2026 NPPES data Optometrist NPI 1588762231 O.D
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GELENA BANIN, O.D

Optometrist in PHILADELPHIA, 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
66
Medicare Part D claims · 38 beneficiaries · Optometrist avg: 257
Generic prescribing
61%
generic claims · 39% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
0/100
▼ 83 pts below national avg 83.1 · [object Object]
What the federal data reveals: GELENA BANIN, O.D is a Optometrist ([object Object]) practicing in PHILADELPHIA, Pennsylvania with a Medicare Part D prescribing footprint of 66 claims across 38 beneficiaries — 39% brand-name prescribing . Their CMS MIPS Final Score of 0/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities .

What stands out: GELENA BANIN, O.D reported a CMS MIPS final score of 0 out of 100, below the 83.1 national average, and filed 66 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

GELENA BANIN, O.D at a glance

Below national average

NPI registry status

Active

Issued 09/20/2006

NPI 1588762231

Primary specialty

Optometrist

High-volume

60,463 US NPIs in this specialty

Medicare Part D claims

66 74% vs specialty avg

2023 prescription claims

Specialty avg: 257

MIPS final score

0/100 83.1% pts

Penalty band band

vs 83.1 national avg

Specialty distribution in Pennsylvania

How Optometrist compares to other specialties among Pennsylvania providers

Pennsylvania providers

Optometrist share within Pennsylvania

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

Medicare quality performance — MIPS

GELENA BANIN, O.D's 2023 MIPS final score plotted against the Optometrist national average

Below national average
MIPS Final Score
0/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Optometrist) — 0/100 vs national avg 83.1

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

GELENA BANIN, O.D is a Optometrist provider practicing in PHILADELPHIA, Pennsylvania, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: O.D. NPI: 1588762231. 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.

GELENA BANIN, O.D appears in the CMS NPPES registry as a Optometrist provider holding O.D credentials at 11685 BUSTLETON AVE, PHILADELPHIA, PA, 19116, with a listed phone of (917) 449-5033. NPI 1588762231 was issued on 09/20/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BANIN 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 66 prescription claims written by this provider, covering 38 Medicare beneficiaries and totaling roughly $14K in drug spend, split 39% brand-name and 61% 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 0/100 for the 2023 performance year (Quality 0), 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

11685 BUSTLETON AVE
PHILADELPHIA, PA 19116

Provider Details

NPI 1588762231
Specialty Optometrist
Credentials O.D
Gender Female
NPI Issued 09/20/2006

CMS Quality Score (MIPS)

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

0
Final Score
Avg: 83.1
0
Quality

Reporting: Individual

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 GELENA BANIN, O.D. To verify GELENA BANIN, O.D'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

GELENA BANIN, O.D — brand share 39.0%
Specialty average (est.)

39% brand-name claims vs 61% generic, on 66 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.

66
Total Claims
$14K
Total Drug Cost
38
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
72
Total Day Supply
1,538
Brand vs Generic
39% brand / 61% generic
Brand Drug Cost
$14K
Generic Drug Cost
$645

Patient Demographics

Average Patient Age
80.2 years
Avg HCC Risk Score
1.63
Gender Split
63% female / 37% male
Age Distribution
<65: 0, 65-74: 11, 75-84: 16, 85+: 11

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Restasis
Cyclosporine
17
Erythromycin
Erythromycin Base
14
Moxifloxacin
Moxifloxacin Hcl
14
Olopatadine Hcl
11

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

Optometrist Overview

How GELENA BANIN, O.D fits within the Optometrist landscape nationally.

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

GELENA BANIN, O.D's 66 claims are below the specialty average of 257.

Nearby Optometrist Providers in Pennsylvania

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

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

Frequently Asked Questions

What is GELENA BANIN, O.D's specialty?
GELENA BANIN, O.D specializes in Optometrist and practices in PHILADELPHIA, Pennsylvania. Credentials: O.D.
How much does GELENA BANIN, O.D prescribe under Medicare Part D?
In 2023, GELENA BANIN, O.D wrote 66 Medicare Part D claims totaling $14K in drug costs for 38 beneficiaries.
What is GELENA BANIN, O.D's Medicare quality score?
GELENA BANIN, O.D has a CMS MIPS Final Score of 0/100 (Quality: 0). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is GELENA BANIN, O.D located?
GELENA BANIN, O.D is located at 11685 BUSTLETON AVE, PHILADELPHIA, PA, 19116. Phone: (917) 449-5033.
What is GELENA BANIN, O.D's NPI number?
GELENA BANIN, O.D's National Provider Identifier (NPI) is 1588762231, issued on 09/20/2006.
Does GELENA BANIN, O.D prescribe more brand-name or generic drugs?
GELENA BANIN, O.D's prescribing is 39% brand-name and 61% generic drugs by claim count, with $14K 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 GELENA BANIN, O.D prescribe most often?
Based on 2023 Medicare Part D data, GELENA BANIN, O.D's most frequently prescribed drugs include Restasis, Erythromycin, Moxifloxacin. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does GELENA BANIN, O.D accept Medicare?
GELENA BANIN, O.D appears in CMS Medicare data with 66 Part D claims and 38 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify GELENA BANIN, O.D's credentials?
GELENA BANIN, O.D's NPI is 1588762231 with credentials O.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