NPI registry status
Active
2026 NPPES data Plastic Surgery Physician NPI 1326087206 MD
Verify on CMS → Dana Balderrama, MD
Plastic Surgery Physician in Topeka, Kansas.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 5,316 in Plastic Surgery Physician, 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
78
Medicare Part D claims · 72 beneficiaries · Plastic Surgery Physician avg: 84
MIPS score
12.9/100
▼ 70 pts below national avg 83.1 · Penalty band
Industry payments
$1.9K
11 payments · CMS Open Payments (Sunshine Act)
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
Dana Balderrama, MD reported a CMS MIPS final score of 12.9/100 - below the 83.1 national average - and filed 78 Medicare Part D claims in 2023.
- 12.9/100
- MIPS score · -70 vs avg
- 78
- Part D claims, 2023
- 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.
Dana Balderrama, MD's MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
13 2nd percentile higher than 2% 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 Dana Balderrama, MD sits
This provider among plastic surgery physician peers
Across the 561 plastic surgery physician providers who report both Medicare Part D prescribing and a MIPS quality score, Dana Balderrama, MD writes more Part D claims than 58% of them and scores higher on MIPS quality than 4% - placing this provider in the high-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 plastic surgery physician peer from a representative sample of 60; the gold marker is Dana Balderrama, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Dana Balderrama, 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 Dana Balderrama, MD?
Below national averagePrimary specialty
Plastic Surgery Physician
Medicare Part D claims
78 7% vs specialty avg
MIPS final score
12.9/100 70.2 pts vs avg
Specialty distribution in Kansas
How Plastic Surgery Physician compares to other specialties among Kansas providers
Medicare quality performance, MIPS
Dana Balderrama, MD's 2023 MIPS final score plotted against the Plastic Surgery Physician national average
- MIPS Final Score
- 12.9/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Plastic Surgery Physician) - 12.9/100 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).
Dana Balderrama, MD appears in the CMS NPPES registry as a Plastic Surgery Physician provider holding MD credentials at 2902 SW ASBURY DR, Topeka, KS, 66614, with a listed phone of (785) 354-9591. NPI 1326087206 was issued on 06/06/2006.
Medicare Part D records for calendar year 2023 show 78 prescription claims written by this provider, covering 72 Medicare beneficiaries and totaling roughly $128 in drug spend, with an opioid prescribing rate of 94.9%. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 12.9/100 for the 2023 performance year (Quality 0, Cost 43), compared with the national average of 83.1.
Plastic Surgery Physician is a mid-sized specialty nationwide, with 5,316 enrolled providers across 52 states and an average of 84 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 | 1326087206 |
|---|---|
| Specialty | Plastic Surgery Physician |
| Credentials | MD |
| Gender | Male |
| NPI Issued | 06/06/2006 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
12.9042
Final Score
Avg: 83.1
0
Quality
43.0141
Cost
Reporting: Individual
Hospital and facility affiliations
Facilities where Dana Balderrama, 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.
Cotton-O'Neil Clinic Revocable Trust
Manhattan, KS
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 Dana Balderrama, MD. Source: openpaymentsdata.cms.gov.
Total received
$1.9K
Largest payer
ACUMED 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.
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2023.
78
Total Claims
$128
Total Drug Cost
72
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 78
- Total Day Supply
- 181
- Brand Drug Cost
- $0
- Generic Drug Cost
- $128
- Opioid Claims
- 74 (94.9% rate)
Patient Demographics
- Average Patient Age
- 73.5 years
- Avg HCC Risk Score
- 1.11
- Gender Split
- 46% female / 54% 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 |
|---|---|
| Tramadol Hcl | 71 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Plastic Surgery Physician Overview
How Dana Balderrama, MD fits within the Plastic Surgery Physician landscape nationally.
5,316
Plastic Surgery Physician Providers in US
52
States with Plastic Surgery Physician
84
Avg Claims per Provider
Dana Balderrama, MD's 78 claims are below the specialty average of 84.
Nearby Plastic Surgery Physician Providers in Kansas
Other clinicians with the same primary specialty enrolled in Kansas, drawn from the same CMS NPPES roster as Balderrama.
Megan Angermayer
Bucyrus, KS
Dr. Marc Baraban
MD
Topeka, KS
Dr. Abbey Bays
MPAS, PA-C
Overland Park, KS
Dr. Danny Bennett
M.D.
Overland Park, KS
Dr. Dhaval Bhavsar
M.D.
Kansas City, KS
Compare Plastic Surgery Physician 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 Kansas medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Plastic Surgery Physician 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.
Healthcare Guides
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How to Find a Doctor
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Medical Specialties Explained
Who treats what and how specialties differ
Understanding Medicare Claims Data
What prescribing data reveals about a provider
In-Network vs Out-of-Network
How insurance networks affect your costs
Telehealth Guide
Virtual care options and coverage in 2026
Explore Kansas
Frequently Asked Questions
What is Dana Balderrama, MD's specialty? ▼
Dana Balderrama, MD specializes in Plastic Surgery Physician and practices in Topeka, Kansas. Credentials: MD.
How much does Dana Balderrama, MD prescribe under Medicare Part D? ▼
In 2023, Dana Balderrama, MD wrote 78 Medicare Part D claims totaling $128 in drug costs for 72 beneficiaries.
What is Dana Balderrama, MD's Medicare quality score? ▼
Dana Balderrama, MD has a CMS MIPS Final Score of 12.9/100 (Quality: 0, Cost: 43). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Dana Balderrama, MD located? ▼
Dana Balderrama, MD is located at 2902 SW ASBURY DR, Topeka, KS, 66614. Phone: (785) 354-9591.
What is Dana Balderrama, MD's NPI number? ▼
Dana Balderrama, MD's National Provider Identifier (NPI) is 1326087206, issued on 06/06/2006.
Does Dana Balderrama, MD prescribe opioids? ▼
Yes, Dana Balderrama, MD had 74 opioid claims in 2023 with an opioid prescribing rate of 94.9%.
How many Plastic Surgery Physician providers are there in the US? ▼
There are 5,316 Plastic Surgery Physician providers across 52 states in the US. The average Plastic Surgery Physician provider writes 84 Medicare Part D claims per year.
What drugs does Dana Balderrama, MD prescribe most often? ▼
Based on 2023 Medicare Part D data, Dana Balderrama, MD's most frequently prescribed drugs include Tramadol Hcl. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Dana Balderrama, MD accept Medicare? ▼
Dana Balderrama, MD appears in CMS Medicare data with 78 Part D claims and 72 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Dana Balderrama, MD's credentials? ▼
Dana Balderrama, MD's NPI is 1326087206 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
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.