2026 NPPES data Orthopaedic Surgery Physician NPI 1265850309 MD
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BENJAMIN ZMISTOWSKI, MD

Orthopaedic Surgery Physician in SAINT LOUIS, Missouri. 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
263
Medicare Part D claims · 150 beneficiaries · Orthopaedic Surgery Physician avg: 324
Generic prescribing
95%
generic claims · 5% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
79.292/100
▼ 4 pts below national avg 83.1 · [object Object]
Industry payments
$33.5K
66 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

BENJAMIN ZMISTOWSKI, MD reported a CMS MIPS final score of 79.292/100 — below the 83.1 national average — and filed 263 Medicare Part D claims in 2023.

79.292/100
MIPS score · -4 vs avg
263
Part D claims, 2023
95%
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.

BENJAMIN ZMISTOWSKI, MD's MIPS score vs every scored U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023 — the federal quality measure

79 30th percentile higher than 30% of 477,587 scored providers

0–10: 8,684 scored providers (2%). Below this entry. 10–20: 3,008 scored providers (1%). Below this entry. 20–30: 3,069 scored providers (1%). Below this entry. 30–40: 2,746 scored providers (1%). Below this entry. 40–50: 2,928 scored providers (1%). Below this entry. 50–60: 5,882 scored providers (1%). Below this entry. 60–70: 13,906 scored providers (3%). Below this entry. 70–80: 118,074 scored providers (25%). This entry sits in this band. 80–90: 129,887 scored providers (27%). Above this entry. 90–100: 189,403 scored providers (40%). Above this entry. This provider 0 100 every MIPS-scored clinician, bucketed by value

Each bar is a band; taller bars hold more scored 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.

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

Board certification likely (heuristic — not verified)

BENJAMIN ZMISTOWSKI, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 3 hospital affiliations — 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 ZMISTOWSKI, MD?

Near national average

NPI registry status

Active

Issued 04/05/2014

NPI 1265850309

Primary specialty

Orthopaedic Surgery Physician

Mid-sized

25,781 US NPIs in this specialty

Medicare Part D claims

263 19% vs specialty avg

2023 prescription claims

Specialty avg: 324

MIPS final score

79.292/100 3.8079999999999927% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in Missouri

How Orthopaedic Surgery Physician compares to other specialties among Missouri providers

Missouri providers

Orthopaedic Surgery Physician share within Missouri

1. Orthopaedic Surgery Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Orthopaedic Surgery Physician share within Missouri

Medicare quality performance — MIPS

BENJAMIN ZMISTOWSKI, MD's 2023 MIPS final score plotted against the Orthopaedic Surgery Physician national average

Near national average
MIPS Final Score
79.292/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Orthopaedic Surgery Physician) — 79.292/100 vs national avg 83.1

0%100%National avg83%79.3%
MIPS final score (Orthopaedic Surgery Physician) — 79.292/100 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).

BENJAMIN ZMISTOWSKI, MD appears in the CMS NPPES registry as a Orthopaedic Surgery Physician provider holding MD credentials at 4921 PARKVIEW PL, SAINT LOUIS, MO, 63110, with a listed phone of (314) 514-3500. NPI 1265850309 was issued on 04/05/2014. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what ZMISTOWSKI 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 263 prescription claims written by this provider, covering 150 Medicare beneficiaries and totaling roughly $13K in drug spend, split 5% brand-name and 95% generic by claim count, with an opioid prescribing rate of 34.6%. 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 79.292/100 for the 2023 performance year (Quality 71.46, Cost 59.5132), compared with the national average of 83.1.

Orthopaedic Surgery Physician is a mid-sized specialty nationwide, with 25,781 enrolled providers across 56 states and an average of 324 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

4921 PARKVIEW PL
SAINT LOUIS, MO 63110

Provider Details

NPI 1265850309
Specialty Orthopaedic Surgery Physician
Credentials MD
Gender Male
NPI Issued 04/05/2014

CMS Quality Score (MIPS)

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

79.292
Final Score
Avg: 83.1
71.46
Quality
59.5132
Cost
100
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where BENJAMIN ZMISTOWSKI, 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.

ARNOLD PHYSICAL THERAPY AND SPORTS MEDICINE LLC
SAINT LOUIS, MO
PHYSICAL THERAPY SPINE AND SPORTS MEDICINE LLC
BALLWIN, MO
WASHINGTON UNIVERSITY
SAINT LOUIS, MO

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 ZMISTOWSKI, MD. Source: openpaymentsdata.cms.gov.

Total received

$33.5K

Largest payer

Zimmer Biomet Holdings, Inc.

Most common payment type

Consulting Fee

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 · Generic-heavy

BENJAMIN ZMISTOWSKI, MD — brand share 5.0%
Specialty average (est.)

5% brand-name claims vs 95% generic, on 263 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.

263
Total Claims
$13K
Total Drug Cost
150
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
263
Total Day Supply
2,723
Brand vs Generic
5% brand / 95% generic
Brand Drug Cost
$11K
Generic Drug Cost
$2K
Opioid Claims
91 (34.6% rate)
Antibiotic Claims
61

Patient Demographics

Average Patient Age
69.0 years
Avg HCC Risk Score
1.44
Gender Split
65% female / 35% male

Top Prescribed Drugs (Medicare Part D)

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

What BENJAMIN ZMISTOWSKI, MD prescribes most

Top Medicare Part D drugs by claim count, 2023

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2023
Drug Claims
Oxycodone Hcl
67
Amoxicillin
30
Naproxen
26
Ondansetron Odt
Ondansetron
14
Methylprednisolone
13
Hydrocodone-Acetaminophen
Hydrocodone/Acetaminophen
12

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

Orthopaedic Surgery Physician Overview

How BENJAMIN ZMISTOWSKI, MD fits within the Orthopaedic Surgery Physician landscape nationally.

25,781
Orthopaedic Surgery Physician Providers in US
56
States with Orthopaedic Surgery Physician
324
Avg Claims per Provider

BENJAMIN ZMISTOWSKI, MD's 263 claims are below the specialty average of 324.

Nearby Orthopaedic Surgery Physician Providers in Missouri

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

Compare Orthopaedic Surgery Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is BENJAMIN ZMISTOWSKI, MD's specialty?
BENJAMIN ZMISTOWSKI, MD specializes in Orthopaedic Surgery Physician and practices in SAINT LOUIS, Missouri. Credentials: MD.
How much does BENJAMIN ZMISTOWSKI, MD prescribe under Medicare Part D?
In 2023, BENJAMIN ZMISTOWSKI, MD wrote 263 Medicare Part D claims totaling $13K in drug costs for 150 beneficiaries.
What is BENJAMIN ZMISTOWSKI, MD's Medicare quality score?
BENJAMIN ZMISTOWSKI, MD has a CMS MIPS Final Score of 79.292/100 (Quality: 71.46, Cost: 59.5132). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is BENJAMIN ZMISTOWSKI, MD located?
BENJAMIN ZMISTOWSKI, MD is located at 4921 PARKVIEW PL, SAINT LOUIS, MO, 63110. Phone: (314) 514-3500.
What is BENJAMIN ZMISTOWSKI, MD's NPI number?
BENJAMIN ZMISTOWSKI, MD's National Provider Identifier (NPI) is 1265850309, issued on 04/05/2014.
Does BENJAMIN ZMISTOWSKI, MD prescribe more brand-name or generic drugs?
BENJAMIN ZMISTOWSKI, MD's prescribing is 5% brand-name and 95% generic drugs by claim count, with $11K in brand drug costs.
Does BENJAMIN ZMISTOWSKI, MD prescribe opioids?
Yes, BENJAMIN ZMISTOWSKI, MD had 91 opioid claims in 2023 with an opioid prescribing rate of 34.6%.
How many Orthopaedic Surgery Physician providers are there in the US?
There are 25,781 Orthopaedic Surgery Physician providers across 56 states in the US. The average Orthopaedic Surgery Physician provider writes 324 Medicare Part D claims per year.
What drugs does BENJAMIN ZMISTOWSKI, MD prescribe most often?
Based on 2023 Medicare Part D data, BENJAMIN ZMISTOWSKI, MD's most frequently prescribed drugs include Oxycodone Hcl, Amoxicillin, Naproxen. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does BENJAMIN ZMISTOWSKI, MD accept Medicare?
BENJAMIN ZMISTOWSKI, MD appears in CMS Medicare data with 263 Part D claims and 150 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify BENJAMIN ZMISTOWSKI, MD's credentials?
BENJAMIN ZMISTOWSKI, MD's NPI is 1265850309 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