2026 NPPES data Ophthalmology Physician NPI 1538113865 MD
Verify on CMS →

FRANK BALOH, MD

Ophthalmology Physician in ALLENTOWN, Pennsylvania. 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
1K
Medicare Part D claims · 723 beneficiaries · Ophthalmology Physician avg: 1K
Generic prescribing
75%
generic claims · 25% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
100/100
▲ 17 pts above national avg 83.1 · [object Object]
Industry payments
$52.86
2 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: FRANK BALOH, MD is a Ophthalmology Physician ([object Object]) practicing in ALLENTOWN, Pennsylvania with a Medicare Part D prescribing footprint of 1K claims across 723 beneficiaries — 25% brand-name prescribing . Their CMS MIPS Final Score of 100/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $52.86 across 2 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: FRANK BALOH, MD reported a CMS MIPS final score of 100 out of 100, above the 83.1 national average, and filed 1,365 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)

FRANK BALOH, MD 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).

FRANK BALOH, MD at a glance

High performer (top quartile)

NPI registry status

Active

Issued 05/20/2006

NPI 1538113865

Primary specialty

Ophthalmology Physician

Mid-sized

22,090 US NPIs in this specialty

Medicare Part D claims

1,365 4% vs specialty avg

2023 prescription claims

Specialty avg: 1,420

MIPS final score

100/100 16.900000000000006% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Pennsylvania

How Ophthalmology Physician compares to other specialties among Pennsylvania providers

Pennsylvania providers

Ophthalmology Physician share within Pennsylvania

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

Medicare quality performance — MIPS

FRANK BALOH, MD's 2023 MIPS final score plotted against the Ophthalmology Physician national average

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

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

0%100%National avg83%99%
MIPS final score (Ophthalmology Physician) — 100/100 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).

FRANK BALOH, MD is a Ophthalmology Physician provider practicing in ALLENTOWN, Pennsylvania, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: MD. NPI: 1538113865. 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.

FRANK BALOH, MD appears in the CMS NPPES registry as a Ophthalmology Physician provider holding MD credentials at 400 N 17TH ST, ALLENTOWN, PA, 18104, with a listed phone of (610) 433-0450. NPI 1538113865 was issued on 05/20/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BALOH 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 1,365 prescription claims written by this provider, covering 723 Medicare beneficiaries and totaling roughly $332K in drug spend, split 25% brand-name and 75% generic by claim count, with an opioid prescribing rate of 16.8%. 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 100/100 for the 2023 performance year (Quality 100), compared with the national average of 83.1.

Ophthalmology Physician is a mid-sized specialty nationwide, with 22,090 enrolled providers across 56 states and an average of 1,420 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

400 N 17TH ST
ALLENTOWN, PA 18104

Provider Details

NPI 1538113865
Specialty Ophthalmology Physician
Credentials MD
Gender Male
NPI Issued 05/20/2006

CMS Quality Score (MIPS)

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

100
Final Score
Avg: 83.1
100
Quality

Reporting: Group practice

Hospital and facility affiliations

Facilities where FRANK BALOH, 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.

LEHIGH VALLEY EYE CENTER, P.C.
ALLENTOWN, PA
POCONO EYE ASSOCIATES INC
BRODHEADSVILLE, PA

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 FRANK BALOH, MD. Source: openpaymentsdata.cms.gov.

Total received

$53

Largest payer

Alcon Vision LLC

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.

License & disciplinary context — Pennsylvania PA-BOM 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 ~45K Pennsylvania medical licensees in 2023 — they are NOT specific to FRANK BALOH, MD. To verify FRANK BALOH, MD's current license status, search the PA-BOM public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

133
Total board actions, Pennsylvania 2023
Across 129 cases
2.96
Actions per 1,000 licensees
Pennsylvania statewide rate
probation
Most common action type
48 cases

PA-BOM 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 Pennsylvania disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Above average

FRANK BALOH, MD — brand share 25.0%
Specialty average (est.)

25% brand-name claims vs 75% generic, on 1,365 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.

1,365
Total Claims
$332K
Total Drug Cost
723
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
1,606
Total Day Supply
24,957
Brand vs Generic
25% brand / 75% generic
Brand Drug Cost
$307K
Generic Drug Cost
$25K
Opioid Claims
229 (16.8% rate)
Antibiotic Claims
13

Patient Demographics

Average Patient Age
76.2 years
Avg HCC Risk Score
1.13
Gender Split
60% female / 40% male
Age Distribution
<65: 20, 65-74: 292, 75-84: 307, 85+: 104

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Erythromycin
Erythromycin Base
576
Acetaminophen-Codeine
Acetaminophen With Codeine
229
Neomycin-Polymyxin-Dexameth
Neomycin/Polymyxin B/Dexametha
212
Restasis
Cyclosporine
68
Tobramycin-Dexamethasone
Tobramycin/Dexamethasone
53
Cyclosporine
46
Ofloxacin
37
Loteprednol Etabonate
35
Prednisolone Acetate
26
Cephalexin
12

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

Ophthalmology Physician Overview

How FRANK BALOH, MD fits within the Ophthalmology Physician landscape nationally.

22,090
Ophthalmology Physician Providers in US
56
States with Ophthalmology Physician
1,420
Avg Claims per Provider

FRANK BALOH, MD's 1,365 claims are below the specialty average of 1,420.

Nearby Ophthalmology Physician Providers in Pennsylvania

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

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

Frequently Asked Questions

What is FRANK BALOH, MD's specialty?
FRANK BALOH, MD specializes in Ophthalmology Physician and practices in ALLENTOWN, Pennsylvania. Credentials: MD.
How much does FRANK BALOH, MD prescribe under Medicare Part D?
In 2023, FRANK BALOH, MD wrote 1,365 Medicare Part D claims totaling $332K in drug costs for 723 beneficiaries.
What is FRANK BALOH, MD's Medicare quality score?
FRANK BALOH, MD has a CMS MIPS Final Score of 100/100 (Quality: 100). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is FRANK BALOH, MD located?
FRANK BALOH, MD is located at 400 N 17TH ST, ALLENTOWN, PA, 18104. Phone: (610) 433-0450.
What is FRANK BALOH, MD's NPI number?
FRANK BALOH, MD's National Provider Identifier (NPI) is 1538113865, issued on 05/20/2006.
Does FRANK BALOH, MD prescribe more brand-name or generic drugs?
FRANK BALOH, MD's prescribing is 25% brand-name and 75% generic drugs by claim count, with $307K in brand drug costs.
Does FRANK BALOH, MD prescribe opioids?
Yes, FRANK BALOH, MD had 229 opioid claims in 2023 with an opioid prescribing rate of 16.8%.
How many Ophthalmology Physician providers are there in the US?
There are 22,090 Ophthalmology Physician providers across 56 states in the US. The average Ophthalmology Physician provider writes 1,420 Medicare Part D claims per year.
What drugs does FRANK BALOH, MD prescribe most often?
Based on 2023 Medicare Part D data, FRANK BALOH, MD's most frequently prescribed drugs include Erythromycin, Acetaminophen-Codeine, Neomycin-Polymyxin-Dexameth. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does FRANK BALOH, MD accept Medicare?
FRANK BALOH, MD appears in CMS Medicare data with 1,365 Part D claims and 723 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify FRANK BALOH, MD's credentials?
FRANK BALOH, MD's NPI is 1538113865 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