2026 NPPES data Nephrology Physician NPI 1629135470 M.D.
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ERNESTO BANALAGAY, M.D.

Nephrology Physician in PORTSMOUTH, Ohio. 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
695
Medicare Part D claims · 130 beneficiaries · Nephrology Physician avg: 1K
Generic prescribing
83%
generic claims · 17% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
94.6799/100
▲ 12 pts above national avg 83.1 · [object Object]
Industry payments
$119.67
11 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: ERNESTO BANALAGAY, M.D. is a Nephrology Physician ([object Object]) practicing in PORTSMOUTH, Ohio with a Medicare Part D prescribing footprint of 695 claims across 130 beneficiaries — 17% brand-name prescribing . Their CMS MIPS Final Score of 94.6799/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $119.67 across 11 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: ERNESTO BANALAGAY, M.D. reported a CMS MIPS final score of 94.6799 out of 100, above the 83.1 national average, and filed 695 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)

ERNESTO BANALAGAY, M.D. 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).

ERNESTO BANALAGAY, M.D. at a glance

High performer (top quartile)

NPI registry status

Active

Issued 01/02/2007

NPI 1629135470

Primary specialty

Nephrology Physician

Mid-sized

10,534 US NPIs in this specialty

Medicare Part D claims

695 52% vs specialty avg

2023 prescription claims

Specialty avg: 1,454

MIPS final score

94.6799/100 11.57990000000001% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Ohio

How Nephrology Physician compares to other specialties among Ohio providers

Ohio providers

Nephrology Physician share within Ohio

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

Medicare quality performance — MIPS

ERNESTO BANALAGAY, M.D.'s 2023 MIPS final score plotted against the Nephrology Physician national average

High performer (top quartile)
MIPS Final Score
94.6799/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Nephrology Physician) — 94.6799/100 vs national avg 83.1

0%100%National avg83%94.7%
MIPS final score (Nephrology Physician) — 94.6799/100 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).

ERNESTO BANALAGAY, M.D. is a Nephrology Physician provider practicing in PORTSMOUTH, Ohio, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: M.D.. NPI: 1629135470. 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 BANALAGAY, M.D. appears in the CMS NPPES registry as a Nephrology Physician provider holding M.D. credentials at 1711 27TH ST, PORTSMOUTH, OH, 45662, with a listed phone of (740) 356-5393. NPI 1629135470 was issued on 01/02/2007. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BANALAGAY 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 695 prescription claims written by this provider, covering 130 Medicare beneficiaries and totaling roughly $61K in drug spend, split 17% brand-name and 83% 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 94.6799/100 for the 2023 performance year (Quality 83.0018, Cost 72.017), compared with the national average of 83.1.

Nephrology Physician is a mid-sized specialty nationwide, with 10,534 enrolled providers across 55 states and an average of 1,454 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

1711 27TH ST
PORTSMOUTH, OH 45662

Provider Details

NPI 1629135470
Specialty Nephrology Physician
Credentials M.D.
Gender Male
NPI Issued 01/02/2007

CMS Quality Score (MIPS)

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

94.6799
Final Score
Avg: 83.1
83.0018
Quality
72.017
Cost

Reporting: Individual

Hospital and facility affiliations

Facilities where ERNESTO BANALAGAY, M.D. 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.

SOMC MEDICAL CARE FOUNDATION, INC.
PORTSMOUTH, OH

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 ERNESTO BANALAGAY, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$120

Largest payer

Travere Therapeutics, Inc.

Most common payment type

Education

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 — Ohio OMB 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 ~48K Ohio medical licensees in 2023 — they are NOT specific to ERNESTO BANALAGAY, M.D.. To verify ERNESTO BANALAGAY, M.D.'s current license status, search the OMB public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

158
Total board actions, Ohio 2023
Across 154 cases
3.29
Actions per 1,000 licensees
Ohio statewide rate
probation
Most common action type
56 cases

OMB 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 Ohio disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Typical

ERNESTO BANALAGAY, M.D. — brand share 17.0%
Specialty average (est.)

17% brand-name claims vs 83% generic, on 695 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.

695
Total Claims
$61K
Total Drug Cost
130
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
1,046
Total Day Supply
29,975
Brand vs Generic
17% brand / 83% generic
Brand Drug Cost
$36K
Generic Drug Cost
$25K

Patient Demographics

Average Patient Age
70.5 years
Avg HCC Risk Score
4.97
Gender Split
57% female / 43% male

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Sevelamer Carbonate
140
Calcitriol
90
Amlodipine Besylate
56
Hydralazine Hcl
55
Lisinopril
46
Furosemide
43
Lokelma
Sodium Zirconium Cyclosilicate
41
Calcium Acetate
36
Potassium Chloride
21
Pantoprazole Sodium
20

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

Nephrology Physician Overview

How ERNESTO BANALAGAY, M.D. fits within the Nephrology Physician landscape nationally.

10,534
Nephrology Physician Providers in US
55
States with Nephrology Physician
1,454
Avg Claims per Provider

ERNESTO BANALAGAY, M.D.'s 695 claims are below the specialty average of 1,454.

Nearby Nephrology Physician Providers in Ohio

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

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

Frequently Asked Questions

What is ERNESTO BANALAGAY, M.D.'s specialty?
ERNESTO BANALAGAY, M.D. specializes in Nephrology Physician and practices in PORTSMOUTH, Ohio. Credentials: M.D..
How much does ERNESTO BANALAGAY, M.D. prescribe under Medicare Part D?
In 2023, ERNESTO BANALAGAY, M.D. wrote 695 Medicare Part D claims totaling $61K in drug costs for 130 beneficiaries.
What is ERNESTO BANALAGAY, M.D.'s Medicare quality score?
ERNESTO BANALAGAY, M.D. has a CMS MIPS Final Score of 94.6799/100 (Quality: 83.0018, Cost: 72.017). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is ERNESTO BANALAGAY, M.D. located?
ERNESTO BANALAGAY, M.D. is located at 1711 27TH ST, PORTSMOUTH, OH, 45662. Phone: (740) 356-5393.
What is ERNESTO BANALAGAY, M.D.'s NPI number?
ERNESTO BANALAGAY, M.D.'s National Provider Identifier (NPI) is 1629135470, issued on 01/02/2007.
Does ERNESTO BANALAGAY, M.D. prescribe more brand-name or generic drugs?
ERNESTO BANALAGAY, M.D.'s prescribing is 17% brand-name and 83% generic drugs by claim count, with $36K in brand drug costs.
How many Nephrology Physician providers are there in the US?
There are 10,534 Nephrology Physician providers across 55 states in the US. The average Nephrology Physician provider writes 1,454 Medicare Part D claims per year.
What drugs does ERNESTO BANALAGAY, M.D. prescribe most often?
Based on 2023 Medicare Part D data, ERNESTO BANALAGAY, M.D.'s most frequently prescribed drugs include Sevelamer Carbonate, Calcitriol, Amlodipine Besylate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does ERNESTO BANALAGAY, M.D. accept Medicare?
ERNESTO BANALAGAY, M.D. appears in CMS Medicare data with 695 Part D claims and 130 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify ERNESTO BANALAGAY, M.D.'s credentials?
ERNESTO BANALAGAY, M.D.'s NPI is 1629135470 with credentials M.D.. 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