ERNESTO AGBAYANI, M.D.
Family Medicine Physician in MARTINSBURG, West Virginia. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.
What stands out: ERNESTO AGBAYANI, M.D. filed 4,579 Medicare Part D claims in 2023 across MARTINSBURG, West Virginia. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.
ERNESTO AGBAYANI, M.D. practices in an ABMS-board-eligible specialty but we don't have enough CMS-participation signals to confirm active board-certified status. Consult CertificationMatters.org (the official ABMS public lookup).
ERNESTO AGBAYANI, M.D. at a glance
Quality data not reportedPrimary specialty
Medicare Part D claims
Specialty distribution in West Virginia
How Family Medicine Physician compares to other specialties among West Virginia providers
Family Medicine Physician share within West Virginia
Family Medicine Physician is one of the more visible NUCC categories in West Virginia
Each bar reflects the share of in-state providers whose primary NUCC taxonomy matches the specialty. Long tail of ~690 NUCC codes folded into "Other" to keep the comparison legible.
Specialty board-certification context
Estimated specialty board-certified rate — Family Medicine Physician (ABMS / AOA reference)
- Est. board-certified rate
- 78%
- Family Medicine Physician ABMS/AOA estimate
Est. board-certified rate (Family Medicine Physician) — ABMS / AOA estimate
Verify credentials
- Verify via ABMS free public lookup
- Verify via AOA osteopathic boards
- Specialty volume Family Medicine Physician US NPIs
Specialty board-certified rate — Family Medicine Physician estimate
Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus Maintenance of Certification cycles. CMS does not publish a per-provider board-certification field; the figure shown is the specialty-level estimated rate from ABMS / AOA reference data.
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).
ERNESTO AGBAYANI, M.D. is a Family Medicine Physician provider practicing in MARTINSBURG, West Virginia, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: M.D.. NPI: 1497778427. 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.
ERNESTO AGBAYANI, M.D. appears in the CMS NPPES registry as a Family Medicine Physician provider holding M.D. credentials at 155 HEALTH CARE LN, MARTINSBURG, WV, 25401, with a listed phone of (304) 596-6911. NPI 1497778427 was issued on 07/25/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what AGBAYANI 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 4,579 prescription claims written by this provider, covering 360 Medicare beneficiaries and totaling roughly $401K in drug spend, split 12% brand-name and 88% generic by claim count, with an opioid prescribing rate of 0.5%. 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.
Family Medicine Physician is a high-volume specialty nationwide, with 147,640 enrolled providers across 56 states and an average of 3,418 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
Provider Details
| NPI | 1497778427 |
|---|---|
| Specialty | Family Medicine Physician |
| Credentials | M.D. |
| Gender | Male |
| NPI Issued | 07/25/2006 |
Verify this provider's license
PlainDoctor pulls this profile from the CMS NPPES public registry. Confirm ERNESTO AGBAYANI, M.D.'s current license status, disciplinary history, and board certifications with the West Virginia Board of Medicine in West Virginia before relying on this page for a clinical or care decision.
How we sourced this profile
Brand vs generic prescribing mix · Typical
12% brand-name claims vs 88% generic, on 4,579 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.
Prescribing Breakdown
- 30-Day Fills
- 10,738
- Total Day Supply
- 316,074
- Brand vs Generic
- 12% brand / 88% generic
- Brand Drug Cost
- $336K
- Generic Drug Cost
- $63K
- Opioid Claims
- 25 (0.5% rate)
- Antibiotic Claims
- 56
Patient Demographics
- Average Patient Age
- 74.5 years
- Avg HCC Risk Score
- 0.99
- Gender Split
- 54% female / 46% male
- Age Distribution
- <65: 28, 65-74: 164, 75-84: 115, 85+: 53
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
| Drug | Claims |
|---|---|
| Levothyroxine Sodium | 263 |
| Amlodipine Besylate | 252 |
| Atorvastatin Calcium | 223 |
| Hydrochlorothiazide | 219 |
| Rosuvastatin Calcium | 188 |
| Losartan Potassium | 172 |
| Lisinopril | 116 |
| Albuterol Sulfate Hfa Albuterol Sulfate | 110 |
| Metoprolol Succinate | 94 |
| Metformin Hcl Er Metformin Hcl | 92 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Family Medicine Physician Overview
How ERNESTO AGBAYANI, M.D. fits within the Family Medicine Physician landscape nationally.
ERNESTO AGBAYANI, M.D.'s 4,579 claims are above the specialty average of 3,418.
Nearby Family Medicine Physician Providers in West Virginia
Other clinicians with the same primary specialty enrolled in West Virginia, drawn from the same CMS NPPES roster as AGBAYANI.
Compare Family Medicine Physician nationally: see state-by-state distribution →
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Frequently Asked Questions
What is ERNESTO AGBAYANI, M.D.'s specialty? ▼
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What is ERNESTO AGBAYANI, M.D.'s NPI number? ▼
Does ERNESTO AGBAYANI, M.D. prescribe more brand-name or generic drugs? ▼
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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.
- 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