2026 NPPES data Cardiovascular Disease Physician NPI 1659381697 NP
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DONNA BALGAVY, NP

Cardiovascular Disease Physician in NORFOLK, Virginia. 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
3K
Medicare Part D claims · 673 beneficiaries · Cardiovascular Disease Physician avg: 3K
Generic prescribing
85%
generic claims · 15% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
95.1126/100
▲ 12 pts above national avg 83.1 · [object Object]
What the federal data reveals: DONNA BALGAVY, NP is a Cardiovascular Disease Physician ([object Object]) practicing in NORFOLK, Virginia with a Medicare Part D prescribing footprint of 3K claims across 673 beneficiaries — 15% brand-name prescribing . Their CMS MIPS Final Score of 95.1126/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities .

What stands out: DONNA BALGAVY, NP reported a CMS MIPS final score of 95.1126 out of 100, above the 83.1 national average, and filed 2,908 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)

DONNA BALGAVY, NP 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).

DONNA BALGAVY, NP at a glance

High performer (top quartile)

NPI registry status

Active

Issued 08/09/2006

NPI 1659381697

Primary specialty

Cardiovascular Disease Physician

Mid-sized

24,795 US NPIs in this specialty

Medicare Part D claims

2,908 4% vs specialty avg

2023 prescription claims

Specialty avg: 3,033

MIPS final score

95.1126/100 12.012600000000006% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Virginia

How Cardiovascular Disease Physician compares to other specialties among Virginia providers

Virginia providers

Cardiovascular Disease Physician share within Virginia

1. Cardiovascular Disease Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Cardiovascular Disease Physician share within Virginia

Medicare quality performance — MIPS

DONNA BALGAVY, NP's 2023 MIPS final score plotted against the Cardiovascular Disease Physician national average

High performer (top quartile)
MIPS Final Score
95.1126/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Cardiovascular Disease Physician) — 95.1126/100 vs national avg 83.1

0%100%National avg83%95.1%
MIPS final score (Cardiovascular Disease Physician) — 95.1126/100 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).

DONNA BALGAVY, NP is a Cardiovascular Disease Physician provider practicing in NORFOLK, Virginia, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: NP. NPI: 1659381697. 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.

DONNA BALGAVY, NP appears in the CMS NPPES registry as a Cardiovascular Disease Physician provider holding NP credentials at 100 KINGSLEY LN, NORFOLK, VA, 23505, with a listed phone of (757) 889-5351. NPI 1659381697 was issued on 08/09/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BALGAVY 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 2,908 prescription claims written by this provider, covering 673 Medicare beneficiaries and totaling roughly $459K in drug spend, split 15% brand-name and 85% 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 95.1126/100 for the 2023 performance year (Quality 86.3184), compared with the national average of 83.1.

Cardiovascular Disease Physician is a mid-sized specialty nationwide, with 24,795 enrolled providers across 54 states and an average of 3,033 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

100 KINGSLEY LN
NORFOLK, VA 23505

Provider Details

NPI 1659381697
Specialty Cardiovascular Disease Physician
Credentials NP
Gender Female
NPI Issued 08/09/2006

CMS Quality Score (MIPS)

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

95.1126
Final Score
Avg: 83.1
86.3184
Quality
100
Promoting Interoperability

Reporting: Alternative Payment Model

Hospital and facility affiliations

Facilities where DONNA BALGAVY, NP 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.

SENTARA MEDICAL GROUP
VIRGINIA BEACH, VA

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

Brand vs generic prescribing mix · Typical

DONNA BALGAVY, NP — brand share 15.0%
Specialty average (est.)

15% brand-name claims vs 85% generic, on 2,908 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.

2,908
Total Claims
$459K
Total Drug Cost
673
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
7,531
Total Day Supply
224,284
Brand vs Generic
15% brand / 85% generic
Brand Drug Cost
$402K
Generic Drug Cost
$57K

Patient Demographics

Average Patient Age
75.4 years
Avg HCC Risk Score
1.73
Gender Split
49% female / 51% male
Age Distribution
<65: 46, 65-74: 257, 75-84: 276, 85+: 94

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Eliquis
Apixaban
251
Metoprolol Succinate
242
Carvedilol
191
Atorvastatin Calcium
179
Furosemide
178
Amlodipine Besylate
176
Losartan Potassium
168
Metoprolol Tartrate
165
Hydralazine Hcl
125
Lisinopril
124

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

Cardiovascular Disease Physician Overview

How DONNA BALGAVY, NP fits within the Cardiovascular Disease Physician landscape nationally.

24,795
Cardiovascular Disease Physician Providers in US
54
States with Cardiovascular Disease Physician
3,033
Avg Claims per Provider

DONNA BALGAVY, NP's 2,908 claims are below the specialty average of 3,033.

Nearby Cardiovascular Disease Physician Providers in Virginia

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

Compare Cardiovascular Disease Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is DONNA BALGAVY, NP's specialty?
DONNA BALGAVY, NP specializes in Cardiovascular Disease Physician and practices in NORFOLK, Virginia. Credentials: NP.
How much does DONNA BALGAVY, NP prescribe under Medicare Part D?
In 2023, DONNA BALGAVY, NP wrote 2,908 Medicare Part D claims totaling $459K in drug costs for 673 beneficiaries.
What is DONNA BALGAVY, NP's Medicare quality score?
DONNA BALGAVY, NP has a CMS MIPS Final Score of 95.1126/100 (Quality: 86.3184). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is DONNA BALGAVY, NP located?
DONNA BALGAVY, NP is located at 100 KINGSLEY LN, NORFOLK, VA, 23505. Phone: (757) 889-5351.
What is DONNA BALGAVY, NP's NPI number?
DONNA BALGAVY, NP's National Provider Identifier (NPI) is 1659381697, issued on 08/09/2006.
Does DONNA BALGAVY, NP prescribe more brand-name or generic drugs?
DONNA BALGAVY, NP's prescribing is 15% brand-name and 85% generic drugs by claim count, with $402K in brand drug costs.
How many Cardiovascular Disease Physician providers are there in the US?
There are 24,795 Cardiovascular Disease Physician providers across 54 states in the US. The average Cardiovascular Disease Physician provider writes 3,033 Medicare Part D claims per year.
What drugs does DONNA BALGAVY, NP prescribe most often?
Based on 2023 Medicare Part D data, DONNA BALGAVY, NP's most frequently prescribed drugs include Eliquis, Metoprolol Succinate, Carvedilol. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does DONNA BALGAVY, NP accept Medicare?
DONNA BALGAVY, NP appears in CMS Medicare data with 2,908 Part D claims and 673 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify DONNA BALGAVY, NP's credentials?
DONNA BALGAVY, NP's NPI is 1659381697 with credentials NP. 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