2026 NPPES data Ophthalmology Physician NPI 1215598024 MD, PHD
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Daniel Balikov, MD, PHD

Ophthalmology Physician in Chicago, Illinois. This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 22,090 in Ophthalmology 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
474
Medicare Part D claims · 165 beneficiaries · Ophthalmology Physician avg: 1K
Generic prescribing
57%
generic claims · 43% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
81.3/100
▼ 2 pts below national avg 83.1 · Above neutral
Industry payments
$1.1K
7 payments · CMS Open Payments (Sunshine Act)
Compiled from official public sources by the PlainDoctor editorial team.

What the federal data shows

Daniel Balikov, MD, PHD reported a CMS MIPS final score of 81.3/100 - below the 83.1 national average - and filed 474 Medicare Part D claims in 2023.

81.3/100
MIPS score · -2 vs avg
474
Part D claims, 2023
57%
generic prescribing
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.

Daniel Balikov, MD, PHD's MIPS score vs every scored U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure

81 36th percentile higher than 36% of 477,587 scored providers

0–10: 8,684 scored providers (2%). Below this entry. 10–20: 3,008 scored providers (1%). Below this entry. 20–30: 3,069 scored providers (1%). Below this entry. 30–40: 2,746 scored providers (1%). Below this entry. 40–50: 2,928 scored providers (1%). Below this entry. 50–60: 5,882 scored providers (1%). Below this entry. 60–70: 13,906 scored providers (3%). Below this entry. 70–80: 118,074 scored providers (25%). Below this entry. 80–90: 129,887 scored providers (27%). This entry sits in this band. 90+: 189,403 scored providers (40%). Above this entry. This provider 0 100 every MIPS-scored clinician, bucketed by value

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 Daniel Balikov, MD, PHD sits

This provider among ophthalmology physician peers

Across the 9,866 ophthalmology physician providers who report both Medicare Part D prescribing and a MIPS quality score, Daniel Balikov, MD, PHD writes more Part D claims than 24% of them and scores higher on MIPS quality than 37% - 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

Lower volume · High qualityHigh volume · High qualityLower volume · Lower qualityHigh volume · Lower quality0255075100024.448.873.297.7Part D claim volume, percentile in specialtyMIPS quality, percentilePart D claim volume, percentile in specialty: 33 · MIPS quality, percentile: 58Part D claim volume, percentile in specialty: 72 · MIPS quality, percentile: 87Part D claim volume, percentile in specialty: 32 · MIPS quality, percentile: 93Part D claim volume, percentile in specialty: 75 · MIPS quality, percentile: 13Part D claim volume, percentile in specialty: 93 · MIPS quality, percentile: 80Part D claim volume, percentile in specialty: 97 · MIPS quality, percentile: 67Part D claim volume, percentile in specialty: 0 · MIPS quality, percentile: 18Part D claim volume, percentile in specialty: 73 · MIPS quality, percentile: 93Part D claim volume, percentile in specialty: 17 · MIPS quality, percentile: 93Part D claim volume, percentile in specialty: 68 · MIPS quality, percentile: 63Part D claim volume, percentile in specialty: 42 · MIPS quality, percentile: 53Part D claim volume, percentile in specialty: 88 · MIPS quality, percentile: 93Part D claim volume, percentile in specialty: 95 · MIPS quality, percentile: 68Part D claim volume, percentile in specialty: 47 · MIPS quality, percentile: 75Part D claim volume, percentile in specialty: 37 · MIPS quality, percentile: 55Part D claim volume, percentile in specialty: 65 · MIPS quality, percentile: 15Part D claim volume, percentile in specialty: 98 · MIPS quality, percentile: 43Part D claim volume, percentile in specialty: 38 · MIPS quality, percentile: 78Part D claim volume, percentile in specialty: 12 · MIPS quality, percentile: 57Part D claim volume, percentile in specialty: 22 · MIPS quality, percentile: 77Part D claim volume, percentile in specialty: 23 · MIPS quality, percentile: 20Part D claim volume, percentile in specialty: 45 · MIPS quality, percentile: 20Part D claim volume, percentile in specialty: 57 · MIPS quality, percentile: 83Part D claim volume, percentile in specialty: 28 · MIPS quality, percentile: 65Part D claim volume, percentile in specialty: 48 · MIPS quality, percentile: 70Part D claim volume, percentile in specialty: 90 · MIPS quality, percentile: 20Part D claim volume, percentile in specialty: 43 · MIPS quality, percentile: 30Part D claim volume, percentile in specialty: 2 · MIPS quality, percentile: 73Part D claim volume, percentile in specialty: 35 · MIPS quality, percentile: 10Part D claim volume, percentile in specialty: 50 · MIPS quality, percentile: 62Part D claim volume, percentile in specialty: 10 · MIPS quality, percentile: 60Part D claim volume, percentile in specialty: 5 · MIPS quality, percentile: 90Part D claim volume, percentile in specialty: 8 · MIPS quality, percentile: 52Part D claim volume, percentile in specialty: 20 · MIPS quality, percentile: 40Part D claim volume, percentile in specialty: 70 · MIPS quality, percentile: 32Part D claim volume, percentile in specialty: 27 · MIPS quality, percentile: 37Part D claim volume, percentile in specialty: 53 · MIPS quality, percentile: 85Part D claim volume, percentile in specialty: 60 · MIPS quality, percentile: 92Part D claim volume, percentile in specialty: 40 · MIPS quality, percentile: 93Part D claim volume, percentile in specialty: 80 · MIPS quality, percentile: 7Part D claim volume, percentile in specialty: 63 · MIPS quality, percentile: 38Part D claim volume, percentile in specialty: 62 · MIPS quality, percentile: 42Part D claim volume, percentile in specialty: 85 · MIPS quality, percentile: 0Part D claim volume, percentile in specialty: 30 · MIPS quality, percentile: 20Part D claim volume, percentile in specialty: 87 · MIPS quality, percentile: 72Part D claim volume, percentile in specialty: 77 · MIPS quality, percentile: 3Part D claim volume, percentile in specialty: 15 · MIPS quality, percentile: 5Part D claim volume, percentile in specialty: 67 · MIPS quality, percentile: 88Part D claim volume, percentile in specialty: 82 · MIPS quality, percentile: 33Part D claim volume, percentile in specialty: 78 · MIPS quality, percentile: 12Part D claim volume, percentile in specialty: 83 · MIPS quality, percentile: 50Part D claim volume, percentile in specialty: 58 · MIPS quality, percentile: 8Part D claim volume, percentile in specialty: 55 · MIPS quality, percentile: 20Part D claim volume, percentile in specialty: 13 · MIPS quality, percentile: 45Part D claim volume, percentile in specialty: 92 · MIPS quality, percentile: 47Part D claim volume, percentile in specialty: 25 · MIPS quality, percentile: 17Part D claim volume, percentile in specialty: 100 · MIPS quality, percentile: 20Part D claim volume, percentile in specialty: 7 · MIPS quality, percentile: 35Part D claim volume, percentile in specialty: 52 · MIPS quality, percentile: 0Part D claim volume, percentile in specialty: 3 · MIPS quality, percentile: 82Daniel Balikov, MD, PHD-Part D claim volume, percentile in specialty: 24 · MIPS quality, percentile: 37
Part D claim volume vs MIPS quality, by specialty percentile

Each dot is one ophthalmology physician peer from a representative sample of 60; the gold marker is Daniel Balikov, MD, PHD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.

Board certification likely (heuristic, not verified)

Daniel Balikov, MD, PHD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 2 hospital affiliations - 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 Daniel Balikov, MD, PHD?

Near national average

NPI registry status

Active

Issued 06/24/2019

NPI 1215598024

Primary specialty

Ophthalmology Physician

Mid-sized

22,090 US NPIs in this specialty

Medicare Part D claims

474 67% vs specialty avg

2023 prescription claims

Specialty avg: 1,420

MIPS final score

81.3/100 1.8 pts vs avg

Above neutral band

vs 83.1 national avg

Specialty distribution in Illinois

How Ophthalmology Physician compares to other specialties among Illinois providers

Illinois providers

Largest specialties in Illinois (% of in-state providers)

Clinical Social Worker - 5.2%Clinical Social Worker5.2%Physical Therapist - 5%Physical Therapist5%Mental Health Counselor - 4.5%Mental Health Counselor4.5%Speech-Language Pathologist - 4.2%Speech-Language Pathologist4.2%Student in an Organized Health Care Education/Training Program - 4.2%Student in an Organized Health Care Education/Training Program4.2%Pharmacist - 4.1%Pharmacist4.1%Ophthalmology Physician - 0.4%Ophthalmology Physician0.4%
Largest specialties in Illinois (% of in-state providers)

Medicare quality performance, MIPS

Daniel Balikov, MD, PHD's 2023 MIPS final score plotted against the Ophthalmology Physician national average

Near national average
MIPS Final Score
81.3/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Ophthalmology Physician) - 81.3/100 vs national avg 83.1

0%100%National avg83%81.3%
MIPS final score (Ophthalmology Physician) - 81.3/100 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).

Daniel Balikov, MD, PHD appears in the CMS NPPES registry as a Ophthalmology Physician provider holding MD, PHD credentials at 4822 S COTTAGE GROVE AVE STE 2-300, Chicago, IL, 60061, with a listed phone of (312) 695-8150. NPI 1215598024 was issued on 06/24/2019. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what Balikov 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 474 prescription claims written by this provider, covering 165 Medicare beneficiaries and totaling roughly $94K in drug spend, split 43% brand-name and 57% generic by claim count. 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 81.3/100 for the 2023 performance year (Quality 78.5, Cost 50.6), compared with the national average of 83.1.

Ophthalmology Physician is a mid-sized specialty nationwide, with 22,090 enrolled providers across 56 states and an average of 1,420 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

4822 S COTTAGE GROVE AVE STE 2-300
Chicago, IL 60061

Provider Details

NPI 1215598024
Specialty Ophthalmology Physician
Credentials MD, PHD
Gender Male
NPI Issued 06/24/2019

CMS Quality Score (MIPS)

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

81.3101
Final Score
Avg: 83.1
78.455
Quality
50.5984
Cost
100
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where Daniel Balikov, MD, PHD 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.

Northwestern Medical Faculty Foundation
Chicago, IL
University OF Miami
Miami, FL

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 Daniel Balikov, MD, PHD. Source: openpaymentsdata.cms.gov.

Total received

$1.1K

Largest payer

Alimera Sciences, 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 - Illinois IDFPR 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 ~42K Illinois medical licensees in 2023 - they are NOT specific to Daniel Balikov, MD, PHD. To verify Daniel Balikov, MD, PHD's current license status, search the IDFPR public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

106
Total board actions, Illinois 2023
Across 103 cases
2.52
Actions per 1,000 licensees
Illinois statewide rate
probation
Most common action type
38 cases

IDFPR 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 Illinois disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Above average

Daniel Balikov, MD, PHD - brand share 43.0%
Ophthalmology Physician average

43% brand-name claims vs 57% generic, on 474 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.

474
Total Claims
$94K
Total Drug Cost
165
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
806
Total Day Supply
22,711
Brand vs Generic
43% brand / 57% generic
Brand Drug Cost
$80K
Generic Drug Cost
$14K

Patient Demographics

Average Patient Age
74.3 years
Avg HCC Risk Score
1.53
Gender Split
60% female / 40% male
Age Distribution
<65: 19, 65-74: 70, 75-84: 49, 85+: 27

Top Prescribed Drugs (Medicare Part D)

Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.

What Daniel Balikov, MD, PHD prescribes most

Top Medicare Part D drugs by claim count, 2023

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2023
Drug Claims
Latanoprost
81
Prednisolone Acetate
54
Timolol Maleate
47
Restasis
Cyclosporine
28
Brimonidine Tartrate
27
Dorzolamide Hcl
25
Cyclosporine
18
Dorzolamide-Timolol
Dorzolamide Hcl/Timolol Maleat
17
Alphagan P
Brimonidine Tartrate
15
Fluorometholone
12

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

Ophthalmology Physician Overview

How Daniel Balikov, MD, PHD fits within the Ophthalmology Physician landscape nationally.

22,090
Ophthalmology Physician Providers in US
56
States with Ophthalmology Physician
1,420
Avg Claims per Provider

Daniel Balikov, MD, PHD's 474 claims are below the specialty average of 1,420.

Nearby Ophthalmology Physician Providers in Illinois

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

Compare Ophthalmology 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 Illinois medical board, federal registration is not a license check. Credential verification guide
  • Weigh a second option: compare this provider with a nearby Ophthalmology 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.

Frequently Asked Questions

What is Daniel Balikov, MD, PHD's specialty?
Daniel Balikov, MD, PHD specializes in Ophthalmology Physician and practices in Chicago, Illinois. Credentials: MD, PHD.
How much does Daniel Balikov, MD, PHD prescribe under Medicare Part D?
In 2023, Daniel Balikov, MD, PHD wrote 474 Medicare Part D claims totaling $94K in drug costs for 165 beneficiaries.
What is Daniel Balikov, MD, PHD's Medicare quality score?
Daniel Balikov, MD, PHD has a CMS MIPS Final Score of 81.3/100 (Quality: 78.5, Cost: 50.6). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Daniel Balikov, MD, PHD located?
Daniel Balikov, MD, PHD is located at 4822 S COTTAGE GROVE AVE STE 2-300, Chicago, IL, 60061. Phone: (312) 695-8150.
What is Daniel Balikov, MD, PHD's NPI number?
Daniel Balikov, MD, PHD's National Provider Identifier (NPI) is 1215598024, issued on 06/24/2019.
Does Daniel Balikov, MD, PHD prescribe more brand-name or generic drugs?
Daniel Balikov, MD, PHD's prescribing is 43% brand-name and 57% generic drugs by claim count, with $80K in brand drug costs.
How many Ophthalmology Physician providers are there in the US?
There are 22,090 Ophthalmology Physician providers across 56 states in the US. The average Ophthalmology Physician provider writes 1,420 Medicare Part D claims per year.
What drugs does Daniel Balikov, MD, PHD prescribe most often?
Based on 2023 Medicare Part D data, Daniel Balikov, MD, PHD's most frequently prescribed drugs include Latanoprost, Prednisolone Acetate, Timolol Maleate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Daniel Balikov, MD, PHD accept Medicare?
Daniel Balikov, MD, PHD appears in CMS Medicare data with 474 Part D claims and 165 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Daniel Balikov, MD, PHD's credentials?
Daniel Balikov, MD, PHD's NPI is 1215598024 with credentials MD, PHD. 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

Compiled from official public sources by the PlainDoctor editorial team.