PlainDoctor

2026 NPPES data Family Medicine Physician NPI 1194755843
Verify on CMS →

Elizabeth Heredia

Family Medicine Physician in St Charles, 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 147,760 in Family Medicine 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
2K
Medicare Part D claims · 253 beneficiaries · Family Medicine Physician avg: 3K
Generic prescribing
91%
generic claims · 8% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
94.1/100
▲ 11 pts above national avg 83.5 · Exceptional
Verify NPI on CMS Methodology
Compiled from official public sources by the editorial process.

What the federal data shows

Elizabeth Heredia reported a CMS MIPS final score of 94.1/100 - above the 83.5 national average - and filed 2,171 Medicare Part D claims in 2023.

94.1/100
MIPS score · +11 vs avg
2K
Part D claims, 2023
91%
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.

CMS NPPES provider registry desk

NPI 1194755843 · Family Medicine Physician

NPI-10 · ENUM-LEGACY · TAX-MEGA · MIPS-ELITE · RX-MID · BOOK-MID · PHOTO-FINISH

  • NPI-10 1194755843
  • ENUM-LEGACY 2006
  • TAX-MEGA 148K Family Medicine
  • MIPS-ELITE 94.1/100
  • RX-MID 2,171
  • BOOK-MID 5,817 in Illinois
  • PHOTO-FINISH James Carsten · ±0.0

MIPS final-score neighbourhood

Same-specialty nationwide peers by CMS final score, not geographic proximity

MIPS pts

What this shows Nearest measured MIPS peers for this NUCC specialty (2023 performance year).

Source CMS Quality Payment Program (MIPS) As of 2023

Elizabeth Heredia's MIPS score vs every measured U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure. Clinicians whose score CMS assigned without scoring any category are excluded.

94 ≥ 73rd percentile 73% of 454,083 measured providers are in lower value bands

0–10: 8,684 measured providers (2%). Below this entry. 10–20: 3,008 measured providers (1%). Below this entry. 20–30: 3,069 measured providers (1%). Below this entry. 30–40: 2,746 measured providers (1%). Below this entry. 40–50: 2,928 measured providers (1%). Below this entry. 50–60: 5,882 measured providers (1%). Below this entry. 60–70: 13,906 measured providers (3%). Below this entry. 70–80: 94,570 measured providers (21%). Below this entry. 80–90: 129,887 measured providers (29%). Below this entry. 90+: 189,403 measured providers (42%). This entry sits in this band. This provider 0 100 every measured MIPS clinician, bucketed by value

Each bar is a band; taller bars hold more measured 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.

The percentile is a conservative whole-score-point band: it counts only measured clinicians in lower score bands. A CMS MIPS metric is not a recommendation or a clinical-quality rating by PlainDoctor. See methodology § corpus placement.

Source CMS Merit-based Incentive Payment System (MIPS) · 2023

Where Elizabeth Heredia sits

This provider among family medicine physician peers

Across the 21,266 family medicine physician providers who report both Medicare Part D prescribing and a MIPS quality score, Elizabeth Heredia writes more Part D claims than 47% of them and scores higher on MIPS quality than 74% - placing this provider in the lower-volume, high-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.

Lower volume · High qualityHigh volume · High qualityLower volume · Lower qualityHigh volume · Lower quality02550751000255075100Part D claim volume, percentile in specialtyMIPS quality, percentilePoint, Part D claim volume, percentile in specialty: 92 · MIPS quality, percentile: 82Point, Part D claim volume, percentile in specialty: 68 · MIPS quality, percentile: 45Point, Part D claim volume, percentile in specialty: 17 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 65 · MIPS quality, percentile: 58Point, Part D claim volume, percentile in specialty: 42 · MIPS quality, percentile: 77Point, Part D claim volume, percentile in specialty: 22 · MIPS quality, percentile: 33Point, Part D claim volume, percentile in specialty: 3 · MIPS quality, percentile: 80Point, Part D claim volume, percentile in specialty: 27 · MIPS quality, percentile: 90Point, Part D claim volume, percentile in specialty: 5 · MIPS quality, percentile: 37Point, Part D claim volume, percentile in specialty: 7 · MIPS quality, percentile: 92Point, Part D claim volume, percentile in specialty: 70 · MIPS quality, percentile: 62Point, Part D claim volume, percentile in specialty: 63 · MIPS quality, percentile: 57Point, Part D claim volume, percentile in specialty: 32 · MIPS quality, percentile: 40Point, Part D claim volume, percentile in specialty: 20 · MIPS quality, percentile: 20Point, Part D claim volume, percentile in specialty: 72 · MIPS quality, percentile: 13Point, Part D claim volume, percentile in specialty: 12 · MIPS quality, percentile: 98Point, Part D claim volume, percentile in specialty: 62 · MIPS quality, percentile: 18Point, Part D claim volume, percentile in specialty: 37 · MIPS quality, percentile: 12Point, Part D claim volume, percentile in specialty: 43 · MIPS quality, percentile: 32Point, Part D claim volume, percentile in specialty: 18 · MIPS quality, percentile: 42Point, Part D claim volume, percentile in specialty: 77 · MIPS quality, percentile: 10Point, Part D claim volume, percentile in specialty: 23 · MIPS quality, percentile: 70Point, Part D claim volume, percentile in specialty: 2 · MIPS quality, percentile: 15Point, Part D claim volume, percentile in specialty: 10 · MIPS quality, percentile: 2Point, Part D claim volume, percentile in specialty: 53 · MIPS quality, percentile: 8Point, Part D claim volume, percentile in specialty: 82 · MIPS quality, percentile: 73Point, Part D claim volume, percentile in specialty: 87 · MIPS quality, percentile: 87Point, Part D claim volume, percentile in specialty: 88 · MIPS quality, percentile: 3Point, Part D claim volume, percentile in specialty: 33 · MIPS quality, percentile: 92Point, Part D claim volume, percentile in specialty: 13 · MIPS quality, percentile: 38Point, Part D claim volume, percentile in specialty: 83 · MIPS quality, percentile: 23Point, Part D claim volume, percentile in specialty: 85 · MIPS quality, percentile: 97Point, Part D claim volume, percentile in specialty: 98 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 27 · MIPS quality, percentile: 48Point, Part D claim volume, percentile in specialty: 48 · MIPS quality, percentile: 78Point, Part D claim volume, percentile in specialty: 50 · MIPS quality, percentile: 5Point, Part D claim volume, percentile in specialty: 93 · MIPS quality, percentile: 60Point, Part D claim volume, percentile in specialty: 90 · MIPS quality, percentile: 25Point, Part D claim volume, percentile in specialty: 55 · MIPS quality, percentile: 28Point, Part D claim volume, percentile in specialty: 97 · MIPS quality, percentile: 22Point, Part D claim volume, percentile in specialty: 67 · MIPS quality, percentile: 48Point, Part D claim volume, percentile in specialty: 8 · MIPS quality, percentile: 15Point, Part D claim volume, percentile in specialty: 75 · MIPS quality, percentile: 47Point, Part D claim volume, percentile in specialty: 40 · MIPS quality, percentile: 30Point, Part D claim volume, percentile in specialty: 25 · MIPS quality, percentile: 7Point, Part D claim volume, percentile in specialty: 15 · MIPS quality, percentile: 27Point, Part D claim volume, percentile in specialty: 45 · MIPS quality, percentile: 43Point, Part D claim volume, percentile in specialty: 30 · MIPS quality, percentile: 82Point, Part D claim volume, percentile in specialty: 100 · MIPS quality, percentile: 98Point, Part D claim volume, percentile in specialty: 38 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 0 · MIPS quality, percentile: 73Point, Part D claim volume, percentile in specialty: 80 · MIPS quality, percentile: 48Point, Part D claim volume, percentile in specialty: 52 · MIPS quality, percentile: 53Point, Part D claim volume, percentile in specialty: 60 · MIPS quality, percentile: 85Point, Part D claim volume, percentile in specialty: 57 · MIPS quality, percentile: 62Point, Part D claim volume, percentile in specialty: 73 · MIPS quality, percentile: 87Point, Part D claim volume, percentile in specialty: 78 · MIPS quality, percentile: 55Point, Part D claim volume, percentile in specialty: 35 · MIPS quality, percentile: 65Point, Part D claim volume, percentile in specialty: 95 · MIPS quality, percentile: 92Point, Part D claim volume, percentile in specialty: 47 · MIPS quality, percentile: 35Elizabeth Heredia, Part D claim volume, percentile in specialty: 47 · MIPS quality, percentile: 74
Part D claim volume vs MIPS quality, by specialty percentile

Each dot is one family medicine physician peer from a representative sample of 60; the gold marker is Elizabeth Heredia. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.

✓
Board certification likely (heuristic, not verified)

Elizabeth Heredia 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 Elizabeth Heredia?

High performer (top quartile)

NPI registry status

Active

Issued 07/04/2006

NPI 1194755843

Primary specialty

Family Medicine Physician

High-volume

147,760 US NPIs in this specialty

Medicare Part D claims

2,171 36% vs specialty avg

2023 prescription claims

Specialty avg: 3,418

MIPS final score

94.1/100 10.6 pts vs avg

Exceptional band

vs 83.5 national avg

Specialty distribution in Illinois

How Family Medicine Physician compares to other specialties among Illinois providers

Illinois providers
Clinical Social Worker5.2%Physical Therapist5%Mental Health Counselor4.5%Speech-Language Pathologist4.2%Student in an Organized Heal…4.2%Pharmacist4.1%Family Medicine Physician2.5%
Largest specialties in Illinois (% of in-state providers)

Medicare quality performance, MIPS

Elizabeth Heredia's 2023 MIPS final score plotted against the Family Medicine Physician national average

High performer (top quartile)
MIPS Final Score
94.1/100
vs 83.5 national avg · 2023 performance year
0%100%National avg84%94.1%
MIPS final score (Family Medicine Physician) - 94.1/100 vs national avg 83.5
How MIPS and board certification work

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).

Practice Address

2900 FOXFIELD RD
St Charles, IL 60174
(630) 377-7900

Provider Details

NPI 1194755843
Specialty Family Medicine Physician
Gender Female
NPI Issued 07/04/2006

CMS Quality Score (MIPS)

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

94.1036
Final Score
Measured-score avg: 83.5
82.5938
Quality
100
Promoting Interoperability

Reporting: Alternative Payment Model

Hospital and facility affiliations

Facilities where Elizabeth Heredia 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.

Central Dupage Physician Group
Wheaton, IL
Northwestern Medical Faculty Foundation
Bloomingdale, 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 Elizabeth Heredia. To verify Elizabeth Heredia'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 · Generic-heavy

Elizabeth Heredia - brand share 8.0%
Family Medicine Physician average

8% brand-name claims vs 91% generic, on 2,171 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.

2,171
Total Claims
$96K
Total Drug Cost
253
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
5,454
Total Day Supply
158,643
Brand vs Generic
8% brand / 91% generic
Brand Drug Cost
$55K
Generic Drug Cost
$40K
Opioid Claims
12 (0.6% rate)
Antibiotic Claims
24

Patient Demographics

Average Patient Age
73.0 years
Avg HCC Risk Score
0.86
Gender Split
87% female / 13% male

Top Prescribed Drugs (Medicare Part D)

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

What Elizabeth Heredia 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
Atorvastatin Calcium
 157
Levothyroxine Sodium
 154
Lisinopril
 114
Hydrochlorothiazide
 93
Amlodipine Besylate
 89
Rosuvastatin Calcium
 72
Metformin Hcl Er
Metformin Hcl
66
Alprazolam
 65
Escitalopram Oxalate
 62
Pantoprazole Sodium
 61

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

More Family Medicine Physician in IL → All providers in Illinois → Compare specialties →

Family Medicine Physician Overview

How Elizabeth Heredia fits within the Family Medicine Physician landscape nationally.

147,760
Family Medicine Physician Providers in US
56
States with Family Medicine Physician
3,418
Avg Claims per Provider

Elizabeth Heredia's 2,171 claims are below the specialty average of 3,418.

Nationwide Family Medicine Physician peers with similar MIPS or enrollment year

Two federal-record peer sets for Heredia, both outside Illinois so the neighborhoods are not geographic containment.

Similar MIPS final score

Nearest same-specialty clinicians by CMS MIPS final score (94.1 here).

James Carsten 94.1 TN Yael Horvath 94.1 PA Konstantinos Papadopoulos 94.1 PA Rakesh Patel 94.1 AZ

Same NPPES enumeration year (2006)

Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.

Brendella Montgomery Madison, AL David Civalier Redding, CA Kevin O'Connell Wausau, WI James Carsten Ooltewah, TN

Nearby Family Medicine Physician Providers in Illinois

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

One of 5,817 Family Medicine Physician providers enrolled in Illinois, 5 are shown here.

Dr. Jon Aagaard
MD
Wheaton, IL
Dr. Napoleon Abando
MD
Woodstock, IL
Dr. Nikka Abaricia
MD
Chicago, IL
Mohemmed Abbas
Chicago, IL
Muhammad Abbas
Alton, IL

Compare Family Medicine Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is Elizabeth Heredia's specialty? ▼
Elizabeth Heredia specializes in Family Medicine Physician and practices in St Charles, Illinois.
How much does Elizabeth Heredia prescribe under Medicare Part D? ▼
In 2023, Elizabeth Heredia wrote 2,171 Medicare Part D claims totaling $96K in drug costs for 253 beneficiaries.
What is Elizabeth Heredia's Medicare quality score? ▼
Elizabeth Heredia has a CMS MIPS Final Score of 94.1/100 (Quality: 82.6). The average MIPS Final Score across the 454,083 clinicians with at least one published category score is 83.5; clinicians whose score CMS assigned without scoring any category are excluded from that average. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Elizabeth Heredia located? ▼
Elizabeth Heredia is located at 2900 FOXFIELD RD, St Charles, IL, 60174. Phone: (630) 377-7900.
What is Elizabeth Heredia's NPI number? ▼
Elizabeth Heredia's National Provider Identifier (NPI) is 1194755843, issued on 07/04/2006.
Does Elizabeth Heredia prescribe more brand-name or generic drugs? ▼
Elizabeth Heredia's prescribing is 8% brand-name and 91% generic drugs by claim count, with $55K in brand drug costs.
Does Elizabeth Heredia prescribe opioids? ▼
Yes, Elizabeth Heredia had 12 opioid claims in 2023 with an opioid prescribing rate of 0.6%.
How many Family Medicine Physician providers are there in the US? ▼
There are 147,760 Family Medicine Physician providers across 56 states in the US. The average Family Medicine Physician provider writes 3,418 Medicare Part D claims per year.
What drugs does Elizabeth Heredia prescribe most often? ▼
Based on 2023 Medicare Part D data, Elizabeth Heredia's most frequently prescribed drugs include Atorvastatin Calcium, Levothyroxine Sodium, Lisinopril. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Elizabeth Heredia accept Medicare? ▼
Elizabeth Heredia appears in CMS Medicare data with 2,171 Part D claims and 253 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Elizabeth Heredia's credentials? ▼
Elizabeth Heredia's NPI is 1194755843. 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

View source datasets and methodology notes
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 editorial process.

Every figure on PlainDoctor is rendered directly from the federal CMS NPPES registry, Medicare Part D, MIPS, and Open Payments records, no number is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of May 2026.