NPI registry status
Active
2026 NPPES data Pediatric Otolaryngology Physician NPI 1801954144 MD
Verify on CMS → Carl Falcone, MD
Pediatric Otolaryngology Physician in Concord, New Hampshire.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 586 in Pediatric Otolaryngology 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
123
Medicare Part D claims · 66 beneficiaries · Pediatric Otolaryngology Physician avg: 328
MIPS score
81.9/100
▼ 2 pts below national avg 83.5 · Above neutral
Industry payments
$15.46
1 payments · CMS Open Payments (Sunshine Act)
What the federal data shows
Carl Falcone, MD reported a CMS MIPS final score of 81.9/100 - below the 83.5 national average - and filed 123 Medicare Part D claims in 2024.
- 81.9/100
- MIPS score · -2 vs avg
- 123
- Part D claims, 2024
- Likely
- board-certified (heuristic)
- ≥32nd
- pct among measured MIPS (lower-bound band)
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 Carl Falcone, MD
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 1801954144), first enumerated 12/05/2006.
Source: CMS NPPES
- Reported
Medicare Part D participation
Filed 123 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 81.9/100 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.
- Reported
Industry payment transparency
$15.46 in reported industry payments (1 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 1801954144 · Pediatric Otolaryngology Physician
NPI-10 · ENUM-LEGACY · TAX-NARROW · MIPS-INLINE · RX-LIGHT · BOOK-THIN · PHOTO-FINISH
- NPI-10 1801954144
- ENUM-LEGACY 2006
- TAX-NARROW 586
- MIPS-INLINE 81.9/100
- RX-LIGHT 123
- BOOK-THIN 1 in New Hampshire
- PHOTO-FINISH Luke Jakubowski, M.D. · ±0.2
MIPS final-score neighbourhood
Same-specialty nationwide peers by CMS final score, not geographic proximity
- Luke Jakubowski,…
Luke Jakubowski, M.D.
81.7 MIPS pts
- Falcone · this p…
Falcone · this provider
81.9 MIPS pts
- Zi Yang Jiang, M…
Zi Yang Jiang, MD
82.4 MIPS pts
- Shiva Daram, M.D…
Shiva Daram, M.D.
82.4 MIPS pts
- Zhen Huang, M.D.…
Zhen Huang, M.D.
82.4 MIPS pts
What this shows Nearest measured MIPS peers for this NUCC specialty (2023 performance year).
Carl Falcone, MD'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.
82 ≥ 32nd percentile 32% of 454,083 measured providers are in lower value bands
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 Carl Falcone, MD sits
This provider among pediatric otolaryngology physician peers
Across the 49 pediatric otolaryngology physician providers who report both Medicare Part D prescribing and a MIPS quality score, Carl Falcone, MD writes more Part D claims than 27% of them and scores higher on MIPS quality than 37% - placing this provider in the lower-volume, lower-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Each dot is one pediatric otolaryngology physician peer from a representative sample of 48; the gold marker is Carl Falcone, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Carl Falcone, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting - 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 Carl Falcone, MD?
Near national averagePrimary specialty
Pediatric Otolaryngology Physician
Medicare Part D claims
123 62% vs specialty avg
MIPS final score
81.9/100 1.6 pts vs avg
Specialty distribution in New Hampshire
How Pediatric Otolaryngology Physician compares to other specialties among New Hampshire providers
Medicare quality performance, MIPS
Carl Falcone, MD's 2023 MIPS final score plotted against the Pediatric Otolaryngology Physician national average
- MIPS Final Score
- 81.9/100
- vs 83.5 national avg · 2023 performance year
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
Provider Details
| NPI | 1801954144 |
|---|---|
| Specialty | Pediatric Otolaryngology Physician |
| Credentials | MD |
| Gender | Male |
| NPI Issued | 12/05/2006 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
81.9011
Final Score
Measured-score avg: 83.5
72.4303
Quality
59.5972
Cost
100
Promoting Interoperability
Reporting: Group practice
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 Carl Falcone, MD. Source: openpaymentsdata.cms.gov.
Total received
$15
Largest payer
Genentech USA, 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.
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2024.
123
Total Claims
$2K
Total Drug Cost
66
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 132
- Total Day Supply
- 2,878
- Generic Drug Cost
- $2K
- Antibiotic Claims
- 49
Patient Demographics
- Average Patient Age
- 69.9 years
- Avg HCC Risk Score
- 1.35
- Gender Split
- 42% female / 58% male
- Age Distribution
- <65: 13, 65-74: 30, 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 Carl Falcone, MD prescribes most
Top Medicare Part D drugs by claim count, 2024
- Prednisone
Prednisone
37 claims
- Ciprofloxacin Hcl
Ciprofloxacin Hcl
31 claims
- Clindamycin Hcl 13
Clindamycin Hcl
13 claims
| Drug | Claims |
|---|---|
| Prednisone | 37 |
| Ciprofloxacin Hcl | 31 |
| Clindamycin Hcl | 13 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
More Pediatric Otolaryngology Physician in NH →
All providers in New Hampshire →
Compare specialties →
Pediatric Otolaryngology Physician Overview
How Carl Falcone, MD fits within the Pediatric Otolaryngology Physician landscape nationally.
586
Pediatric Otolaryngology Physician Providers in US
43
States with Pediatric Otolaryngology Physician
328
Avg Claims per Provider
Carl Falcone, MD's 123 claims are below the specialty average of 328.
Nationwide Pediatric Otolaryngology Physician peers with similar MIPS or enrollment year
Two federal-record peer sets for Falcone, both outside New Hampshire so the neighborhoods are not geographic containment.
Similar MIPS final score
Nearest same-specialty clinicians by CMS MIPS final score (81.9 here).
Same NPPES enumeration year (2006)
Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.
Frequently Asked Questions
What is Carl Falcone, MD's specialty? ▼
Carl Falcone, MD specializes in Pediatric Otolaryngology Physician and practices in Concord, New Hampshire. Credentials: MD.
How much does Carl Falcone, MD prescribe under Medicare Part D? ▼
In 2024, Carl Falcone, MD wrote 123 Medicare Part D claims totaling $2K in drug costs for 66 beneficiaries.
What is Carl Falcone, MD's Medicare quality score? ▼
Carl Falcone, MD has a CMS MIPS Final Score of 81.9/100 (Quality: 72.4, Cost: 59.6). 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 Carl Falcone, MD located? ▼
Carl Falcone, MD is located at 60 COMMERCIAL ST STE 401, Concord, NH, 03301. Phone: (603) 789-9150.
What is Carl Falcone, MD's NPI number? ▼
Carl Falcone, MD's National Provider Identifier (NPI) is 1801954144, issued on 12/05/2006.
How many Pediatric Otolaryngology Physician providers are there in the US? ▼
There are 586 Pediatric Otolaryngology Physician providers across 43 states in the US. The average Pediatric Otolaryngology Physician provider writes 328 Medicare Part D claims per year.
What drugs does Carl Falcone, MD prescribe most often? ▼
Based on 2024 Medicare Part D data, Carl Falcone, MD's most frequently prescribed drugs include Prednisone, Ciprofloxacin Hcl, Clindamycin Hcl. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Carl Falcone, MD accept Medicare? ▼
Carl Falcone, MD appears in CMS Medicare data with 123 Part D claims and 66 Medicare beneficiaries in 2024. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Carl Falcone, MD's credentials? ▼
Carl Falcone, MD's NPI is 1801954144 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
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
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.