2026 NPPES data Optometrist NPI 1093060683 OD
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BRETT BALOCCA, OD

Optometrist in PHOENIX, Arizona. 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
41
Medicare Part D claims · 12 beneficiaries · Optometrist avg: 257
Generic prescribing
68%
generic claims · 32% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
0/100
▼ 83 pts below national avg 83.1 · [object Object]
Industry payments
$190.11
9 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: BRETT BALOCCA, OD is a Optometrist ([object Object]) practicing in PHOENIX, Arizona with a Medicare Part D prescribing footprint of 41 claims across 12 beneficiaries — 32% brand-name prescribing . Their CMS MIPS Final Score of 0/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $190.11 across 9 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: BRETT BALOCCA, OD reported a CMS MIPS final score of 0 out of 100, below the 83.1 national average, and filed 41 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

BRETT BALOCCA, OD at a glance

Below national average

NPI registry status

Active

Issued 07/19/2012

NPI 1093060683

Primary specialty

Optometrist

High-volume

60,463 US NPIs in this specialty

Medicare Part D claims

41 84% vs specialty avg

2023 prescription claims

Specialty avg: 257

MIPS final score

0/100 83.1% pts

Penalty band band

vs 83.1 national avg

Specialty distribution in Arizona

How Optometrist compares to other specialties among Arizona providers

Arizona providers

Optometrist share within Arizona

1. Optometrist42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Optometrist share within Arizona

Medicare quality performance — MIPS

BRETT BALOCCA, OD's 2023 MIPS final score plotted against the Optometrist national average

Below national average
MIPS Final Score
0/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Optometrist) — 0/100 vs national avg 83.1

0%100%National avg83%0%
MIPS final score (Optometrist) — 0/100 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).

BRETT BALOCCA, OD is a Optometrist provider practicing in PHOENIX, Arizona, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: OD. NPI: 1093060683. 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.

BRETT BALOCCA, OD appears in the CMS NPPES registry as a Optometrist provider holding OD credentials at 18631 N 19TH AVE, PHOENIX, AZ, 85027, with a listed phone of (623) 516-4710. NPI 1093060683 was issued on 07/19/2012. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BALOCCA 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 41 prescription claims written by this provider, covering 12 Medicare beneficiaries and totaling roughly $10K in drug spend, split 32% brand-name and 68% 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 0/100 for the 2023 performance year (Quality 0), compared with the national average of 83.1.

Optometrist is a high-volume specialty nationwide, with 60,463 enrolled providers across 56 states and an average of 257 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

18631 N 19TH AVE
PHOENIX, AZ 85027

Provider Details

NPI 1093060683
Specialty Optometrist
Credentials OD
Gender Male
NPI Issued 07/19/2012

CMS Quality Score (MIPS)

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

0
Final Score
Avg: 83.1
0
Quality

Reporting: Individual

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 BRETT BALOCCA, OD. Source: openpaymentsdata.cms.gov.

Total received

$190

Largest payer

BIOTISSUE HOLDINGS INC.

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 · Above average

BRETT BALOCCA, OD — brand share 32.0%
Specialty average (est.)

32% brand-name claims vs 68% generic, on 41 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.

41
Total Claims
$10K
Total Drug Cost
12
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
72
Total Day Supply
2,024
Brand vs Generic
32% brand / 68% generic
Brand Drug Cost
$10K
Generic Drug Cost
$548

Patient Demographics

Average Patient Age
73.2 years
Avg HCC Risk Score
1.06
Age Distribution
<65: 0, 65-74: N/A, 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
Latanoprost
12

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

Optometrist Overview

How BRETT BALOCCA, OD fits within the Optometrist landscape nationally.

60,463
Optometrist Providers in US
56
States with Optometrist
257
Avg Claims per Provider

BRETT BALOCCA, OD's 41 claims are below the specialty average of 257.

Nearby Optometrist Providers in Arizona

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

Compare Optometrist nationally: see state-by-state distribution →

Frequently Asked Questions

What is BRETT BALOCCA, OD's specialty?
BRETT BALOCCA, OD specializes in Optometrist and practices in PHOENIX, Arizona. Credentials: OD.
How much does BRETT BALOCCA, OD prescribe under Medicare Part D?
In 2023, BRETT BALOCCA, OD wrote 41 Medicare Part D claims totaling $10K in drug costs for 12 beneficiaries.
What is BRETT BALOCCA, OD's Medicare quality score?
BRETT BALOCCA, OD has a CMS MIPS Final Score of 0/100 (Quality: 0). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is BRETT BALOCCA, OD located?
BRETT BALOCCA, OD is located at 18631 N 19TH AVE, PHOENIX, AZ, 85027. Phone: (623) 516-4710.
What is BRETT BALOCCA, OD's NPI number?
BRETT BALOCCA, OD's National Provider Identifier (NPI) is 1093060683, issued on 07/19/2012.
Does BRETT BALOCCA, OD prescribe more brand-name or generic drugs?
BRETT BALOCCA, OD's prescribing is 32% brand-name and 68% generic drugs by claim count, with $10K in brand drug costs.
How many Optometrist providers are there in the US?
There are 60,463 Optometrist providers across 56 states in the US. The average Optometrist provider writes 257 Medicare Part D claims per year.
What drugs does BRETT BALOCCA, OD prescribe most often?
Based on 2023 Medicare Part D data, BRETT BALOCCA, OD's most frequently prescribed drugs include Latanoprost. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does BRETT BALOCCA, OD accept Medicare?
BRETT BALOCCA, OD appears in CMS Medicare data with 41 Part D claims and 12 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify BRETT BALOCCA, OD's credentials?
BRETT BALOCCA, OD's NPI is 1093060683 with credentials OD. 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