2026 NPPES data Rheumatology Physician NPI 1598731200 MD
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ELENA BARNES, MD

Rheumatology Physician in MELBOURNE, Florida. 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
4K
Medicare Part D claims · 687 beneficiaries · Rheumatology Physician avg: 2K
MIPS score
85.3855/100
▲ 2 pts above national avg 83.1 · [object Object]
Industry payments
$6.8K
5 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

ELENA BARNES, MD reported a CMS MIPS final score of 85.3855/100 — above the 83.1 national average — and filed 4,021 Medicare Part D claims in 2023.

85.3855/100
MIPS score · +2 vs avg
4K
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.

ELENA BARNES, MD's MIPS score vs every scored U.S. clinician

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

85 49th percentile higher than 49% 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. 90–100: 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

Board certification likely (heuristic — not verified)

ELENA BARNES, 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 ELENA BARNES, MD?

High performer (top quartile)

NPI registry status

Active

Issued 02/23/2006

NPI 1598731200

Primary specialty

Rheumatology Physician

Mid-sized

6,181 US NPIs in this specialty

Medicare Part D claims

4,021 96% vs specialty avg

2023 prescription claims

Specialty avg: 2,054

MIPS final score

85.3855/100 2.285499999999999% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in Florida

How Rheumatology Physician compares to other specialties among Florida providers

Florida providers

Rheumatology Physician share within Florida

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

Medicare quality performance — MIPS

ELENA BARNES, MD's 2023 MIPS final score plotted against the Rheumatology Physician national average

High performer (top quartile)
MIPS Final Score
85.3855/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Rheumatology Physician) — 85.3855/100 vs national avg 83.1

0%100%National avg83%85.4%
MIPS final score (Rheumatology Physician) — 85.3855/100 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).

ELENA BARNES, MD appears in the CMS NPPES registry as a Rheumatology Physician provider holding MD credentials at 1223 GATEWAY DR STE 2H, MELBOURNE, FL, 32901, with a listed phone of (321) 361-5632. NPI 1598731200 was issued on 02/23/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BARNES 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 4,021 prescription claims written by this provider, covering 687 Medicare beneficiaries and totaling roughly $3.6 million in drug spend, with an opioid prescribing rate of 14.3%. 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 85.3855/100 for the 2023 performance year (Quality 81.653), compared with the national average of 83.1.

Rheumatology Physician is a mid-sized specialty nationwide, with 6,181 enrolled providers across 52 states and an average of 2,054 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

1223 GATEWAY DR STE 2H
MELBOURNE, FL 32901

Provider Details

NPI 1598731200
Specialty Rheumatology Physician
Credentials MD
Gender Female
NPI Issued 02/23/2006

CMS Quality Score (MIPS)

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

85.3855
Final Score
Avg: 83.1
81.653
Quality
78
Promoting Interoperability

Reporting: Alternative Payment Model

Hospital and facility affiliations

Facilities where ELENA BARNES, 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.

HEALTH FIRST MEDICAL GROUP, LLC
MELBOURNE, 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 ELENA BARNES, MD. Source: openpaymentsdata.cms.gov.

Total received

$6.8K

Largest payer

ABBVIE INC.

Most common payment type

Compensation for services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program

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 — Florida FLDOH 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 ~75K Florida medical licensees in 2023 — they are NOT specific to ELENA BARNES, MD. To verify ELENA BARNES, MD's current license status, search the FLDOH public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

480
Total board actions, Florida 2023
Across 467 cases
6.40
Actions per 1,000 licensees
Florida statewide rate
monetary fine
Most common action type
138 cases

FLDOH 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 Florida 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.

4,021
Total Claims
$3.6M
Total Drug Cost
687
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
8,581
Total Day Supply
253,036
Generic Drug Cost
$230K
Opioid Claims
575 (14.3% rate)
Antibiotic Claims
19

Patient Demographics

Average Patient Age
73.1 years
Avg HCC Risk Score
1.56
Gender Split
75% female / 25% male
Age Distribution
<65: 68, 65-74: 316, 75-84: 244, 85+: 59

Top Prescribed Drugs (Medicare Part D)

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

What ELENA BARNES, MD 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
Prednisone
558
Hydroxychloroquine Sulfate
505
Methotrexate
Methotrexate Sodium
399
Hydrocodone-Acetaminophen
Hydrocodone/Acetaminophen
283
Allopurinol
191
Oxycodone-Acetaminophen
Oxycodone Hcl/Acetaminophen
176
Gabapentin
99
Alendronate Sodium
86
Ibandronate Sodium
83
Methylprednisolone
79

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

Rheumatology Physician Overview

How ELENA BARNES, MD fits within the Rheumatology Physician landscape nationally.

6,181
Rheumatology Physician Providers in US
52
States with Rheumatology Physician
2,054
Avg Claims per Provider

ELENA BARNES, MD's 4,021 claims are above the specialty average of 2,054.

Nearby Rheumatology Physician Providers in Florida

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

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

Frequently Asked Questions

What is ELENA BARNES, MD's specialty?
ELENA BARNES, MD specializes in Rheumatology Physician and practices in MELBOURNE, Florida. Credentials: MD.
How much does ELENA BARNES, MD prescribe under Medicare Part D?
In 2023, ELENA BARNES, MD wrote 4,021 Medicare Part D claims totaling $3.6M in drug costs for 687 beneficiaries.
What is ELENA BARNES, MD's Medicare quality score?
ELENA BARNES, MD has a CMS MIPS Final Score of 85.3855/100 (Quality: 81.653). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is ELENA BARNES, MD located?
ELENA BARNES, MD is located at 1223 GATEWAY DR STE 2H, MELBOURNE, FL, 32901. Phone: (321) 361-5632.
What is ELENA BARNES, MD's NPI number?
ELENA BARNES, MD's National Provider Identifier (NPI) is 1598731200, issued on 02/23/2006.
Does ELENA BARNES, MD prescribe opioids?
Yes, ELENA BARNES, MD had 575 opioid claims in 2023 with an opioid prescribing rate of 14.3%.
How many Rheumatology Physician providers are there in the US?
There are 6,181 Rheumatology Physician providers across 52 states in the US. The average Rheumatology Physician provider writes 2,054 Medicare Part D claims per year.
What drugs does ELENA BARNES, MD prescribe most often?
Based on 2023 Medicare Part D data, ELENA BARNES, MD's most frequently prescribed drugs include Prednisone, Hydroxychloroquine Sulfate, Methotrexate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does ELENA BARNES, MD accept Medicare?
ELENA BARNES, MD appears in CMS Medicare data with 4,021 Part D claims and 687 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify ELENA BARNES, MD's credentials?
ELENA BARNES, MD's NPI is 1598731200 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

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