2026 NPPES data Family Medicine Physician NPI 1891706917 MD
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CARL SHEALY, MD

Family Medicine Physician in LEXINGTON, South Carolina. 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
10K
Medicare Part D claims · 764 beneficiaries · Family Medicine Physician avg: 3K
Generic prescribing
87%
generic claims · 13% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
83.0384/100
▼ 0 pts below national avg 83.1 · [object Object]
Industry payments
$20.75
1 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

CARL SHEALY, MD reported a CMS MIPS final score of 83.0384/100 — below the 83.1 national average — and filed 10,163 Medicare Part D claims in 2023.

83.0384/100
MIPS score · 0 vs avg
10K
Part D claims, 2023
87%
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.

CARL SHEALY, MD's MIPS score vs every scored U.S. clinician

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

83 42nd percentile higher than 42% 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%). Below this entry. 80–90: 129,887 scored providers (27%). This entry sits in this band. 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)

CARL SHEALY, MD 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 CARL SHEALY, MD?

Near national average

NPI registry status

Active

Issued 08/11/2006

NPI 1891706917

Primary specialty

Family Medicine Physician

High-volume

147,640 US NPIs in this specialty

Medicare Part D claims

10,163 197% vs specialty avg

2023 prescription claims

Specialty avg: 3,418

MIPS final score

83.0384/100 0.061599999999998545% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in South Carolina

How Family Medicine Physician compares to other specialties among South Carolina providers

South Carolina providers

Family Medicine Physician share within South Carolina

1. Family Medicine Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Family Medicine Physician share within South Carolina

Medicare quality performance — MIPS

CARL SHEALY, MD's 2023 MIPS final score plotted against the Family Medicine Physician national average

Near national average
MIPS Final Score
83.0384/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Family Medicine Physician) — 83.0384/100 vs national avg 83.1

0%100%National avg83%83%
MIPS final score (Family Medicine Physician) — 83.0384/100 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).

CARL SHEALY, MD appears in the CMS NPPES registry as a Family Medicine Physician provider holding MD credentials at 2006 AUGUSTA HWY, LEXINGTON, SC, 29072, with a listed phone of (803) 785-4747. NPI 1891706917 was issued on 08/11/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what SHEALY 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 10,163 prescription claims written by this provider, covering 764 Medicare beneficiaries and totaling roughly $985K in drug spend, split 13% brand-name and 87% generic by claim count, with an opioid prescribing rate of 1.8%. 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 83.0384/100 for the 2023 performance year (Quality 80.4541, Cost 72.1739), compared with the national average of 83.1.

Family Medicine Physician is a high-volume specialty nationwide, with 147,640 enrolled providers across 56 states and an average of 3,418 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

2006 AUGUSTA HWY
LEXINGTON, SC 29072

Provider Details

NPI 1891706917
Specialty Family Medicine Physician
Credentials MD
Gender Male
NPI Issued 08/11/2006

CMS Quality Score (MIPS)

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

83.0384
Final Score
Avg: 83.1
80.4541
Quality
72.1739
Cost
89
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where CARL SHEALY, 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.

LEXINGTON HEALTH INC
LEXINGTON, SC

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 CARL SHEALY, MD. Source: openpaymentsdata.cms.gov.

Total received

$21

Largest payer

GlaxoSmithKline, LLC.

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

CARL SHEALY, MD — brand share 13.0%
Specialty average (est.)

13% brand-name claims vs 87% generic, on 10,163 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.

10,163
Total Claims
$985K
Total Drug Cost
764
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
21,806
Total Day Supply
627,234
Brand vs Generic
13% brand / 87% generic
Brand Drug Cost
$806K
Generic Drug Cost
$175K
Opioid Claims
185 (1.8% rate)
Antibiotic Claims
455

Patient Demographics

Average Patient Age
73.5 years
Avg HCC Risk Score
1.02
Gender Split
51% female / 49% male
Age Distribution
<65: 64, 65-74: 362, 75-84: 262, 85+: 76

Top Prescribed Drugs (Medicare Part D)

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

What CARL SHEALY, 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
Amlodipine Besylate
432
Levothyroxine Sodium
406
Atorvastatin Calcium
364
Metoprolol Succinate
309
Omeprazole
271
Gabapentin
242
Losartan Potassium
222
Rosuvastatin Calcium
222
Lisinopril
217
Tamsulosin Hcl
201

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

Family Medicine Physician Overview

How CARL SHEALY, MD fits within the Family Medicine Physician landscape nationally.

147,640
Family Medicine Physician Providers in US
56
States with Family Medicine Physician
3,418
Avg Claims per Provider

CARL SHEALY, MD's 10,163 claims are above the specialty average of 3,418.

Nearby Family Medicine Physician Providers in South Carolina

Other clinicians with the same primary specialty enrolled in South Carolina, drawn from the same CMS NPPES roster as SHEALY.

Compare Family Medicine Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is CARL SHEALY, MD's specialty?
CARL SHEALY, MD specializes in Family Medicine Physician and practices in LEXINGTON, South Carolina. Credentials: MD.
How much does CARL SHEALY, MD prescribe under Medicare Part D?
In 2023, CARL SHEALY, MD wrote 10,163 Medicare Part D claims totaling $985K in drug costs for 764 beneficiaries.
What is CARL SHEALY, MD's Medicare quality score?
CARL SHEALY, MD has a CMS MIPS Final Score of 83.0384/100 (Quality: 80.4541, Cost: 72.1739). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is CARL SHEALY, MD located?
CARL SHEALY, MD is located at 2006 AUGUSTA HWY, LEXINGTON, SC, 29072. Phone: (803) 785-4747.
What is CARL SHEALY, MD's NPI number?
CARL SHEALY, MD's National Provider Identifier (NPI) is 1891706917, issued on 08/11/2006.
Does CARL SHEALY, MD prescribe more brand-name or generic drugs?
CARL SHEALY, MD's prescribing is 13% brand-name and 87% generic drugs by claim count, with $806K in brand drug costs.
Does CARL SHEALY, MD prescribe opioids?
Yes, CARL SHEALY, MD had 185 opioid claims in 2023 with an opioid prescribing rate of 1.8%.
How many Family Medicine Physician providers are there in the US?
There are 147,640 Family Medicine Physician providers across 56 states in the US. The average Family Medicine Physician provider writes 3,418 Medicare Part D claims per year.
What drugs does CARL SHEALY, MD prescribe most often?
Based on 2023 Medicare Part D data, CARL SHEALY, MD's most frequently prescribed drugs include Amlodipine Besylate, Levothyroxine Sodium, Atorvastatin Calcium. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does CARL SHEALY, MD accept Medicare?
CARL SHEALY, MD appears in CMS Medicare data with 10,163 Part D claims and 764 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify CARL SHEALY, MD's credentials?
CARL SHEALY, MD's NPI is 1891706917 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