NPI registry status
Active
2026 NPPES data Family Medicine Physician NPI 1861598526 MD
Verify on CMS → Gary Wikholm, MD
Family Medicine Physician in Santa Paula, California.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 147,760 in Family Medicine Physician, and covers specialty classification, practice address, and Medicare Part D prescribing data when reported. According to CMS, every field reflects the provider's official federal registration, see our methodology.
Federal data, no proprietary rating.
We show these CMS records as-is - no composite score, no star rating, no editorial opinion layered on top.
Prescribing volume
8K
Medicare Part D claims · 324 beneficiaries · Family Medicine Physician avg: 3K
Generic prescribing
86%
generic claims · 13% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
96.5/100
▲ 13 pts above national avg 83.5 · Exceptional
Industry payments
$90.89
3 payments · CMS Open Payments (Sunshine Act)
Source: CMS Medicare Part D Prescriber Public Use File, 2023
What the federal data shows
Gary Wikholm, MD reported a CMS MIPS final score of 96.5/100 - above the 83.5 national average - and filed 7,545 Medicare Part D claims in 2023.
- 96.5/100
- MIPS score · +13 vs avg
- 8K
- Part D claims, 2023
- 86%
- generic prescribing
- Likely
- board-certified (heuristic)
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.
CMS NPPES provider registry desk
NPI 1861598526 · Family Medicine Physician
NPI-10 · ENUM-LEGACY · TAX-MEGA · MIPS-ELITE · RX-MID · BOOK-MID · PHOTO-FINISH
- NPI-10 1861598526
- ENUM-LEGACY 2006
- TAX-MEGA 148K Family Medicine
- MIPS-ELITE 96.5/100
- RX-MID 7,545
- BOOK-MID 15,933 in California
- PHOTO-FINISH Wendy Cicek Steiger · ±0.0
MIPS final-score neighbourhood
Same-specialty nationwide peers by CMS final score, not geographic proximity
- Wikholm · this p…
Wikholm · this provider
96.5 MIPS pts
- Josh Ostrue · hi…
Josh Ostrue
96.5 MIPS pts
- Wendy Cicek Stei…
Wendy Cicek Steiger
96.5 MIPS pts
- Reyn Higa · near
Reyn Higa
96.5 MIPS pts
- Ryan Nicholas · …
Ryan Nicholas
96.5 MIPS pts
What this shows Nearest measured MIPS peers for this NUCC specialty (2023 performance year).
Gary Wikholm, MD's MIPS score vs every measured U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure. Clinicians whose score CMS assigned without scoring any category are excluded.
97 ≥ 82nd percentile 82% of 454,083 measured providers are in lower value bands
Each bar is a band; taller bars hold more measured 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.
The percentile is a conservative whole-score-point band: it counts only measured clinicians in lower score bands. A CMS MIPS metric is not a recommendation or a clinical-quality rating by PlainDoctor. See methodology § corpus placement.
Source CMS Merit-based Incentive Payment System (MIPS) · 2023
Where Gary Wikholm, MD sits
This provider among family medicine physician peers
Across the 21,266 family medicine physician providers who report both Medicare Part D prescribing and a MIPS quality score, Gary Wikholm, MD writes more Part D claims than 80% of them and scores higher on MIPS quality than 85% - placing this provider in the high-volume, high-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Each dot is one family medicine physician peer from a representative sample of 60; the gold marker is Gary Wikholm, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Gary Wikholm, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting - signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).
What does the federal data show about Gary Wikholm, MD?
High performer (top quartile)Primary specialty
Family Medicine Physician
Medicare Part D claims
7,545 121% vs specialty avg
MIPS final score
96.5/100 13 pts vs avg
Specialty distribution in California
How Family Medicine Physician compares to other specialties among California providers
Medicare quality performance, MIPS
Gary Wikholm, MD's 2023 MIPS final score plotted against the Family Medicine Physician national average
- MIPS Final Score
- 96.5/100
- vs 83.5 national avg · 2023 performance year
How MIPS and board certification work
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).
Practice Address
Provider Details
| NPI | 1861598526 |
|---|---|
| Specialty | Family Medicine Physician |
| Credentials | MD |
| Gender | Male |
| NPI Issued | 09/16/2006 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
96.5085
Final Score
Measured-score avg: 83.5
80.342
Quality
100
Promoting Interoperability
Reporting: Alternative Payment Model
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 Gary Wikholm, MD. Source: openpaymentsdata.cms.gov.
Total received
$91
Largest payer
HARMONY BIOSCIENCES 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 - California MBC 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 ~150K California medical licensees in 2023 - they are NOT specific to Gary Wikholm, MD. To verify Gary Wikholm, MD's current license status, search the MBC public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.
576
Total board actions, California 2023
Across 556 cases
3.84
Actions per 1,000 licensees
California statewide rate
probation
Most common action type
186 cases
MBC 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 California disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.
Brand vs generic prescribing mix · Typical
Gary Wikholm, MD - brand share 13.0%
Family Medicine Physician average
13% brand-name claims vs 86% generic, on 7,545 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.
7,545
Total Claims
$576K
Total Drug Cost
324
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 12,120
- Total Day Supply
- 330,937
- Brand vs Generic
- 13% brand / 86% generic
- Brand Drug Cost
- $383K
- Generic Drug Cost
- $190K
- Opioid Claims
- 483 (6.4% rate)
- Antibiotic Claims
- 161
Patient Demographics
- Average Patient Age
- 73.6 years
- Avg HCC Risk Score
- 1.48
- Gender Split
- 43% female / 57% male
- Age Distribution
- <65: 35, 65-74: 154, 75-84: 90, 85+: 45
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Gary Wikholm, MD prescribes most
Top Medicare Part D drugs by claim count, 2023
- Atorvastatin Calcium
Atorvastatin Calcium
415 claims
- Amlodipine Besylate
Amlodipine Besylate
320 claims
- Hydrocodone-Acetam…
Hydrocodone-Acetaminophen
268 claims
- Levothyroxine Sodium
Levothyroxine Sodium
208 claims
- Omeprazole
Omeprazole
204 claims
- Lisinopril
Lisinopril
198 claims
- Metformin Hcl
Metformin Hcl
177 claims
- Furosemide
Furosemide
175 claims
| Drug | Claims |
|---|---|
| Atorvastatin Calcium | 415 |
| Amlodipine Besylate | 320 |
| Hydrocodone-Acetaminophen Hydrocodone/Acetaminophen | 268 |
| Levothyroxine Sodium | 208 |
| Omeprazole | 204 |
| Lisinopril | 198 |
| Metformin Hcl | 177 |
| Furosemide | 175 |
| Metoprolol Succinate | 169 |
| Tamsulosin Hcl | 147 |
* 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 Gary Wikholm, MD fits within the Family Medicine Physician landscape nationally.
147,760
Family Medicine Physician Providers in US
56
States with Family Medicine Physician
3,418
Avg Claims per Provider
Gary Wikholm, MD's 7,545 claims are above the specialty average of 3,418.
Nationwide Family Medicine Physician peers with similar MIPS or enrollment year
Two federal-record peer sets for Wikholm, both outside California so the neighborhoods are not geographic containment.
Similar MIPS final score
Nearest same-specialty clinicians by CMS MIPS final score (96.5 here).
Same NPPES enumeration year (2006)
Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.
Nearby Family Medicine Physician Providers in California
Other clinicians with the same primary specialty enrolled in California, drawn from the same CMS NPPES roster as Wikholm.
One of 15,933 Family Medicine Physician providers enrolled in California, 5 are shown here.
Dr. Omer Aba-Omer
MD
Santa Monica, CA
Dr. Michelle Ababa
MD
Wilmington, CA
Dr. Anna Tzeitel Abalos
MD
Roseville, CA
Dr. Adan Abarca
MD
Anaheim, CA
Dr. Lorraine Abate
M.D.
Sacramento, CA
Compare Family Medicine Physician nationally: see state-by-state distribution →
Frequently Asked Questions
What is Gary Wikholm, MD's specialty? ▼
Gary Wikholm, MD specializes in Family Medicine Physician and practices in Santa Paula, California. Credentials: MD.
How much does Gary Wikholm, MD prescribe under Medicare Part D? ▼
In 2023, Gary Wikholm, MD wrote 7,545 Medicare Part D claims totaling $576K in drug costs for 324 beneficiaries.
What is Gary Wikholm, MD's Medicare quality score? ▼
Gary Wikholm, MD has a CMS MIPS Final Score of 96.5/100 (Quality: 80.3). The average MIPS Final Score across the 454,083 clinicians with at least one published category score is 83.5; clinicians whose score CMS assigned without scoring any category are excluded from that average. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Gary Wikholm, MD located? ▼
Gary Wikholm, MD is located at 247 W HARVARD BLVD, Santa Paula, CA, 93060. Phone: (805) 525-0907.
What is Gary Wikholm, MD's NPI number? ▼
Gary Wikholm, MD's National Provider Identifier (NPI) is 1861598526, issued on 09/16/2006.
Does Gary Wikholm, MD prescribe more brand-name or generic drugs? ▼
Gary Wikholm, MD's prescribing is 13% brand-name and 86% generic drugs by claim count, with $383K in brand drug costs.
Does Gary Wikholm, MD prescribe opioids? ▼
Yes, Gary Wikholm, MD had 483 opioid claims in 2023 with an opioid prescribing rate of 6.4%.
How many Family Medicine Physician providers are there in the US? ▼
There are 147,760 Family Medicine Physician providers across 56 states in the US. The average Family Medicine Physician provider writes 3,418 Medicare Part D claims per year.
What drugs does Gary Wikholm, MD prescribe most often? ▼
Based on 2023 Medicare Part D data, Gary Wikholm, MD's most frequently prescribed drugs include Atorvastatin Calcium, Amlodipine Besylate, Hydrocodone-Acetaminophen. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Gary Wikholm, MD accept Medicare? ▼
Gary Wikholm, MD appears in CMS Medicare data with 7,545 Part D claims and 324 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Gary Wikholm, MD's credentials? ▼
Gary Wikholm, MD's NPI is 1861598526 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
View source datasets and methodology notes
- 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
Every figure on PlainDoctor is rendered directly from the federal CMS NPPES registry, Medicare Part D, MIPS, and Open Payments records, no number is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of May 2026.