BHAVNA BALI
Addiction Medicine (Internal Medicine) Physician in ATHENS, Georgia. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.
What stands out: BHAVNA BALI reported a CMS MIPS final score of 71.7884 out of 100, below the 83.1 national average, and filed 414 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.
BHAVNA BALI practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 2 hospital affiliations — signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).
BHAVNA BALI at a glance
Below national averagePrimary specialty
Medicare Part D claims
MIPS final score
Specialty distribution in Georgia
How Addiction Medicine (Internal Medicine) Physician compares to other specialties among Georgia providers
Addiction Medicine (Internal Medicine) Physician share within Georgia
Addiction Medicine (Internal Medicine) Physician is one of the more visible NUCC categories in Georgia
Each bar reflects the share of in-state providers whose primary NUCC taxonomy matches the specialty. Long tail of ~690 NUCC codes folded into "Other" to keep the comparison legible.
Medicare quality performance — MIPS
BHAVNA BALI's 2023 MIPS final score plotted against the Addiction Medicine (Internal Medicine) Physician national average
- MIPS Final Score
- 71.7884/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Addiction Medicine (Internal Medicine) Physician) — 71.7884/100 vs national avg 83.1
Quality benchmarks
- National MIPS avg 2023 reporting year
- Quality dim CMS Quality category
- Cost dim CMS Cost category
- Specialty volume Addiction Medicine (Internal Medicine) Physician US NPIs
71.7884/100 MIPS final score — 11.3 pts below the 83.1 national average
Quality, Cost, Promoting Interoperability, and Improvement Activities composite score for the 2023 performance year. Specialty: Addiction Medicine (Internal Medicine) Physician. Quality dim: 48.3237. Cost dim: 57.6377.
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).
BHAVNA BALI is a Addiction Medicine (Internal Medicine) Physician provider practicing in ATHENS, Georgia, according to the CMS National Plan and Provider Enumeration System (NPPES). NPI: 1437681541. 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.
BHAVNA BALI appears in the CMS NPPES registry as a Addiction Medicine (Internal Medicine) Physician provider at 1270 PRINCE AVE # 70, ATHENS, GA, 30606, with a listed phone of (706) 475-7055. NPI 1437681541 was issued on 03/29/2017. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BALI 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 414 prescription claims written by this provider, covering 59 Medicare beneficiaries and totaling roughly $116K in drug spend, split 12% brand-name and 88% 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 71.7884/100 for the 2023 performance year (Quality 48.3237, Cost 57.6377), compared with the national average of 83.1.
Addiction Medicine (Internal Medicine) Physician is a narrow specialty nationwide, with 553 enrolled providers across 46 states and an average of 1,403 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
Provider Details
| NPI | 1437681541 |
|---|---|
| Specialty | Addiction Medicine (Internal Medicine) Physician |
| Gender | Female |
| NPI Issued | 03/29/2017 |
Verify this provider's license
PlainDoctor pulls this profile from the CMS NPPES public registry. Confirm BHAVNA BALI's current license status, disciplinary history, and board certifications with the Georgia Composite Medical Board in Georgia before relying on this page for a clinical or care decision.
How we sourced this profile
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
Reporting: Group practice
Hospital and facility affiliations
Facilities where BHAVNA BALI 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.
Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).
Brand vs generic prescribing mix · Typical
12% brand-name claims vs 88% generic, on 414 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.
Prescribing Breakdown
- 30-Day Fills
- 424
- Total Day Supply
- 10,200
- Brand vs Generic
- 12% brand / 88% generic
- Brand Drug Cost
- $52K
- Generic Drug Cost
- $63K
Patient Demographics
- Average Patient Age
- 58.4 years
- Avg HCC Risk Score
- 1.76
- Gender Split
- 51% female / 49% male
- Age Distribution
- <65: 35, 65-74: 20, 75-84: N/A, 85+: N/A
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
| Drug | Claims |
|---|---|
| Buprenorphine-Naloxone Buprenorphine Hcl/Naloxone Hcl | 244 |
| Zubsolv Buprenorphine Hcl/Naloxone Hcl | 29 |
| Gabapentin | 21 |
| Naltrexone Hcl | 13 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Addiction Medicine (Internal Medicine) Physician Overview
How BHAVNA BALI fits within the Addiction Medicine (Internal Medicine) Physician landscape nationally.
BHAVNA BALI's 414 claims are below the specialty average of 1,403.
Nearby Addiction Medicine (Internal Medicine) Physician Providers in Georgia
Other clinicians with the same primary specialty enrolled in Georgia, drawn from the same CMS NPPES roster as BALI.
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Frequently Asked Questions
What is BHAVNA BALI's specialty? ▼
How much does BHAVNA BALI prescribe under Medicare Part D? ▼
What is BHAVNA BALI's Medicare quality score? ▼
Where is BHAVNA BALI located? ▼
What is BHAVNA BALI's NPI number? ▼
Does BHAVNA BALI prescribe more brand-name or generic drugs? ▼
How many Addiction Medicine (Internal Medicine) Physician providers are there in the US? ▼
What drugs does BHAVNA BALI prescribe most often? ▼
Does BHAVNA BALI accept Medicare? ▼
How can I verify BHAVNA BALI's credentials? ▼
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