2026 NPPES data Ophthalmology Physician NPI 1295723385 MD
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GAUTAM MISHRA, MD

Ophthalmology Physician in HARRISBURG, 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
914
Medicare Part D claims · 346 beneficiaries · Ophthalmology Physician avg: 1K
Generic prescribing
66%
generic claims · 34% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
94.1082/100
▲ 11 pts above national avg 83.1 · [object Object]
Industry payments
$353.22
16 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

GAUTAM MISHRA, MD reported a CMS MIPS final score of 94.1082/100 — above the 83.1 national average — and filed 914 Medicare Part D claims in 2023.

94.1082/100
MIPS score · +11 vs avg
914
Part D claims, 2023
66%
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.

GAUTAM MISHRA, MD's MIPS score vs every scored U.S. clinician

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

94 Top 25% higher than 75% 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

Board certification likely (heuristic — not verified)

GAUTAM MISHRA, MD 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).

What does the federal data show about GAUTAM MISHRA, MD?

High performer (top quartile)

NPI registry status

Active

Issued 10/12/2005

NPI 1295723385

Primary specialty

Ophthalmology Physician

Mid-sized

22,090 US NPIs in this specialty

Medicare Part D claims

914 36% vs specialty avg

2023 prescription claims

Specialty avg: 1,420

MIPS final score

94.1082/100 11.008200000000002% 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

GAUTAM MISHRA, MD's 2023 MIPS final score plotted against the Ophthalmology Physician national average

High performer (top quartile)
MIPS Final Score
94.1082/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Ophthalmology Physician) — 94.1082/100 vs national avg 83.1

0%100%National avg83%94.1%
MIPS final score (Ophthalmology Physician) — 94.1082/100 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).

GAUTAM MISHRA, MD appears in the CMS NPPES registry as a Ophthalmology Physician provider holding MD credentials at 10 CAPITAL DRIVE, HARRISBURG, PA, 17110, with a listed phone of (717) 233-3937. NPI 1295723385 was issued on 10/12/2005. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what MISHRA 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 914 prescription claims written by this provider, covering 346 Medicare beneficiaries and totaling roughly $135K in drug spend, split 34% brand-name and 66% 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 94.1082/100 for the 2023 performance year (Quality 100, Cost 80.3606), 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

10 CAPITAL DRIVE
HARRISBURG, PA 17110

Provider Details

NPI 1295723385
Specialty Ophthalmology Physician
Credentials MD
Gender Male
NPI Issued 10/12/2005

CMS Quality Score (MIPS)

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

94.1082
Final Score
Avg: 83.1
100
Quality
80.3606
Cost

Reporting: Group practice

Hospital and facility affiliations

Facilities where GAUTAM MISHRA, 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.

VISTAURA EYE PC
HARRISBURG, 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 GAUTAM MISHRA, MD. Source: openpaymentsdata.cms.gov.

Total received

$353

Largest payer

ABBVIE 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.

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 GAUTAM MISHRA, MD. To verify GAUTAM MISHRA, 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

GAUTAM MISHRA, MD — brand share 34.0%
Specialty average (est.)

34% brand-name claims vs 66% generic, on 914 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.

914
Total Claims
$135K
Total Drug Cost
346
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
1,704
Total Day Supply
44,742
Brand vs Generic
34% brand / 66% generic
Brand Drug Cost
$109K
Generic Drug Cost
$27K

Patient Demographics

Average Patient Age
76.0 years
Avg HCC Risk Score
0.98
Gender Split
64% female / 36% male

Top Prescribed Drugs (Medicare Part D)

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

What GAUTAM MISHRA, MD 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
Lorazepam
144
Timolol Maleate
142
Latanoprost
94
Dorzolamide-Timolol
Dorzolamide Hcl/Timolol Maleat
65
Lumigan
Bimatoprost
56
Prednisolone Acetate
38
Difluprednate
34
Fluorometholone
32
Loteprednol Etabonate
32
Travoprost
32

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

Ophthalmology Physician Overview

How GAUTAM MISHRA, 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

GAUTAM MISHRA, MD's 914 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 MISHRA.

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

Frequently Asked Questions

What is GAUTAM MISHRA, MD's specialty?
GAUTAM MISHRA, MD specializes in Ophthalmology Physician and practices in HARRISBURG, Pennsylvania. Credentials: MD.
How much does GAUTAM MISHRA, MD prescribe under Medicare Part D?
In 2023, GAUTAM MISHRA, MD wrote 914 Medicare Part D claims totaling $135K in drug costs for 346 beneficiaries.
What is GAUTAM MISHRA, MD's Medicare quality score?
GAUTAM MISHRA, MD has a CMS MIPS Final Score of 94.1082/100 (Quality: 100, Cost: 80.3606). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is GAUTAM MISHRA, MD located?
GAUTAM MISHRA, MD is located at 10 CAPITAL DRIVE, HARRISBURG, PA, 17110. Phone: (717) 233-3937.
What is GAUTAM MISHRA, MD's NPI number?
GAUTAM MISHRA, MD's National Provider Identifier (NPI) is 1295723385, issued on 10/12/2005.
Does GAUTAM MISHRA, MD prescribe more brand-name or generic drugs?
GAUTAM MISHRA, MD's prescribing is 34% brand-name and 66% generic drugs by claim count, with $109K in brand drug costs.
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 GAUTAM MISHRA, MD prescribe most often?
Based on 2023 Medicare Part D data, GAUTAM MISHRA, MD's most frequently prescribed drugs include Lorazepam, Timolol Maleate, Latanoprost. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does GAUTAM MISHRA, MD accept Medicare?
GAUTAM MISHRA, MD appears in CMS Medicare data with 914 Part D claims and 346 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify GAUTAM MISHRA, MD's credentials?
GAUTAM MISHRA, MD's NPI is 1295723385 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