PlainDoctor

2026 NPPES data Rheumatology Physician NPI 1366974826 M.D.
Verify on CMS →

Benjamin Boone, M.D.

Rheumatology Physician in Louisville, Kentucky.

This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 6,377 in Rheumatology Physician, and covers specialty classification, practice address, and Medicare Part D prescribing data when reported. According to CMS, every field reflects the provider's official federal registration, see our methodology.

Federal data, no proprietary rating. We show these CMS records as-is - no composite score, no star rating, no editorial opinion layered on top.
Prescribing volume
679
Medicare Part D claims · 198 beneficiaries · Rheumatology Physician avg: 2K
Generic prescribing
85%
generic claims · 15% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
79.3/100
▼ 4 pts below national avg 83.5 · Above neutral
Industry payments
$27.2K
244 payments · CMS Open Payments (Sunshine Act)
Verify NPI on CMS Methodology
Compiled from official public sources by the editorial process.

What the federal data shows

Benjamin Boone, M.D. reported a CMS MIPS final score of 79.3/100 - below the 83.5 national average - and filed 679 Medicare Part D claims in 2024.

79.3/100
MIPS score · -4 vs avg
679
Part D claims, 2024
85%
generic prescribing
Likely
board-certified (heuristic)

Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) - no proprietary rating or editorial opinion is applied.

Federal trust snapshot

What official records show about Benjamin Boone, M.D.

Federal records show an active NPI with both Medicare prescribing volume and a measured CMS quality score — objective registry data, not patient reviews.

  • Verified

    NPI registry status

    Active listing in the CMS National Provider Identifier Registry (NPI 1366974826), first enumerated 04/03/2017.

    Source: CMS NPPES

  • Reported

    Medicare Part D participation

    Filed 679 Medicare Part D prescription claims in the 2023 CMS public use file — indicates active Medicare prescribing participation.

    Source: CMS Part D Prescriber PUF

  • Reported

    CMS quality reporting (MIPS)

    Reported a CMS MIPS final score of 79.3/100 in the Quality Payment Program — a federal quality measure, not a patient review.

    Source: CMS Quality Payment Program

  • Reported

    Board certification signal

    Heuristic suggests board-certified status based on ABMS-eligible specialty taxonomy plus active CMS participation signals — not a direct ABMS verification.

    Source: NUCC taxonomy + CMS participation heuristic

  • Reported

    Hospital affiliations

    1 CMS Care Compare hospital affiliation on record — practice footprint from the Doctors and Clinicians file.

    Source: CMS Care Compare

  • Reported

    Industry payment transparency

    $27.2K in reported industry payments (244 transfers) in 2024 under the federal Sunshine Act — disclosed transfers of value, not a quality rating.

    Source: CMS Open Payments

  • Not in federal data

    Individual sanction lookup

    PlainDoctor does not publish per-provider disciplinary determinations. Confirm current license and any individual actions through the state medical board or FSMB verification service.

    Source: State medical board / FSMB

This trust snapshot summarizes only what appears in federal CMS/NPPES public records. It is not a composite score, star rating, patient review, or clinical recommendation. PlainDoctor never fabricates reviews or AggregateRating schema.

CMS NPPES provider registry desk

NPI 1366974826 · Rheumatology Physician

NPI-10 · ENUM-RECENT · TAX-MID · MIPS-BELOW · RX-LIGHT · BOOK-THIN · PHOTO-FINISH

  • NPI-10 1366974826
  • ENUM-RECENT 2017
  • TAX-MID 6K Rheumatology Physician
  • MIPS-BELOW 79.3/100
  • RX-LIGHT 679
  • BOOK-THIN 63 in Kentucky
  • PHOTO-FINISH Colin Diffie · ±0.0

MIPS final-score neighbourhood

Same-specialty nationwide peers by CMS final score, not geographic proximity

MIPS pts

What this shows Nearest measured MIPS peers for this NUCC specialty (2023 performance year).

Source CMS Quality Payment Program (MIPS) As of 2023

Benjamin Boone, M.D.'s MIPS score vs every measured U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure. Clinicians whose score CMS assigned without scoring any category are excluded.

79 ≥ 26th percentile 26% of 454,083 measured providers are in lower value bands

0–10: 8,684 measured providers (2%). Below this entry. 10–20: 3,008 measured providers (1%). Below this entry. 20–30: 3,069 measured providers (1%). Below this entry. 30–40: 2,746 measured providers (1%). Below this entry. 40–50: 2,928 measured providers (1%). Below this entry. 50–60: 5,882 measured providers (1%). Below this entry. 60–70: 13,906 measured providers (3%). Below this entry. 70–80: 94,570 measured providers (21%). This entry sits in this band. 80–90: 129,887 measured providers (29%). Above this entry. 90+: 189,403 measured providers (42%). Above this entry. This provider 0 100 every measured MIPS clinician, bucketed by value

Each bar is a band; taller bars hold more measured providers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.

The percentile is a conservative whole-score-point band: it counts only measured clinicians in lower score bands. A CMS MIPS metric is not a recommendation or a clinical-quality rating by PlainDoctor. See methodology § corpus placement.

Source CMS Merit-based Incentive Payment System (MIPS) · 2023

Where Benjamin Boone, M.D. sits

This provider among rheumatology physician peers

Across the 1,970 rheumatology physician providers who report both Medicare Part D prescribing and a MIPS quality score, Benjamin Boone, M.D. writes more Part D claims than 18% of them and scores higher on MIPS quality than 28% - placing this provider in the lower-volume, lower-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.

Lower volume · High qualityHigh volume · High qualityLower volume · Lower qualityHigh volume · Lower quality0255075100024.949.974.899.8Part D claim volume, percentile in specialtyMIPS quality, percentilePoint, Part D claim volume, percentile in specialty: 25 · MIPS quality, percentile: 13Point, Part D claim volume, percentile in specialty: 28 · MIPS quality, percentile: 10Point, Part D claim volume, percentile in specialty: 32 · MIPS quality, percentile: 22Point, Part D claim volume, percentile in specialty: 80 · MIPS quality, percentile: 12Point, Part D claim volume, percentile in specialty: 38 · MIPS quality, percentile: 95Point, Part D claim volume, percentile in specialty: 18 · MIPS quality, percentile: 90Point, Part D claim volume, percentile in specialty: 8 · MIPS quality, percentile: 45Point, Part D claim volume, percentile in specialty: 12 · MIPS quality, percentile: 83Point, Part D claim volume, percentile in specialty: 90 · MIPS quality, percentile: 23Point, Part D claim volume, percentile in specialty: 75 · MIPS quality, percentile: 90Point, Part D claim volume, percentile in specialty: 35 · MIPS quality, percentile: 20Point, Part D claim volume, percentile in specialty: 15 · MIPS quality, percentile: 50Point, Part D claim volume, percentile in specialty: 68 · MIPS quality, percentile: 72Point, Part D claim volume, percentile in specialty: 48 · MIPS quality, percentile: 80Point, Part D claim volume, percentile in specialty: 97 · MIPS quality, percentile: 35Point, Part D claim volume, percentile in specialty: 53 · MIPS quality, percentile: 58Point, Part D claim volume, percentile in specialty: 72 · MIPS quality, percentile: 8Point, Part D claim volume, percentile in specialty: 57 · MIPS quality, percentile: 63Point, Part D claim volume, percentile in specialty: 42 · MIPS quality, percentile: 90Point, Part D claim volume, percentile in specialty: 30 · MIPS quality, percentile: 95Point, Part D claim volume, percentile in specialty: 88 · MIPS quality, percentile: 53Point, Part D claim volume, percentile in specialty: 92 · MIPS quality, percentile: 42Point, Part D claim volume, percentile in specialty: 10 · MIPS quality, percentile: 28Point, Part D claim volume, percentile in specialty: 0 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 33 · MIPS quality, percentile: 58Point, Part D claim volume, percentile in specialty: 58 · MIPS quality, percentile: 32Point, Part D claim volume, percentile in specialty: 78 · MIPS quality, percentile: 95Point, Part D claim volume, percentile in specialty: 37 · MIPS quality, percentile: 58Point, Part D claim volume, percentile in specialty: 20 · MIPS quality, percentile: 17Point, Part D claim volume, percentile in specialty: 87 · MIPS quality, percentile: 5Point, Part D claim volume, percentile in specialty: 100 · MIPS quality, percentile: 52Point, Part D claim volume, percentile in specialty: 83 · MIPS quality, percentile: 23Point, Part D claim volume, percentile in specialty: 3 · MIPS quality, percentile: 45Point, Part D claim volume, percentile in specialty: 67 · MIPS quality, percentile: 43Point, Part D claim volume, percentile in specialty: 17 · MIPS quality, percentile: 15Point, Part D claim volume, percentile in specialty: 73 · MIPS quality, percentile: 87Point, Part D claim volume, percentile in specialty: 63 · MIPS quality, percentile: 82Point, Part D claim volume, percentile in specialty: 62 · MIPS quality, percentile: 55Point, Part D claim volume, percentile in specialty: 65 · MIPS quality, percentile: 2Point, Part D claim volume, percentile in specialty: 82 · MIPS quality, percentile: 3Point, Part D claim volume, percentile in specialty: 52 · MIPS quality, percentile: 73Point, Part D claim volume, percentile in specialty: 70 · MIPS quality, percentile: 40Point, Part D claim volume, percentile in specialty: 85 · MIPS quality, percentile: 30Point, Part D claim volume, percentile in specialty: 55 · MIPS quality, percentile: 95Point, Part D claim volume, percentile in specialty: 60 · MIPS quality, percentile: 77Point, Part D claim volume, percentile in specialty: 23 · MIPS quality, percentile: 33Point, Part D claim volume, percentile in specialty: 40 · MIPS quality, percentile: 48Point, Part D claim volume, percentile in specialty: 47 · MIPS quality, percentile: 27Point, Part D claim volume, percentile in specialty: 77 · MIPS quality, percentile: 65Point, Part D claim volume, percentile in specialty: 5 · MIPS quality, percentile: 75Point, Part D claim volume, percentile in specialty: 2 · MIPS quality, percentile: 7Point, Part D claim volume, percentile in specialty: 7 · MIPS quality, percentile: 85Point, Part D claim volume, percentile in specialty: 45 · MIPS quality, percentile: 68Point, Part D claim volume, percentile in specialty: 98 · MIPS quality, percentile: 70Point, Part D claim volume, percentile in specialty: 27 · MIPS quality, percentile: 37Point, Part D claim volume, percentile in specialty: 43 · MIPS quality, percentile: 57Point, Part D claim volume, percentile in specialty: 95 · MIPS quality, percentile: 37Point, Part D claim volume, percentile in specialty: 50 · MIPS quality, percentile: 77Point, Part D claim volume, percentile in specialty: 93 · MIPS quality, percentile: 88Point, Part D claim volume, percentile in specialty: 13 · MIPS quality, percentile: 67Benjamin Boone, M.D., Part D claim volume, percentile in specialty: 18 · MIPS quality, percentile: 28
Part D claim volume vs MIPS quality, by specialty percentile

Each dot is one rheumatology physician peer from a representative sample of 60; the gold marker is Benjamin Boone, M.D.. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.

✓
Board certification likely (heuristic, not verified)

Benjamin Boone, 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).

What does the federal data show about Benjamin Boone, M.D.?

Near national average

NPI registry status

Active

Issued 04/03/2017

NPI 1366974826

Primary specialty

Rheumatology Physician

Mid-sized

6,377 US NPIs in this specialty

Medicare Part D claims

679 67% vs specialty avg

2024 prescription claims

Specialty avg: 2,058

MIPS final score

79.3/100 4.2 pts vs avg

Above neutral band

vs 83.5 national avg

Specialty distribution in Kentucky

How Rheumatology Physician compares to other specialties among Kentucky providers

Kentucky providers
Family Nurse Practitioner5.8%Student in an Organized Heal…5.2%Pharmacist4.8%Mental Health Counselor4.6%Clinical Social Worker4.2%Physical Therapist3.6%Rheumatology Physician0.1%
Largest specialties in Kentucky (% of in-state providers)

Medicare quality performance, MIPS

Benjamin Boone, M.D.'s 2023 MIPS final score plotted against the Rheumatology Physician national average

Near national average
MIPS Final Score
79.3/100
vs 83.5 national avg · 2023 performance year
0%100%National avg84%79.3%
MIPS final score (Rheumatology Physician) - 79.3/100 vs national avg 83.5
How MIPS and board certification work

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).

Practice Address

3430 NEWBURG RD STE 250
Louisville, KY 40218
(502) 893-3963

Provider Details

NPI 1366974826
Specialty Rheumatology Physician
Credentials M.D.
Gender Male
NPI Issued 04/03/2017

CMS Quality Score (MIPS)

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

79.2504
Final Score
Measured-score avg: 83.5
100
Quality
34.168
Cost
96
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where Benjamin Boone, 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.

Rheumatology Associates, PLLC
Louisville, KY

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 Benjamin Boone, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$27.2K

Largest payer

Novartis Pharmaceuticals Corporation

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.

Brand vs generic prescribing mix · Typical

Benjamin Boone, M.D. - brand share 15.0%
Rheumatology Physician average

15% brand-name claims vs 85% generic, on 679 2024 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 2024.

679
Total Claims
$986K
Total Drug Cost
198
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
1,373.833
Total Day Supply
39,498
Brand vs Generic
15% brand / 85% generic
Brand Drug Cost
$970K
Generic Drug Cost
$16K

Patient Demographics

Average Patient Age
72.5 years
Avg HCC Risk Score
1.32
Gender Split
60% female / 40% male
Age Distribution
<65: 20, 65-74: 102, 75-84: N/A, 85+: N/A

Top Prescribed Drugs (Medicare Part D)

Top drugs by claim count for calendar year 2024. Based on Medicare Part D data only.

What Benjamin Boone, M.D. prescribes most

Top Medicare Part D drugs by claim count, 2024

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2024
Drug Claims
Prednisone
 233
Methotrexate
Methotrexate Sodium
84
Hydroxychloroquine Sulfate
 58
Colchicine
 52
Allopurinol
 32
Methylprednisolone
 30
Enbrel Sureclick
Etanercept
28
Folic Acid
 19
Alendronate Sodium
 15
Kevzara
Sarilumab
15

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

More Rheumatology Physician in KY → All providers in Kentucky → Compare specialties →

Rheumatology Physician Overview

How Benjamin Boone, M.D. fits within the Rheumatology Physician landscape nationally.

6,377
Rheumatology Physician Providers in US
52
States with Rheumatology Physician
2,058
Avg Claims per Provider

Benjamin Boone, M.D.'s 679 claims are below the specialty average of 2,058.

Nationwide Rheumatology Physician peers with similar MIPS or enrollment year

Two federal-record peer sets for Boone, both outside Kentucky so the neighborhoods are not geographic containment.

Similar MIPS final score

Nearest same-specialty clinicians by CMS MIPS final score (79.3 here).

Timothy Howard 79.2 PA Hossam Elzawawy 79.2 FL Colin Diffie 79.3 MO Maria Gonzalez-Mayda 79.3 MO

Same NPPES enumeration year (2017)

Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.

Mohamed Tageldin Knoxville, TN Monsoon Rashid Brooklyn, NY Sowmika Rao Cumming, GA Stephanie Ribelli Willoughby Hills, OH

Nearby Rheumatology Physician Providers in Kentucky

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

One of 63 Rheumatology Physician providers enrolled in Kentucky, 5 are shown here.

Dr. Syed Abbas
M.D.
Lexington, KY
Dr. Elaine Alexander
M.D.
Lexington, KY
Dr. Reem Alkilany
MD
Lexington, KY
Dr. Izabela Antic
DO
Lexington, KY
Dr. Billy Bailey
MD
Paducah, KY

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

Frequently Asked Questions

What is Benjamin Boone, M.D.'s specialty? ▼
Benjamin Boone, M.D. specializes in Rheumatology Physician and practices in Louisville, Kentucky. Credentials: M.D..
How much does Benjamin Boone, M.D. prescribe under Medicare Part D? ▼
In 2024, Benjamin Boone, M.D. wrote 679 Medicare Part D claims totaling $986K in drug costs for 198 beneficiaries.
What is Benjamin Boone, M.D.'s Medicare quality score? ▼
Benjamin Boone, M.D. has a CMS MIPS Final Score of 79.3/100 (Quality: 100, Cost: 34.2). The average MIPS Final Score across the 454,083 clinicians with at least one published category score is 83.5; clinicians whose score CMS assigned without scoring any category are excluded from that average. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Benjamin Boone, M.D. located? ▼
Benjamin Boone, M.D. is located at 3430 NEWBURG RD STE 250, Louisville, KY, 40218. Phone: (502) 893-3963.
What is Benjamin Boone, M.D.'s NPI number? ▼
Benjamin Boone, M.D.'s National Provider Identifier (NPI) is 1366974826, issued on 04/03/2017.
Does Benjamin Boone, M.D. prescribe more brand-name or generic drugs? ▼
Benjamin Boone, M.D.'s prescribing is 15% brand-name and 85% generic drugs by claim count, with $970K in brand drug costs.
How many Rheumatology Physician providers are there in the US? ▼
There are 6,377 Rheumatology Physician providers across 52 states in the US. The average Rheumatology Physician provider writes 2,058 Medicare Part D claims per year.
What drugs does Benjamin Boone, M.D. prescribe most often? ▼
Based on 2024 Medicare Part D data, Benjamin Boone, M.D.'s most frequently prescribed drugs include Prednisone, Methotrexate, Hydroxychloroquine Sulfate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Benjamin Boone, M.D. accept Medicare? ▼
Benjamin Boone, M.D. appears in CMS Medicare data with 679 Part D claims and 198 Medicare beneficiaries in 2024. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Benjamin Boone, M.D.'s credentials? ▼
Benjamin Boone, M.D.'s NPI is 1366974826 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

View source datasets and methodology notes
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 (2024). 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 August 2026 (NPPES) / 2024 (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

Compiled from official public sources by the editorial process.

Every figure on PlainDoctor is rendered directly from the federal CMS NPPES registry, Medicare Part D, MIPS, and Open Payments records, no number is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of August 2026.