2026 NPPES data Optometrist NPI 1548596356 OD
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GAIL KELLEY, OD

Optometrist in WILMINGTON, North Carolina. 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
213
Medicare Part D claims · 104 beneficiaries · Optometrist avg: 257
Generic prescribing
44%
generic claims · 56% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
90.5764/100
▲ 7 pts above national avg 83.1 · [object Object]
Industry payments
$3.1K
45 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

GAIL KELLEY, OD reported a CMS MIPS final score of 90.5764/100 — above the 83.1 national average — and filed 213 Medicare Part D claims in 2023.

90.5764/100
MIPS score · +7 vs avg
213
Part D claims, 2023
44%
generic prescribing
$3.1K
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.

GAIL KELLEY, OD's MIPS score vs every scored U.S. clinician

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

91 Top 40% higher than 60% 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%). Below this entry. 90–100: 189,403 scored providers (40%). This entry sits in this band. 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 GAIL KELLEY, OD?

High performer (top quartile)

NPI registry status

Active

Issued 10/29/2009

NPI 1548596356

Primary specialty

Optometrist

High-volume

60,463 US NPIs in this specialty

Medicare Part D claims

213 17% vs specialty avg

2023 prescription claims

Specialty avg: 257

MIPS final score

90.5764/100 7.476400000000012% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in North Carolina

How Optometrist compares to other specialties among North Carolina providers

North Carolina providers

Optometrist share within North Carolina

1. Optometrist42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Optometrist share within North Carolina

Medicare quality performance — MIPS

GAIL KELLEY, OD's 2023 MIPS final score plotted against the Optometrist national average

High performer (top quartile)
MIPS Final Score
90.5764/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Optometrist) — 90.5764/100 vs national avg 83.1

0%100%National avg83%90.6%
MIPS final score (Optometrist) — 90.5764/100 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).

GAIL KELLEY, OD appears in the CMS NPPES registry as a Optometrist provider holding OD credentials at 5101 MAKO DR, WILMINGTON, NC, 28409, with a listed phone of (937) 726-6260. NPI 1548596356 was issued on 10/29/2009. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what KELLEY 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 213 prescription claims written by this provider, covering 104 Medicare beneficiaries and totaling roughly $84K in drug spend, split 56% brand-name and 44% 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 90.5764/100 for the 2023 performance year (Quality 100, Cost 68.588), compared with the national average of 83.1.

Optometrist is a high-volume specialty nationwide, with 60,463 enrolled providers across 56 states and an average of 257 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

5101 MAKO DR
WILMINGTON, NC 28409

Provider Details

NPI 1548596356
Specialty Optometrist
Credentials OD
Gender Female
NPI Issued 10/29/2009

CMS Quality Score (MIPS)

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

90.5764
Final Score
Avg: 83.1
100
Quality
68.588
Cost
100
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where GAIL KELLEY, OD 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.

LANE OPTOMETRY PLLC
JACKSONVILLE, NC
WILMINGTON EYE, P.A.
WILMINGTON, NC

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 GAIL KELLEY, OD. Source: openpaymentsdata.cms.gov.

Total received

$3.1K

Largest payer

BIOTISSUE HOLDINGS INC.

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 · Brand-heavy

GAIL KELLEY, OD — brand share 56.0%
Specialty average (est.)

56% brand-name claims vs 44% generic, on 213 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.

213
Total Claims
$84K
Total Drug Cost
104
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
367
Total Day Supply
9,920
Brand vs Generic
56% brand / 44% generic
Brand Drug Cost
$81K
Generic Drug Cost
$3K

Patient Demographics

Average Patient Age
74.3 years
Avg HCC Risk Score
1.14
Gender Split
70% female / 30% male

Top Prescribed Drugs (Medicare Part D)

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

What GAIL KELLEY, OD 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
Latanoprost
36
Restasis
Cyclosporine
33
Tobramycin-Dexamethasone
Tobramycin/Dexamethasone
16
Cyclosporine
12
Prednisolone Acetate
12
Timolol Maleate
12

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

Optometrist Overview

How GAIL KELLEY, OD fits within the Optometrist landscape nationally.

60,463
Optometrist Providers in US
56
States with Optometrist
257
Avg Claims per Provider

GAIL KELLEY, OD's 213 claims are below the specialty average of 257.

Nearby Optometrist Providers in North Carolina

Other clinicians with the same primary specialty enrolled in North Carolina, drawn from the same CMS NPPES roster as KELLEY.

Compare Optometrist nationally: see state-by-state distribution →

Frequently Asked Questions

What is GAIL KELLEY, OD's specialty?
GAIL KELLEY, OD specializes in Optometrist and practices in WILMINGTON, North Carolina. Credentials: OD.
How much does GAIL KELLEY, OD prescribe under Medicare Part D?
In 2023, GAIL KELLEY, OD wrote 213 Medicare Part D claims totaling $84K in drug costs for 104 beneficiaries.
What is GAIL KELLEY, OD's Medicare quality score?
GAIL KELLEY, OD has a CMS MIPS Final Score of 90.5764/100 (Quality: 100, Cost: 68.588). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is GAIL KELLEY, OD located?
GAIL KELLEY, OD is located at 5101 MAKO DR, WILMINGTON, NC, 28409. Phone: (937) 726-6260.
What is GAIL KELLEY, OD's NPI number?
GAIL KELLEY, OD's National Provider Identifier (NPI) is 1548596356, issued on 10/29/2009.
Does GAIL KELLEY, OD prescribe more brand-name or generic drugs?
GAIL KELLEY, OD's prescribing is 56% brand-name and 44% generic drugs by claim count, with $81K in brand drug costs.
How many Optometrist providers are there in the US?
There are 60,463 Optometrist providers across 56 states in the US. The average Optometrist provider writes 257 Medicare Part D claims per year.
What drugs does GAIL KELLEY, OD prescribe most often?
Based on 2023 Medicare Part D data, GAIL KELLEY, OD's most frequently prescribed drugs include Latanoprost, Restasis, Tobramycin-Dexamethasone. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does GAIL KELLEY, OD accept Medicare?
GAIL KELLEY, OD appears in CMS Medicare data with 213 Part D claims and 104 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify GAIL KELLEY, OD's credentials?
GAIL KELLEY, OD's NPI is 1548596356 with credentials OD. 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