2026 NPPES data Diabetes Educator Registered Nurse NPI 1609990381 APNP
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CAROL BALLWEG, APNP

Diabetes Educator Registered Nurse in FITCHBURG, Wisconsin. 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
874
Medicare Part D claims · 91 beneficiaries · Diabetes Educator Registered Nurse avg: 1K
Generic prescribing
90%
generic claims · 10% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
80.2217/100
▼ 3 pts below national avg 83.1 · [object Object]
What the federal data reveals: CAROL BALLWEG, APNP is a Diabetes Educator Registered Nurse ([object Object]) practicing in FITCHBURG, Wisconsin with a Medicare Part D prescribing footprint of 874 claims across 91 beneficiaries — 10% brand-name prescribing . Their CMS MIPS Final Score of 80.2217/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities .

What stands out: CAROL BALLWEG, APNP reported a CMS MIPS final score of 80.2217 out of 100, below the 83.1 national average, and filed 874 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

CAROL BALLWEG, APNP at a glance

Near national average

NPI registry status

Active

Issued 03/19/2007

NPI 1609990381

Primary specialty

Diabetes Educator Registered Nurse

Niche

2,273 US NPIs in this specialty

Medicare Part D claims

874 33% vs specialty avg

2023 prescription claims

Specialty avg: 1,296

MIPS final score

80.2217/100 2.878299999999996% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in Wisconsin

How Diabetes Educator Registered Nurse compares to other specialties among Wisconsin providers

Wisconsin providers

Diabetes Educator Registered Nurse share within Wisconsin

1. Diabetes Educator Registered Nurse42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Diabetes Educator Registered Nurse share within Wisconsin

Medicare quality performance — MIPS

CAROL BALLWEG, APNP's 2023 MIPS final score plotted against the Diabetes Educator Registered Nurse national average

Near national average
MIPS Final Score
80.2217/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Diabetes Educator Registered Nurse) — 80.2217/100 vs national avg 83.1

0%100%National avg83%80.2%
MIPS final score (Diabetes Educator Registered Nurse) — 80.2217/100 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).

CAROL BALLWEG, APNP is a Diabetes Educator Registered Nurse provider practicing in FITCHBURG, Wisconsin, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: APNP. NPI: 1609990381. 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.

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. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BALLWEG 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 874 prescription claims written by this provider, covering 91 Medicare beneficiaries and totaling roughly $40K in drug spend, split 10% brand-name and 90% generic by claim count, with an opioid prescribing rate of 2.1%. 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 80.2217/100 for the 2023 performance year (Quality 85.0677, Cost 49.8379), compared with the national average of 83.1.

Diabetes Educator Registered Nurse is a narrow specialty nationwide, with 2,273 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

3051 CAHILL MAIN
FITCHBURG, WI 53711

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%
Specialty average (est.)

10% brand-name claims vs 90% 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 / 90% 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.

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.

2,273
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.

Compare Diabetes Educator Registered Nurse nationally: see state-by-state distribution →

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 80.2217/100 (Quality: 85.0677, Cost: 49.8379). 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 90% 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 2,273 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

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