2026 NPPES data Gastroenterology Physician NPI 1215022405 M.D.
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DONALD ABRAHM, M.D.

Gastroenterology Physician in NEWPORT BEACH, California. 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 · 501 beneficiaries · Gastroenterology Physician avg: 833
MIPS score
65.3847/100
▼ 18 pts below national avg 83.1 · [object Object]
Industry payments
$2.5K
80 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: DONALD ABRAHM, M.D. is a Gastroenterology Physician ([object Object]) practicing in NEWPORT BEACH, California with a Medicare Part D prescribing footprint of 2K claims across 501 beneficiaries . Their CMS MIPS Final Score of 65.3847/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $2.5K across 80 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: DONALD ABRAHM, M.D. reported a CMS MIPS final score of 65.3847 out of 100, below the 83.1 national average, and filed 1,870 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)

DONALD ABRAHM, M.D. 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).

DONALD ABRAHM, M.D. at a glance

Below national average

NPI registry status

Active

Issued 10/04/2006

NPI 1215022405

Primary specialty

Gastroenterology Physician

Mid-sized

16,567 US NPIs in this specialty

Medicare Part D claims

1,870 124% vs specialty avg

2023 prescription claims

Specialty avg: 833

MIPS final score

65.3847/100 17.7153% pts

Mid-tier band

vs 83.1 national avg

Specialty distribution in California

How Gastroenterology Physician compares to other specialties among California providers

California providers

Gastroenterology Physician share within California

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

Medicare quality performance — MIPS

DONALD ABRAHM, M.D.'s 2023 MIPS final score plotted against the Gastroenterology Physician national average

Below national average
MIPS Final Score
65.3847/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Gastroenterology Physician) — 65.3847/100 vs national avg 83.1

0%100%National avg83%65.4%
MIPS final score (Gastroenterology Physician) — 65.3847/100 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).

DONALD ABRAHM, M.D. is a Gastroenterology Physician provider practicing in NEWPORT BEACH, California, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: M.D.. NPI: 1215022405. 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.

DONALD ABRAHM, M.D. appears in the CMS NPPES registry as a Gastroenterology Physician provider holding M.D. credentials at 1525 SUPERIOR AVENUE, NEWPORT BEACH, CA, 92663, with a listed phone of (949) 631-2670. NPI 1215022405 was issued on 10/04/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what ABRAHM 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 1,870 prescription claims written by this provider, covering 501 Medicare beneficiaries and totaling roughly $1.7 million in drug spend. 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 65.3847/100 for the 2023 performance year (Quality 61.5267, Cost 80.5891), compared with the national average of 83.1.

Gastroenterology Physician is a mid-sized specialty nationwide, with 16,567 enrolled providers across 54 states and an average of 833 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

1525 SUPERIOR AVENUE
NEWPORT BEACH, CA 92663

Provider Details

NPI 1215022405
Specialty Gastroenterology Physician
Credentials M.D.
Gender Male
NPI Issued 10/04/2006

CMS Quality Score (MIPS)

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

65.3847
Final Score
Avg: 83.1
61.5267
Quality
80.5891
Cost
91
Promoting Interoperability

Reporting: Individual

Hospital and facility affiliations

Facilities where DONALD ABRAHM, 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.

DONALD R. ABRAHM M.D., INC
NEWPORT BEACH, CA

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 DONALD ABRAHM, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$2.5K

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 — California MBC 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 ~150K California medical licensees in 2023 — they are NOT specific to DONALD ABRAHM, M.D.. To verify DONALD ABRAHM, M.D.'s current license status, search the MBC public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

576
Total board actions, California 2023
Across 556 cases
3.84
Actions per 1,000 licensees
California statewide rate
probation
Most common action type
186 cases

MBC 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 California disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

1,870
Total Claims
$1.7M
Total Drug Cost
501
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
3,189
Total Day Supply
89,422
Generic Drug Cost
$186K
Antibiotic Claims
99

Patient Demographics

Average Patient Age
76.5 years
Avg HCC Risk Score
1.26
Gender Split
56% female / 44% 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
Pantoprazole Sodium
628
Linzess
Linaclotide
146
Mesalamine
85
Balsalazide Disodium
79
Dicyclomine Hcl
60
Sucralfate
57
Diphenoxylate-Atropine
Diphenoxylate Hcl/Atropine
56
Dexlansoprazole Dr
Dexlansoprazole
54
Famotidine
54
Colesevelam Hcl
51

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

Gastroenterology Physician Overview

How DONALD ABRAHM, M.D. fits within the Gastroenterology Physician landscape nationally.

16,567
Gastroenterology Physician Providers in US
54
States with Gastroenterology Physician
833
Avg Claims per Provider

DONALD ABRAHM, M.D.'s 1,870 claims are above the specialty average of 833.

Nearby Gastroenterology Physician Providers in California

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

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

Frequently Asked Questions

What is DONALD ABRAHM, M.D.'s specialty?
DONALD ABRAHM, M.D. specializes in Gastroenterology Physician and practices in NEWPORT BEACH, California. Credentials: M.D..
How much does DONALD ABRAHM, M.D. prescribe under Medicare Part D?
In 2023, DONALD ABRAHM, M.D. wrote 1,870 Medicare Part D claims totaling $1.7M in drug costs for 501 beneficiaries.
What is DONALD ABRAHM, M.D.'s Medicare quality score?
DONALD ABRAHM, M.D. has a CMS MIPS Final Score of 65.3847/100 (Quality: 61.5267, Cost: 80.5891). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is DONALD ABRAHM, M.D. located?
DONALD ABRAHM, M.D. is located at 1525 SUPERIOR AVENUE, NEWPORT BEACH, CA, 92663. Phone: (949) 631-2670.
What is DONALD ABRAHM, M.D.'s NPI number?
DONALD ABRAHM, M.D.'s National Provider Identifier (NPI) is 1215022405, issued on 10/04/2006.
How many Gastroenterology Physician providers are there in the US?
There are 16,567 Gastroenterology Physician providers across 54 states in the US. The average Gastroenterology Physician provider writes 833 Medicare Part D claims per year.
What drugs does DONALD ABRAHM, M.D. prescribe most often?
Based on 2023 Medicare Part D data, DONALD ABRAHM, M.D.'s most frequently prescribed drugs include Pantoprazole Sodium, Linzess, Mesalamine. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does DONALD ABRAHM, M.D. accept Medicare?
DONALD ABRAHM, M.D. appears in CMS Medicare data with 1,870 Part D claims and 501 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify DONALD ABRAHM, M.D.'s credentials?
DONALD ABRAHM, M.D.'s NPI is 1215022405 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.
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