2026 NPPES data Otology & Neurotology Physician NPI 1427387547 M.D.
Verify on CMS →

ASHLEY BALAKER, M.D.

Otology & Neurotology Physician in LAGUNA HILLS, California. 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
885
Medicare Part D claims · 345 beneficiaries · Otology & Neurotology Physician avg: 401
Generic prescribing
92%
generic claims · 8% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
90.3189/100
▲ 7 pts above national avg 83.1 · [object Object]
Industry payments
$172.31
5 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: ASHLEY BALAKER, M.D. is a Otology & Neurotology Physician ([object Object]) practicing in LAGUNA HILLS, California with a Medicare Part D prescribing footprint of 885 claims across 345 beneficiaries — 8% brand-name prescribing . Their CMS MIPS Final Score of 90.3189/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $172.31 across 5 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: ASHLEY BALAKER, M.D. reported a CMS MIPS final score of 90.3189 out of 100, above the 83.1 national average, and filed 885 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)

ASHLEY BALAKER, M.D. 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).

ASHLEY BALAKER, M.D. at a glance

High performer (top quartile)

NPI registry status

Active

Issued 12/19/2009

NPI 1427387547

Primary specialty

Otology & Neurotology Physician

Rare

333 US NPIs in this specialty

Medicare Part D claims

885 121% vs specialty avg

2023 prescription claims

Specialty avg: 401

MIPS final score

90.3189/100 7.218900000000005% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in California

How Otology & Neurotology Physician compares to other specialties among California providers

California providers

Otology & Neurotology Physician share within California

1. Otology & Neurotology Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Otology & Neurotology Physician share within California

Medicare quality performance — MIPS

ASHLEY BALAKER, M.D.'s 2023 MIPS final score plotted against the Otology & Neurotology Physician national average

High performer (top quartile)
MIPS Final Score
90.3189/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Otology & Neurotology Physician) — 90.3189/100 vs national avg 83.1

0%100%National avg83%90.3%
MIPS final score (Otology & Neurotology Physician) — 90.3189/100 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).

ASHLEY BALAKER, M.D. is a Otology & Neurotology Physician provider practicing in LAGUNA HILLS, California, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: M.D.. NPI: 1427387547. 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.

ASHLEY BALAKER, M.D. appears in the CMS NPPES registry as a Otology & Neurotology Physician provider holding M.D. credentials at 24411 HEALTH CENTER DR STE 370, LAGUNA HILLS, CA, 92653, with a listed phone of (949) 364-4361. NPI 1427387547 was issued on 12/19/2009. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BALAKER 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 885 prescription claims written by this provider, covering 345 Medicare beneficiaries and totaling roughly $31K in drug spend, split 8% brand-name and 92% 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 90.3189/100 for the 2023 performance year (Quality 80.6378), compared with the national average of 83.1.

Otology & Neurotology Physician is a narrow specialty nationwide, with 333 enrolled providers across 46 states and an average of 401 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

24411 HEALTH CENTER DR STE 370
LAGUNA HILLS, CA 92653

Provider Details

NPI 1427387547
Specialty Otology & Neurotology Physician
Credentials M.D.
Gender Female
NPI Issued 12/19/2009

CMS Quality Score (MIPS)

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

90.3189
Final Score
Avg: 83.1
80.6378
Quality

Reporting: Individual

Hospital and facility affiliations

Facilities where ASHLEY BALAKER, M.D. 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.

HEAD AND NECK ASSOCIATES OF ORANGE COUNTY AN INCORPRATE
IRVINE, CA

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 ASHLEY BALAKER, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$172

Largest payer

Cochlear Americas

Most common payment type

Food and Beverage

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 — California MBC 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 ~150K California medical licensees in 2023 — they are NOT specific to ASHLEY BALAKER, M.D.. To verify ASHLEY BALAKER, M.D.'s current license status, search the MBC public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

576
Total board actions, California 2023
Across 556 cases
3.84
Actions per 1,000 licensees
California statewide rate
probation
Most common action type
186 cases

MBC 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 California disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Generic-heavy

ASHLEY BALAKER, M.D. — brand share 8.0%
Specialty average (est.)

8% brand-name claims vs 92% generic, on 885 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.

885
Total Claims
$31K
Total Drug Cost
345
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
1,037
Total Day Supply
22,311
Brand vs Generic
8% brand / 92% generic
Brand Drug Cost
$6K
Generic Drug Cost
$26K
Antibiotic Claims
66

Patient Demographics

Average Patient Age
72.0 years
Avg HCC Risk Score
1.13
Gender Split
63% female / 37% male
Age Distribution
<65: 19, 65-74: 200, 75-84: 102, 85+: 24

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Tobramycin-Dexamethasone
Tobramycin/Dexamethasone
210
Azelastine Hcl
133
Fluticasone Propionate
120
Fluocinolone Acetonide Oil
59
Ipratropium Bromide
59
Prednisone
41
Mupirocin
34
Methylprednisolone
30
Amoxicillin-Clavulanate Potass
Amoxicillin/Potassium Clav
29
Levofloxacin
25

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

Otology & Neurotology Physician Overview

How ASHLEY BALAKER, M.D. fits within the Otology & Neurotology Physician landscape nationally.

333
Otology & Neurotology Physician Providers in US
46
States with Otology & Neurotology Physician
401
Avg Claims per Provider

ASHLEY BALAKER, M.D.'s 885 claims are above the specialty average of 401.

Nearby Otology & Neurotology Physician Providers in California

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

Compare Otology & Neurotology Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is ASHLEY BALAKER, M.D.'s specialty?
ASHLEY BALAKER, M.D. specializes in Otology & Neurotology Physician and practices in LAGUNA HILLS, California. Credentials: M.D..
How much does ASHLEY BALAKER, M.D. prescribe under Medicare Part D?
In 2023, ASHLEY BALAKER, M.D. wrote 885 Medicare Part D claims totaling $31K in drug costs for 345 beneficiaries.
What is ASHLEY BALAKER, M.D.'s Medicare quality score?
ASHLEY BALAKER, M.D. has a CMS MIPS Final Score of 90.3189/100 (Quality: 80.6378). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is ASHLEY BALAKER, M.D. located?
ASHLEY BALAKER, M.D. is located at 24411 HEALTH CENTER DR STE 370, LAGUNA HILLS, CA, 92653. Phone: (949) 364-4361.
What is ASHLEY BALAKER, M.D.'s NPI number?
ASHLEY BALAKER, M.D.'s National Provider Identifier (NPI) is 1427387547, issued on 12/19/2009.
Does ASHLEY BALAKER, M.D. prescribe more brand-name or generic drugs?
ASHLEY BALAKER, M.D.'s prescribing is 8% brand-name and 92% generic drugs by claim count, with $6K in brand drug costs.
How many Otology & Neurotology Physician providers are there in the US?
There are 333 Otology & Neurotology Physician providers across 46 states in the US. The average Otology & Neurotology Physician provider writes 401 Medicare Part D claims per year.
What drugs does ASHLEY BALAKER, M.D. prescribe most often?
Based on 2023 Medicare Part D data, ASHLEY BALAKER, M.D.'s most frequently prescribed drugs include Tobramycin-Dexamethasone, Azelastine Hcl, Fluticasone Propionate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does ASHLEY BALAKER, M.D. accept Medicare?
ASHLEY BALAKER, M.D. appears in CMS Medicare data with 885 Part D claims and 345 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify ASHLEY BALAKER, M.D.'s credentials?
ASHLEY BALAKER, M.D.'s NPI is 1427387547 with credentials M.D.. 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