2026 NPPES data Otolaryngology/Facial Plastic Surgery Physician NPI 1386603066 M.D.
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GERALD PFLUM, M.D.

Otolaryngology/Facial Plastic Surgery Physician in NEPTUNE, New Jersey. 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
742
Medicare Part D claims · 194 beneficiaries · Otolaryngology/Facial Plastic Surgery Physician avg: 561
Generic prescribing
98%
generic claims · 2% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
78.5333/100
▼ 5 pts below national avg 83.1 · [object Object]

What the federal data shows

GERALD PFLUM, M.D. reported a CMS MIPS final score of 78.5333/100 — below the 83.1 national average — and filed 742 Medicare Part D claims in 2023.

78.5333/100
MIPS score · -5 vs avg
742
Part D claims, 2023
98%
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.

GERALD PFLUM, M.D.'s MIPS score vs every scored U.S. clinician

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

79 27th percentile higher than 27% 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%). This entry sits in this band. 80–90: 129,887 scored providers (27%). Above this entry. 90–100: 189,403 scored providers (40%). Above this entry. 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)

GERALD PFLUM, M.D. 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 GERALD PFLUM, M.D.?

Near national average

NPI registry status

Active

Issued 03/21/2006

NPI 1386603066

Primary specialty

Otolaryngology/Facial Plastic Surgery Physician

Niche

744 US NPIs in this specialty

Medicare Part D claims

742 32% vs specialty avg

2023 prescription claims

Specialty avg: 561

MIPS final score

78.5333/100 4.566699999999997% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in New Jersey

How Otolaryngology/Facial Plastic Surgery Physician compares to other specialties among New Jersey providers

New Jersey providers

Otolaryngology/Facial Plastic Surgery Physician share within New Jersey

1. Otolaryngology/Facial Plastic Surgery Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Otolaryngology/Facial Plastic Surgery Physician share within New Jersey

Medicare quality performance — MIPS

GERALD PFLUM, M.D.'s 2023 MIPS final score plotted against the Otolaryngology/Facial Plastic Surgery Physician national average

Near national average
MIPS Final Score
78.5333/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Otolaryngology/Facial Plastic Surgery Physician) — 78.5333/100 vs national avg 83.1

0%100%National avg83%78.5%
MIPS final score (Otolaryngology/Facial Plastic Surgery Physician) — 78.5333/100 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).

GERALD PFLUM, M.D. is a Otolaryngology/Facial Plastic Surgery Physician provider practicing in NEPTUNE, New Jersey, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: M.D.. NPI: 1386603066. 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.

GERALD PFLUM, M.D. appears in the CMS NPPES registry as a Otolaryngology/Facial Plastic Surgery Physician provider holding M.D. credentials at 444 NEPTUNE BLVD, NEPTUNE, NJ, 07753, with a listed phone of (732) 775-1301. NPI 1386603066 was issued on 03/21/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what PFLUM 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 742 prescription claims written by this provider, covering 194 Medicare beneficiaries and totaling roughly $20K in drug spend, split 2% brand-name and 98% 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 78.5333/100 for the 2023 performance year (Quality 57.0667), compared with the national average of 83.1.

Otolaryngology/Facial Plastic Surgery Physician is a narrow specialty nationwide, with 744 enrolled providers across 53 states and an average of 561 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

444 NEPTUNE BLVD
NEPTUNE, NJ 07753

Provider Details

NPI 1386603066
Specialty Otolaryngology/Facial Plastic Surgery Physician
Credentials M.D.
Gender Male
NPI Issued 03/21/2006

CMS Quality Score (MIPS)

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

78.5333
Final Score
Avg: 83.1
57.0667
Quality

Reporting: Individual

Brand vs generic prescribing mix · Generic-heavy

GERALD PFLUM, M.D. — brand share 2.0%
Specialty average (est.)

2% brand-name claims vs 98% generic, on 742 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.

742
Total Claims
$20K
Total Drug Cost
194
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
1,095
Total Day Supply
28,251
Brand vs Generic
2% brand / 98% generic
Brand Drug Cost
$2K
Generic Drug Cost
$18K
Antibiotic Claims
55

Patient Demographics

Average Patient Age
75.4 years
Avg HCC Risk Score
1.38
Gender Split
62% female / 38% male

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Fluticasone Propionate
197
Azelastine Hcl
134
Methylprednisolone
57
Ofloxacin
45
Amoxicillin-Clavulanate Potass
Amoxicillin/Potassium Clav
37
Omeprazole
30
Famotidine
23
Zolpidem Tartrate
16
Lansoprazole
14
Esomeprazole Magnesium
13

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

Otolaryngology/Facial Plastic Surgery Physician Overview

How GERALD PFLUM, M.D. fits within the Otolaryngology/Facial Plastic Surgery Physician landscape nationally.

744
Otolaryngology/Facial Plastic Surgery Physician Providers in US
53
States with Otolaryngology/Facial Plastic Surgery Physician
561
Avg Claims per Provider

GERALD PFLUM, M.D.'s 742 claims are above the specialty average of 561.

Nearby Otolaryngology/Facial Plastic Surgery Physician Providers in New Jersey

Other clinicians with the same primary specialty enrolled in New Jersey, drawn from the same CMS NPPES roster as PFLUM.

Compare Otolaryngology/Facial Plastic Surgery Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is GERALD PFLUM, M.D.'s specialty?
GERALD PFLUM, M.D. specializes in Otolaryngology/Facial Plastic Surgery Physician and practices in NEPTUNE, New Jersey. Credentials: M.D..
How much does GERALD PFLUM, M.D. prescribe under Medicare Part D?
In 2023, GERALD PFLUM, M.D. wrote 742 Medicare Part D claims totaling $20K in drug costs for 194 beneficiaries.
What is GERALD PFLUM, M.D.'s Medicare quality score?
GERALD PFLUM, M.D. has a CMS MIPS Final Score of 78.5333/100 (Quality: 57.0667). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is GERALD PFLUM, M.D. located?
GERALD PFLUM, M.D. is located at 444 NEPTUNE BLVD, NEPTUNE, NJ, 07753. Phone: (732) 775-1301.
What is GERALD PFLUM, M.D.'s NPI number?
GERALD PFLUM, M.D.'s National Provider Identifier (NPI) is 1386603066, issued on 03/21/2006.
Does GERALD PFLUM, M.D. prescribe more brand-name or generic drugs?
GERALD PFLUM, M.D.'s prescribing is 2% brand-name and 98% generic drugs by claim count, with $2K in brand drug costs.
How many Otolaryngology/Facial Plastic Surgery Physician providers are there in the US?
There are 744 Otolaryngology/Facial Plastic Surgery Physician providers across 53 states in the US. The average Otolaryngology/Facial Plastic Surgery Physician provider writes 561 Medicare Part D claims per year.
What drugs does GERALD PFLUM, M.D. prescribe most often?
Based on 2023 Medicare Part D data, GERALD PFLUM, M.D.'s most frequently prescribed drugs include Fluticasone Propionate, Azelastine Hcl, Methylprednisolone. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does GERALD PFLUM, M.D. accept Medicare?
GERALD PFLUM, M.D. appears in CMS Medicare data with 742 Part D claims and 194 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify GERALD PFLUM, M.D.'s credentials?
GERALD PFLUM, M.D.'s NPI is 1386603066 with credentials M.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