2026 NPPES data Physical Medicine & Rehabilitation Physician NPI 1255587010 D.O.
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CAYLI BALCH, D.O.

Physical Medicine & Rehabilitation Physician in FORT WORTH, Texas. 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
2K
Medicare Part D claims · 213 beneficiaries · Physical Medicine & Rehabilitation Physician avg: 781
Generic prescribing
96%
generic claims · 4% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
51.5547/100
▼ 32 pts below national avg 83.1 · [object Object]
Industry payments
$49.99
1 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: CAYLI BALCH, D.O. is a Physical Medicine & Rehabilitation Physician ([object Object]) practicing in FORT WORTH, Texas with a Medicare Part D prescribing footprint of 2K claims across 213 beneficiaries — 4% brand-name prescribing . Their CMS MIPS Final Score of 51.5547/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $49.99 across 1 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: CAYLI BALCH, D.O. reported a CMS MIPS final score of 51.5547 out of 100, below the 83.1 national average, and filed 2,462 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

Board certification likely (heuristic — not verified)

CAYLI BALCH, D.O. 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).

CAYLI BALCH, D.O. at a glance

Below national average

NPI registry status

Active

Issued 08/13/2008

NPI 1255587010

Primary specialty

Physical Medicine & Rehabilitation Physician

Mid-sized

15,306 US NPIs in this specialty

Medicare Part D claims

2,462 215% vs specialty avg

2023 prescription claims

Specialty avg: 781

MIPS final score

51.5547/100 31.545299999999997% pts

Mid-tier band

vs 83.1 national avg

Specialty distribution in Texas

How Physical Medicine & Rehabilitation Physician compares to other specialties among Texas providers

Texas providers

Physical Medicine & Rehabilitation Physician share within Texas

1. Physical Medicine & Rehabilitation Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Physical Medicine & Rehabilitation Physician share within Texas

Medicare quality performance — MIPS

CAYLI BALCH, D.O.'s 2023 MIPS final score plotted against the Physical Medicine & Rehabilitation Physician national average

Below national average
MIPS Final Score
51.5547/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Physical Medicine & Rehabilitation Physician) — 51.5547/100 vs national avg 83.1

0%100%National avg83%51.6%
MIPS final score (Physical Medicine & Rehabilitation Physician) — 51.5547/100 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).

CAYLI BALCH, D.O. is a Physical Medicine & Rehabilitation Physician provider practicing in FORT WORTH, Texas, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: D.O.. NPI: 1255587010. 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.

CAYLI BALCH, D.O. appears in the CMS NPPES registry as a Physical Medicine & Rehabilitation Physician provider holding D.O. credentials at 4319 CAMP BOWIE BLVD, FORT WORTH, TX, 76107, with a listed phone of (817) 984-6210. NPI 1255587010 was issued on 08/13/2008. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BALCH 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 2,462 prescription claims written by this provider, covering 213 Medicare beneficiaries and totaling roughly $137K in drug spend, split 4% brand-name and 96% generic by claim count, with an opioid prescribing rate of 56.3%. 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 51.5547/100 for the 2023 performance year (Quality 39.3527), compared with the national average of 83.1.

Physical Medicine & Rehabilitation Physician is a mid-sized specialty nationwide, with 15,306 enrolled providers across 54 states and an average of 781 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

4319 CAMP BOWIE BLVD
FORT WORTH, TX 76107

Provider Details

NPI 1255587010
Specialty Physical Medicine & Rehabilitation Physician
Credentials D.O.
Gender Female
NPI Issued 08/13/2008

CMS Quality Score (MIPS)

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

51.5547
Final Score
Avg: 83.1
39.3527
Quality
29
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where CAYLI BALCH, D.O. 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.

BALCH INTERVENTIONAL PAIN AND WELLNESS CENTER PLLC
FORT WORTH, TX

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 CAYLI BALCH, D.O.. Source: openpaymentsdata.cms.gov.

Total received

$50

Largest payer

ABBVIE 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.

License & disciplinary context — Texas TMB 2023 annual report

Aggregate state board data only — NOT a determination of any individual provider's status. The figures below describe statewide disciplinary activity across all ~77K Texas medical licensees in 2023 — they are NOT specific to CAYLI BALCH, D.O.. To verify CAYLI BALCH, D.O.'s current license status, search the TMB public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

344
Total board actions, Texas 2023
Across 334 cases
4.47
Actions per 1,000 licensees
Texas statewide rate
probation
Most common action type
94 cases

TMB publishes annual disciplinary statistics as part of public-record reporting under each state's Administrative Procedure Act. See the full breakdown by action type and year on the Texas disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Generic-heavy

CAYLI BALCH, D.O. — brand share 4.0%
Specialty average (est.)

4% brand-name claims vs 96% generic, on 2,462 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.

2,462
Total Claims
$137K
Total Drug Cost
213
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
3,396
Total Day Supply
87,746
Brand vs Generic
4% brand / 96% generic
Brand Drug Cost
$33K
Generic Drug Cost
$103K
Opioid Claims
1,386 (56.3% rate)

Patient Demographics

Average Patient Age
70.3 years
Avg HCC Risk Score
2.53
Gender Split
63% female / 37% male
Age Distribution
<65: 60, 65-74: 74, 75-84: 61, 85+: 18

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
675
Tramadol Hcl
181
Methylprednisolone
144
Gabapentin
132
Pregabalin
128
Oxycodone Hcl
117
Acetaminophen-Codeine
Acetaminophen With Codeine
111
Oxycodone-Acetaminophen
Oxycodone Hcl/Acetaminophen
78
Baclofen
72
Morphine Sulfate
64

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

Physical Medicine & Rehabilitation Physician Overview

How CAYLI BALCH, D.O. fits within the Physical Medicine & Rehabilitation Physician landscape nationally.

15,306
Physical Medicine & Rehabilitation Physician Providers in US
54
States with Physical Medicine & Rehabilitation Physician
781
Avg Claims per Provider

CAYLI BALCH, D.O.'s 2,462 claims are above the specialty average of 781.

Nearby Physical Medicine & Rehabilitation Physician Providers in Texas

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

Compare Physical Medicine & Rehabilitation Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is CAYLI BALCH, D.O.'s specialty?
CAYLI BALCH, D.O. specializes in Physical Medicine & Rehabilitation Physician and practices in FORT WORTH, Texas. Credentials: D.O..
How much does CAYLI BALCH, D.O. prescribe under Medicare Part D?
In 2023, CAYLI BALCH, D.O. wrote 2,462 Medicare Part D claims totaling $137K in drug costs for 213 beneficiaries.
What is CAYLI BALCH, D.O.'s Medicare quality score?
CAYLI BALCH, D.O. has a CMS MIPS Final Score of 51.5547/100 (Quality: 39.3527). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is CAYLI BALCH, D.O. located?
CAYLI BALCH, D.O. is located at 4319 CAMP BOWIE BLVD, FORT WORTH, TX, 76107. Phone: (817) 984-6210.
What is CAYLI BALCH, D.O.'s NPI number?
CAYLI BALCH, D.O.'s National Provider Identifier (NPI) is 1255587010, issued on 08/13/2008.
Does CAYLI BALCH, D.O. prescribe more brand-name or generic drugs?
CAYLI BALCH, D.O.'s prescribing is 4% brand-name and 96% generic drugs by claim count, with $33K in brand drug costs.
Does CAYLI BALCH, D.O. prescribe opioids?
Yes, CAYLI BALCH, D.O. had 1,386 opioid claims in 2023 with an opioid prescribing rate of 56.3%.
How many Physical Medicine & Rehabilitation Physician providers are there in the US?
There are 15,306 Physical Medicine & Rehabilitation Physician providers across 54 states in the US. The average Physical Medicine & Rehabilitation Physician provider writes 781 Medicare Part D claims per year.
What drugs does CAYLI BALCH, D.O. prescribe most often?
Based on 2023 Medicare Part D data, CAYLI BALCH, D.O.'s most frequently prescribed drugs include Hydrocodone-Acetaminophen, Tramadol Hcl, Methylprednisolone. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does CAYLI BALCH, D.O. accept Medicare?
CAYLI BALCH, D.O. appears in CMS Medicare data with 2,462 Part D claims and 213 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify CAYLI BALCH, D.O.'s credentials?
CAYLI BALCH, D.O.'s NPI is 1255587010 with credentials D.O.. 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