2026 NPPES data Pediatrics Physician NPI 1538194600 M.D.
Verify on CMS →

DAVID KOWALSKI, M.D.

Pediatrics Physician in EFFINGHAM, Illinois. 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
14K
Medicare Part D claims · 688 beneficiaries · Pediatrics Physician avg: 762
Generic prescribing
88%
generic claims · 12% brand-name · higher generic rates reduce patient out-of-pocket costs

What the federal data shows

DAVID KOWALSKI, M.D. filed 14,291 Medicare Part D claims in 2023 as a Pediatrics Physician in EFFINGHAM, Illinois, prescribing 88% generic.

14K
Part D claims, 2023
88%
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.

DAVID KOWALSKI, M.D.'s Medicare Part D volume vs every U.S. prescriber

Total Medicare Part D claims, 2023 — across all CMS prescribers nationally

14,291 Top 2% higher than 98% of 1,370,886 prescribers

0–200: 670,926 prescribers (49%). Below this entry. 200–400: 182,923 prescribers (13%). Below this entry. 400–600: 90,619 prescribers (7%). Below this entry. 600–800: 56,224 prescribers (4%). Below this entry. 800–1,000: 40,919 prescribers (3%). Below this entry. 1,000–1,200: 31,827 prescribers (2%). Below this entry. 1,200–1,400: 26,224 prescribers (2%). Below this entry. 1,400–1,600: 21,710 prescribers (2%). Below this entry. 1,600–1,800: 19,072 prescribers (1%). Below this entry. 1,800–2,000: 16,451 prescribers (1%). Below this entry. 2,000–2,200: 213,991 prescribers (16%). This entry sits in this band. This provider 0 2K+ every Part D prescriber (claims/yr), bucketed by value

Each bar is a band; taller bars hold more prescribers. 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 Medicare Part D Prescriber Public Use File · 2023

Board certification likely (heuristic — not verified)

DAVID KOWALSKI, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + 3 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 DAVID KOWALSKI, M.D.?

Quality data not reported

NPI registry status

Active

Issued 07/11/2006

NPI 1538194600

Primary specialty

Pediatrics Physician

High-volume

80,574 US NPIs in this specialty

Medicare Part D claims

14,291 1775% vs specialty avg

2023 prescription claims

Specialty avg: 762

Specialty distribution in Illinois

How Pediatrics Physician compares to other specialties among Illinois providers

Illinois providers

Pediatrics Physician share within Illinois

1. Pediatrics Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Pediatrics Physician share within Illinois

Specialty board-certification context

Estimated specialty board-certified rate — Pediatrics Physician (ABMS / AOA reference)

Quality data not reported
Est. board-certified rate
78%
Pediatrics Physician ABMS/AOA estimate

Est. board-certified rate (Pediatrics Physician) — ABMS / AOA estimate

0%100%78%
Est. board-certified rate (Pediatrics Physician) — ABMS / AOA estimate

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).

DAVID KOWALSKI, M.D. appears in the CMS NPPES registry as a Pediatrics Physician provider holding M.D. credentials at 300 N MAPLE ST, EFFINGHAM, IL, 62401, with a listed phone of (217) 342-4151. NPI 1538194600 was issued on 07/11/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what KOWALSKI 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 14,291 prescription claims written by this provider, covering 688 Medicare beneficiaries and totaling roughly $1.0 million in drug spend, split 12% brand-name and 88% generic by claim count, with an opioid prescribing rate of 3.4%. 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.

Pediatrics Physician is a high-volume specialty nationwide, with 80,574 enrolled providers across 56 states and an average of 762 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

300 N MAPLE ST
EFFINGHAM, IL 62401

Provider Details

NPI 1538194600
Specialty Pediatrics Physician
Credentials M.D.
Gender Male
NPI Issued 07/11/2006

Hospital and facility affiliations

Facilities where DAVID KOWALSKI, M.D. 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.

MARSHALL CLINIC EFFINGHAM S C
EFFINGHAM, IL
SPRINGFIELD CLINIC, LLP
EFFINGHAM, IL
ST ANTHONYS MEMORIAL HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD
EFFINGHAM, IL

Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).

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 DAVID KOWALSKI, M.D.. To verify DAVID KOWALSKI, M.D.'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 · Typical

DAVID KOWALSKI, M.D. — brand share 12.0%
Specialty average (est.)

12% brand-name claims vs 88% generic, on 14,291 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.

14,291
Total Claims
$1.0M
Total Drug Cost
688
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
27,015
Total Day Supply
762,265
Brand vs Generic
12% brand / 88% generic
Brand Drug Cost
$787K
Generic Drug Cost
$254K
Opioid Claims
491 (3.4% rate)
Antibiotic Claims
395

Patient Demographics

Average Patient Age
75.6 years
Avg HCC Risk Score
1.33
Gender Split
50% female / 50% male
Age Distribution
<65: 55, 65-74: 258, 75-84: 255, 85+: 120

Top Prescribed Drugs (Medicare Part D)

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

What DAVID KOWALSKI, M.D. 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
Amlodipine Besylate
588
Lisinopril
543
Atorvastatin Calcium
535
Levothyroxine Sodium
482
Furosemide
455
Simvastatin
427
Omeprazole
392
Losartan Potassium
361
Hydrochlorothiazide
326
Potassium Chloride
294

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

Pediatrics Physician Overview

How DAVID KOWALSKI, M.D. fits within the Pediatrics Physician landscape nationally.

80,574
Pediatrics Physician Providers in US
56
States with Pediatrics Physician
762
Avg Claims per Provider

DAVID KOWALSKI, M.D.'s 14,291 claims are above the specialty average of 762.

Nearby Pediatrics Physician Providers in Illinois

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

Compare Pediatrics Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is DAVID KOWALSKI, M.D.'s specialty?
DAVID KOWALSKI, M.D. specializes in Pediatrics Physician and practices in EFFINGHAM, Illinois. Credentials: M.D..
How much does DAVID KOWALSKI, M.D. prescribe under Medicare Part D?
In 2023, DAVID KOWALSKI, M.D. wrote 14,291 Medicare Part D claims totaling $1.0M in drug costs for 688 beneficiaries.
Where is DAVID KOWALSKI, M.D. located?
DAVID KOWALSKI, M.D. is located at 300 N MAPLE ST, EFFINGHAM, IL, 62401. Phone: (217) 342-4151.
What is DAVID KOWALSKI, M.D.'s NPI number?
DAVID KOWALSKI, M.D.'s National Provider Identifier (NPI) is 1538194600, issued on 07/11/2006.
Does DAVID KOWALSKI, M.D. prescribe more brand-name or generic drugs?
DAVID KOWALSKI, M.D.'s prescribing is 12% brand-name and 88% generic drugs by claim count, with $787K in brand drug costs.
Does DAVID KOWALSKI, M.D. prescribe opioids?
Yes, DAVID KOWALSKI, M.D. had 491 opioid claims in 2023 with an opioid prescribing rate of 3.4%.
How many Pediatrics Physician providers are there in the US?
There are 80,574 Pediatrics Physician providers across 56 states in the US. The average Pediatrics Physician provider writes 762 Medicare Part D claims per year.
What drugs does DAVID KOWALSKI, M.D. prescribe most often?
Based on 2023 Medicare Part D data, DAVID KOWALSKI, M.D.'s most frequently prescribed drugs include Amlodipine Besylate, Lisinopril, Atorvastatin Calcium. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does DAVID KOWALSKI, M.D. accept Medicare?
DAVID KOWALSKI, M.D. appears in CMS Medicare data with 14,291 Part D claims and 688 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify DAVID KOWALSKI, M.D.'s credentials?
DAVID KOWALSKI, M.D.'s NPI is 1538194600 with credentials M.D.. 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.
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