NPI registry status
Active
2026 NPPES data Diabetes Educator Registered Nurse NPI 1609990381 APNP
Verify on CMS → Carol Ballweg, APNP
Diabetes Educator Registered Nurse in Fitchburg, Wisconsin.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 2,283 in Diabetes Educator Registered Nurse, 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
874
Medicare Part D claims · 91 beneficiaries · Diabetes Educator Registered Nurse avg: 1K
Generic prescribing
89%
generic claims · 10% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
80.2/100
▼ 3 pts below national avg 83.1 · Above neutral
Source: CMS Medicare Part D Prescriber Public Use File, 2023
Compiled from official public sources by the PlainDoctor editorial team.
What the federal data shows
Carol Ballweg, APNP reported a CMS MIPS final score of 80.2/100 - below the 83.1 national average - and filed 874 Medicare Part D claims in 2023.
- 80.2/100
- MIPS score · -3 vs avg
- 874
- Part D claims, 2023
- 89%
- generic prescribing
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.
Carol Ballweg, APNP's MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
80 33rd percentile higher than 33% of 477,587 scored providers
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
Where Carol Ballweg, APNP sits
This provider among diabetes educator registered nurse peers
Across the 23 diabetes educator registered nurse providers who report both Medicare Part D prescribing and a MIPS quality score, Carol Ballweg, APNP writes more Part D claims than 43% of them and scores higher on MIPS quality than 22% - placing this provider in the lower-volume, lower-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Part D claim volume vs MIPS quality, by specialty percentile
Each dot is one diabetes educator registered nurse peer from a representative sample of 22; the gold marker is Carol Ballweg, APNP. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
What does the federal data show about Carol Ballweg, APNP?
Near national averagePrimary specialty
Diabetes Educator Registered Nurse
Medicare Part D claims
874 33% vs specialty avg
MIPS final score
80.2/100 2.9 pts vs avg
Specialty distribution in Wisconsin
How Diabetes Educator Registered Nurse compares to other specialties among Wisconsin providers
Medicare quality performance, MIPS
Carol Ballweg, APNP's 2023 MIPS final score plotted against the Diabetes Educator Registered Nurse national average
- MIPS Final Score
- 80.2/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Diabetes Educator Registered Nurse) - 80.2/100 vs national avg 83.1
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).
Carol Ballweg, APNP appears in the CMS NPPES registry as a Diabetes Educator Registered Nurse provider holding APNP credentials at 3051 CAHILL MAIN, Fitchburg, WI, 53711, with a listed phone of (608) 661-7200. NPI 1609990381 was issued on 03/19/2007.
Medicare Part D records for calendar year 2023 show 874 prescription claims written by this provider, covering 91 Medicare beneficiaries and totaling roughly $40K in drug spend, split 10% brand-name and 89% generic by claim count, with an opioid prescribing rate of 2.1%. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 80.2/100 for the 2023 performance year (Quality 85.1, Cost 49.8), compared with the national average of 83.1.
Diabetes Educator Registered Nurse is a narrow specialty nationwide, with 2,283 enrolled providers across 55 states and an average of 1,296 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 | 1609990381 |
|---|---|
| Specialty | Diabetes Educator Registered Nurse |
| Credentials | APNP |
| Gender | Female |
| NPI Issued | 03/19/2007 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
80.2217
Final Score
Avg: 83.1
85.0677
Quality
49.8379
Cost
99
Promoting Interoperability
Reporting: Group practice
Hospital and facility affiliations
Facilities where Carol Ballweg, APNP 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.
Group Health Cooperative OF South Central Wisconsin
Madison, WI
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
Carol Ballweg, APNP - brand share 10.0%
Diabetes Educator Registered Nurse average
10% brand-name claims vs 89% generic, on 874 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.
874
Total Claims
$40K
Total Drug Cost
91
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 1,865
- Total Day Supply
- 53,760
- Brand vs Generic
- 10% brand / 89% generic
- Brand Drug Cost
- $26K
- Generic Drug Cost
- $13K
- Opioid Claims
- 18 (2.1% rate)
- Antibiotic Claims
- 14
Patient Demographics
- Average Patient Age
- 69.2 years
- Avg HCC Risk Score
- 0.68
- Gender Split
- 78% female / 22% male
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Carol Ballweg, APNP prescribes most
Top Medicare Part D drugs by claim count, 2023
- Levothyroxine Sodium
Levothyroxine Sodium
42 claims
- Rosuvastatin Calcium
Rosuvastatin Calcium
35 claims
- Losartan Potassium
Losartan Potassium
33 claims
- Omeprazole
Omeprazole
33 claims
- Bupropion Xl
Bupropion Xl
31 claims
- Simvastatin
Simvastatin
31 claims
- Amlodipine Besylate
Amlodipine Besylate
30 claims
- Sertraline Hcl
Sertraline Hcl
28 claims
| Drug | Claims |
|---|---|
| Levothyroxine Sodium | 42 |
| Rosuvastatin Calcium | 35 |
| Losartan Potassium | 33 |
| Omeprazole | 33 |
| Bupropion Xl Bupropion Hcl | 31 |
| Simvastatin | 31 |
| Amlodipine Besylate | 30 |
| Sertraline Hcl | 28 |
| Atorvastatin Calcium | 26 |
| Hydrochlorothiazide | 26 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Diabetes Educator Registered Nurse Overview
How Carol Ballweg, APNP fits within the Diabetes Educator Registered Nurse landscape nationally.
2,283
Diabetes Educator Registered Nurse Providers in US
55
States with Diabetes Educator Registered Nurse
1,296
Avg Claims per Provider
Carol Ballweg, APNP's 874 claims are below the specialty average of 1,296.
Nearby Diabetes Educator Registered Nurse Providers in Wisconsin
Other clinicians with the same primary specialty enrolled in Wisconsin, drawn from the same CMS NPPES roster as Ballweg.
Dr. Carrie Anderson
RN
Marinette, WI
Dr. Sheryl Ashby
RN CDE
Lac Du Flambeau, WI
Dr. Stacy Barron
RN
Milwaukee, WI
Dr. Theresa Behnke
RN, CDE
Green Bay, WI
Dr. Marie Berry
APNP
Beaver Dam, WI
Compare Diabetes Educator Registered Nurse nationally: see state-by-state distribution →
Before you book an appointment
Use this federal record as your verification checklist, not as a recommendation.
- Confirm the NPI record is current in the official CMS registry, providers update their own NPPES details, and moves can lag. Verify this NPI
- Check the active license and any disciplinary history with the Wisconsin medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Diabetes Educator Registered Nurse peer on Medicare volume and prescribing patterns. Compare providers
Medicare Part D and MIPS figures describe practice patterns in federal programs only, they are not quality ratings, and PlainDoctor does not rate, rank, or recommend providers.
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Frequently Asked Questions
What is Carol Ballweg, APNP's specialty? ▼
Carol Ballweg, APNP specializes in Diabetes Educator Registered Nurse and practices in Fitchburg, Wisconsin. Credentials: APNP.
How much does Carol Ballweg, APNP prescribe under Medicare Part D? ▼
In 2023, Carol Ballweg, APNP wrote 874 Medicare Part D claims totaling $40K in drug costs for 91 beneficiaries.
What is Carol Ballweg, APNP's Medicare quality score? ▼
Carol Ballweg, APNP has a CMS MIPS Final Score of 80.2/100 (Quality: 85.1, Cost: 49.8). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Carol Ballweg, APNP located? ▼
Carol Ballweg, APNP is located at 3051 CAHILL MAIN, Fitchburg, WI, 53711. Phone: (608) 661-7200.
What is Carol Ballweg, APNP's NPI number? ▼
Carol Ballweg, APNP's National Provider Identifier (NPI) is 1609990381, issued on 03/19/2007.
Does Carol Ballweg, APNP prescribe more brand-name or generic drugs? ▼
Carol Ballweg, APNP's prescribing is 10% brand-name and 89% generic drugs by claim count, with $26K in brand drug costs.
Does Carol Ballweg, APNP prescribe opioids? ▼
Yes, Carol Ballweg, APNP had 18 opioid claims in 2023 with an opioid prescribing rate of 2.1%.
How many Diabetes Educator Registered Nurse providers are there in the US? ▼
There are 2,283 Diabetes Educator Registered Nurse providers across 55 states in the US. The average Diabetes Educator Registered Nurse provider writes 1,296 Medicare Part D claims per year.
What drugs does Carol Ballweg, APNP prescribe most often? ▼
Based on 2023 Medicare Part D data, Carol Ballweg, APNP's most frequently prescribed drugs include Levothyroxine Sodium, Rosuvastatin Calcium, Losartan Potassium. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Carol Ballweg, APNP accept Medicare? ▼
Carol Ballweg, APNP appears in CMS Medicare data with 874 Part D claims and 91 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Carol Ballweg, APNP's credentials? ▼
Carol Ballweg, APNP's NPI is 1609990381 with credentials APNP. 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 (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
Compiled from official public sources by the PlainDoctor editorial team.
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 May 2026.