology Physician Providers in Massachusetts

Other clinicians with the same primary specialty enrolled in Massachusetts, drawn from the same CMS NPPES roster as BALLA.

Compare Nephrology Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is ASHFAQ BALLA, MD's specialty?
ASHFAQ BALLA, MD specializes in Nephrology Physician and practices in WORCESTER, Massachusetts. Credentials: MD.
How much does ASHFAQ BALLA, MD prescribe under Medicare Part D?
In 2023, ASHFAQ BALLA, MD wrote 633 Medicare Part D claims totaling $103K in drug costs for 108 beneficiaries.
What is ASHFAQ BALLA, MD's Medicare quality score?
ASHFAQ BALLA, MD has a CMS MIPS Final Score of 97.0218/100 (Quality: 78.0983). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is ASHFAQ BALLA, MD located?
ASHFAQ BALLA, MD is located at 55 LAKE AVE N, WORCESTER, MA, 01655. Phone: (508) 856-3155.
What is ASHFAQ BALLA, MD's NPI number?
ASHFAQ BALLA, MD's National Provider Identifier (NPI) is 1740228220, issued on 06/04/2006.
Does ASHFAQ BALLA, MD prescribe more brand-name or generic drugs?
ASHFAQ BALLA, MD's prescribing is 17% brand-name and 83% generic drugs by claim count, with $86K in brand drug costs.
How many Nephrology Physician providers are there in the US?
There are 10,534 Nephrology Physician providers across 55 states in the US. The average Nephrology Physician provider writes 1,454 Medicare Part D claims per year.
What drugs does ASHFAQ BALLA, MD prescribe most often?
Based on 2023 Medicare Part D data, ASHFAQ BALLA, MD's most frequently prescribed drugs include Amlodipine Besylate, Furosemide, Losartan Potassium. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does ASHFAQ BALLA, MD accept Medicare?
ASHFAQ BALLA, MD appears in CMS Medicare data with 633 Part D claims and 108 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify ASHFAQ BALLA, MD's credentials?
ASHFAQ BALLA, MD's NPI is 1740228220 with credentials MD. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.

Data Sources

Provider Directory
CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
Specialty Classification
NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
Prescribing Data
CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
Quality Performance
CMS Merit-based Incentive Payment System (MIPS) — 2023 performance year.
Limitations
Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.

See our complete data methodology for details on how we collect and process government data.

Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).

Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology