2026 NPPES data Student in an Organized Health Care Education/Training Program NPI 1104050954 MD
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ERIN O'TOOL, MD

Student in an Organized Health Care Education/Training Program in OAK CREEK, Wisconsin. 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
7K
Medicare Part D claims · 453 beneficiaries · Student in an Organized Health Care Education/Training Program avg: 459
Generic prescribing
84%
generic claims · 16% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
82.3961/100
▼ 1 pts below national avg 83.1 · [object Object]
Industry payments
$18.64
1 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

ERIN O'TOOL, MD reported a CMS MIPS final score of 82.3961/100 — below the 83.1 national average — and filed 6,745 Medicare Part D claims in 2023.

82.3961/100
MIPS score · -1 vs avg
7K
Part D claims, 2023
84%
generic prescribing
$18.64
industry payments (Sunshine Act)

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.

ERIN O'TOOL, MD's MIPS score vs every scored U.S. clinician

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

82 39th percentile higher than 39% 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

What does the federal data show about ERIN O'TOOL, MD?

Near national average

NPI registry status

Active

Issued 05/08/2009

NPI 1104050954

Primary specialty

Student in an Organized Health Care Education/Training Program

High-volume

331,761 US NPIs in this specialty

Medicare Part D claims

6,745 1369% vs specialty avg

2023 prescription claims

Specialty avg: 459

MIPS final score

82.3961/100 0.7038999999999902% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in Wisconsin

How Student in an Organized Health Care Education/Training Program compares to other specialties among Wisconsin providers

Wisconsin providers

Student in an Organized Health Care Education/Training Program share within Wisconsin

1. Student in an Organized Health Care Education/Training Program42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Student in an Organized Health Care Education/Training Program share within Wisconsin

Medicare quality performance — MIPS

ERIN O'TOOL, MD's 2023 MIPS final score plotted against the Student in an Organized Health Care Education/Training Program national average

Near national average
MIPS Final Score
82.3961/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Student in an Organized Health Care Education/Training Program) — 82.3961/100 vs national avg 83.1

0%100%National avg83%82.4%
MIPS final score (Student in an Organized Health Care Education/Training Program) — 82.3961/100 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).

ERIN O'TOOL, MD appears in the CMS NPPES registry as a Student in an Organized Health Care Education/Training Program provider holding MD credentials at 8825 S HOWELL AVE, OAK CREEK, WI, 53154, with a listed phone of (414) 647-3920. NPI 1104050954 was issued on 05/08/2009. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what O'TOOL 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 6,745 prescription claims written by this provider, covering 453 Medicare beneficiaries and totaling roughly $848K in drug spend, split 16% brand-name and 84% generic by claim count, with an opioid prescribing rate of 2.1%. 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 82.3961/100 for the 2023 performance year (Quality 77.8816, Cost 74.3833), compared with the national average of 83.1.

Student in an Organized Health Care Education/Training Program is a high-volume specialty nationwide, with 331,761 enrolled providers across 55 states and an average of 459 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

8825 S HOWELL AVE
OAK CREEK, WI 53154

Provider Details

NPI 1104050954
Specialty Student in an Organized Health Care Education/Training Program
Credentials MD
Gender Male
NPI Issued 05/08/2009

CMS Quality Score (MIPS)

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

82.3961
Final Score
Avg: 83.1
77.8816
Quality
74.3833
Cost
81
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where ERIN O'TOOL, 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.

ASCENSION MEDICAL GROUP-SOUTHEAST WISCONSIN INC
WAUWATOSA, WI

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 ERIN O'TOOL, MD. Source: openpaymentsdata.cms.gov.

Total received

$19

Largest payer

AstraZeneca Pharmaceuticals LP

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.

Brand vs generic prescribing mix · Typical

ERIN O'TOOL, MD — brand share 16.0%
Specialty average (est.)

16% brand-name claims vs 84% generic, on 6,745 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.

6,745
Total Claims
$848K
Total Drug Cost
453
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
14,939
Total Day Supply
439,844
Brand vs Generic
16% brand / 84% generic
Brand Drug Cost
$678K
Generic Drug Cost
$155K
Opioid Claims
139 (2.1% rate)
Antibiotic Claims
32

Patient Demographics

Average Patient Age
72.2 years
Avg HCC Risk Score
1.22
Gender Split
48% female / 52% male
Age Distribution
<65: 51, 65-74: 228, 75-84: 139, 85+: 35

Top Prescribed Drugs (Medicare Part D)

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

What ERIN O'TOOL, 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
Atorvastatin Calcium
634
Lisinopril
348
Amlodipine Besylate
239
Metformin Hcl
218
Losartan Potassium
207
Gabapentin
192
Levothyroxine Sodium
190
Hydrochlorothiazide
170
Omeprazole
156
Sertraline Hcl
137

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

Student in an Organized Health Care Education/Training Program Overview

How ERIN O'TOOL, MD fits within the Student in an Organized Health Care Education/Training Program landscape nationally.

331,761
Student in an Organized Health Care Education/Training Program Providers in US
55
States with Student in an Organized Health Care Education/Training Program
459
Avg Claims per Provider

ERIN O'TOOL, MD's 6,745 claims are above the specialty average of 459.

Nearby Student in an Organized Health Care Education/Training Program Providers in Wisconsin

Other clinicians with the same primary specialty enrolled in Wisconsin, drawn from the same CMS NPPES roster as O'TOOL.

Compare Student in an Organized Health Care Education/Training Program nationally: see state-by-state distribution →

Frequently Asked Questions

What is ERIN O'TOOL, MD's specialty?
ERIN O'TOOL, MD specializes in Student in an Organized Health Care Education/Training Program and practices in OAK CREEK, Wisconsin. Credentials: MD.
How much does ERIN O'TOOL, MD prescribe under Medicare Part D?
In 2023, ERIN O'TOOL, MD wrote 6,745 Medicare Part D claims totaling $848K in drug costs for 453 beneficiaries.
What is ERIN O'TOOL, MD's Medicare quality score?
ERIN O'TOOL, MD has a CMS MIPS Final Score of 82.3961/100 (Quality: 77.8816, Cost: 74.3833). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is ERIN O'TOOL, MD located?
ERIN O'TOOL, MD is located at 8825 S HOWELL AVE, OAK CREEK, WI, 53154. Phone: (414) 647-3920.
What is ERIN O'TOOL, MD's NPI number?
ERIN O'TOOL, MD's National Provider Identifier (NPI) is 1104050954, issued on 05/08/2009.
Does ERIN O'TOOL, MD prescribe more brand-name or generic drugs?
ERIN O'TOOL, MD's prescribing is 16% brand-name and 84% generic drugs by claim count, with $678K in brand drug costs.
Does ERIN O'TOOL, MD prescribe opioids?
Yes, ERIN O'TOOL, MD had 139 opioid claims in 2023 with an opioid prescribing rate of 2.1%.
How many Student in an Organized Health Care Education/Training Program providers are there in the US?
There are 331,761 Student in an Organized Health Care Education/Training Program providers across 55 states in the US. The average Student in an Organized Health Care Education/Training Program provider writes 459 Medicare Part D claims per year.
What drugs does ERIN O'TOOL, MD prescribe most often?
Based on 2023 Medicare Part D data, ERIN O'TOOL, MD's most frequently prescribed drugs include Atorvastatin Calcium, Lisinopril, Amlodipine Besylate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does ERIN O'TOOL, MD accept Medicare?
ERIN O'TOOL, MD appears in CMS Medicare data with 6,745 Part D claims and 453 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify ERIN O'TOOL, MD's credentials?
ERIN O'TOOL, MD's NPI is 1104050954 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