2026 NPPES data Interventional Pain Medicine Physician NPI 1053392068 M.D.
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CARLOS GIRON, M.D.

Interventional Pain Medicine Physician in MACON, Georgia. 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
3K
Medicare Part D claims · 397 beneficiaries · Interventional Pain Medicine Physician avg: 2K
Generic prescribing
96%
generic claims · 4% brand-name · higher generic rates reduce patient out-of-pocket costs
Industry payments
$1.4K
16 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: CARLOS GIRON, M.D. is a Interventional Pain Medicine Physician ([object Object]) practicing in MACON, Georgia with a Medicare Part D prescribing footprint of 3K claims across 397 beneficiaries — 4% brand-name prescribing . Industry payments of $1.4K across 16 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: CARLOS GIRON, M.D. filed 2,971 Medicare Part D claims in 2023 across MACON, Georgia. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

Board certification likely (heuristic — not verified)

CARLOS GIRON, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + 1 hospital affiliation — signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).

CARLOS GIRON, M.D. at a glance

Quality data not reported

NPI registry status

Active

Issued 11/07/2005

NPI 1053392068

Primary specialty

Interventional Pain Medicine Physician

Niche

1,528 US NPIs in this specialty

Medicare Part D claims

2,971 35% vs specialty avg

2023 prescription claims

Specialty avg: 2,197

Specialty distribution in Georgia

How Interventional Pain Medicine Physician compares to other specialties among Georgia providers

Georgia providers

Interventional Pain Medicine Physician share within Georgia

1. Interventional Pain Medicine Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Interventional Pain Medicine Physician share within Georgia

Specialty board-certification context

Estimated specialty board-certified rate — Interventional Pain Medicine Physician (ABMS / AOA reference)

Quality data not reported
Est. board-certified rate
78%
Interventional Pain Medicine Physician ABMS/AOA estimate

Est. board-certified rate (Interventional Pain Medicine Physician) — ABMS / AOA estimate

0%100%78%
Est. board-certified rate (Interventional Pain Medicine Physician) — ABMS / AOA estimate

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).

CARLOS GIRON, M.D. is a Interventional Pain Medicine Physician provider practicing in MACON, Georgia, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: M.D.. NPI: 1053392068. 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.

CARLOS GIRON, M.D. appears in the CMS NPPES registry as a Interventional Pain Medicine Physician provider holding M.D. credentials at 3356 VINEVILLE AVE, MACON, GA, 31204, with a listed phone of (478) 476-9886. NPI 1053392068 was issued on 11/07/2005. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what GIRON 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 2,971 prescription claims written by this provider, covering 397 Medicare beneficiaries and totaling roughly $132K in drug spend, split 4% brand-name and 96% generic by claim count, with an opioid prescribing rate of 53.2%. 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.

Interventional Pain Medicine Physician is a narrow specialty nationwide, with 1,528 enrolled providers across 53 states and an average of 2,197 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

3356 VINEVILLE AVE
MACON, GA 31204

Provider Details

NPI 1053392068
Specialty Interventional Pain Medicine Physician
Credentials M.D.
Gender Male
NPI Issued 11/07/2005

Hospital and facility affiliations

Facilities where CARLOS GIRON, M.D. 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.

GEORGIA PAIN INSTITUTE. LLC
MACON, GA

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 CARLOS GIRON, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$1.4K

Largest payer

Boston Scientific Corporation

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 · Generic-heavy

CARLOS GIRON, M.D. — brand share 4.0%
Specialty average (est.)

4% brand-name claims vs 96% generic, on 2,971 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.

2,971
Total Claims
$132K
Total Drug Cost
397
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
3,129
Total Day Supply
90,918
Brand vs Generic
4% brand / 96% generic
Brand Drug Cost
$63K
Generic Drug Cost
$69K
Opioid Claims
1,582 (53.2% rate)

Patient Demographics

Average Patient Age
64.8 years
Avg HCC Risk Score
1.68
Gender Split
65% female / 35% male
Age Distribution
<65: 174, 65-74: 164, 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
Hydrocodone-Acetaminophen
Hydrocodone/Acetaminophen
629
Oxycodone-Acetaminophen
Oxycodone Hcl/Acetaminophen
359
Gabapentin
355
Oxycodone Hcl
319
Tizanidine Hcl
166
Diclofenac Sodium
129
Pregabalin
120
Duloxetine Hcl
113
Cyclobenzaprine Hcl
106
Celecoxib
81

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

Interventional Pain Medicine Physician Overview

How CARLOS GIRON, M.D. fits within the Interventional Pain Medicine Physician landscape nationally.

1,528
Interventional Pain Medicine Physician Providers in US
53
States with Interventional Pain Medicine Physician
2,197
Avg Claims per Provider

CARLOS GIRON, M.D.'s 2,971 claims are above the specialty average of 2,197.

Nearby Interventional Pain Medicine Physician Providers in Georgia

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

Compare Interventional Pain Medicine Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is CARLOS GIRON, M.D.'s specialty?
CARLOS GIRON, M.D. specializes in Interventional Pain Medicine Physician and practices in MACON, Georgia. Credentials: M.D..
How much does CARLOS GIRON, M.D. prescribe under Medicare Part D?
In 2023, CARLOS GIRON, M.D. wrote 2,971 Medicare Part D claims totaling $132K in drug costs for 397 beneficiaries.
Where is CARLOS GIRON, M.D. located?
CARLOS GIRON, M.D. is located at 3356 VINEVILLE AVE, MACON, GA, 31204. Phone: (478) 476-9886.
What is CARLOS GIRON, M.D.'s NPI number?
CARLOS GIRON, M.D.'s National Provider Identifier (NPI) is 1053392068, issued on 11/07/2005.
Does CARLOS GIRON, M.D. prescribe more brand-name or generic drugs?
CARLOS GIRON, M.D.'s prescribing is 4% brand-name and 96% generic drugs by claim count, with $63K in brand drug costs.
Does CARLOS GIRON, M.D. prescribe opioids?
Yes, CARLOS GIRON, M.D. had 1,582 opioid claims in 2023 with an opioid prescribing rate of 53.2%.
How many Interventional Pain Medicine Physician providers are there in the US?
There are 1,528 Interventional Pain Medicine Physician providers across 53 states in the US. The average Interventional Pain Medicine Physician provider writes 2,197 Medicare Part D claims per year.
What drugs does CARLOS GIRON, M.D. prescribe most often?
Based on 2023 Medicare Part D data, CARLOS GIRON, M.D.'s most frequently prescribed drugs include Hydrocodone-Acetaminophen, Oxycodone-Acetaminophen, Gabapentin. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does CARLOS GIRON, M.D. accept Medicare?
CARLOS GIRON, M.D. appears in CMS Medicare data with 2,971 Part D claims and 397 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify CARLOS GIRON, M.D.'s credentials?
CARLOS GIRON, M.D.'s NPI is 1053392068 with credentials M.D.. 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.
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