NPI registry status
Active
2026 NPPES data Nephrology Physician NPI 1063404481 M.D.
Verify on CMS → Harold Helton, M.D.
Nephrology Physician in Somerset, Kentucky.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 10,569 in Nephrology 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
1K
Medicare Part D claims · 231 beneficiaries · Nephrology Physician avg: 1K
Generic prescribing
74%
generic claims · 26% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
65.8/100
▼ 17 pts below national avg 83.1 · Mid-tier
Source: CMS Medicare Part D Prescriber Public Use File, 2023
Compiled from official public sources by the PlainDoctor editorial team.
What the federal data shows
Harold Helton, M.D. reported a CMS MIPS final score of 65.8/100 - below the 83.1 national average - and filed 1,188 Medicare Part D claims in 2023.
- 65.8/100
- MIPS score · -17 vs avg
- 1K
- Part D claims, 2023
- 74%
- 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.
Harold Helton, 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
66 7th percentile higher than 7% of 477,587 scored providers
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
Where Harold Helton, M.D. sits
This provider among nephrology physician peers
Across the 2,476 nephrology physician providers who report both Medicare Part D prescribing and a MIPS quality score, Harold Helton, M.D. writes more Part D claims than 52% of them and scores higher on MIPS quality than 17% - placing this provider in the high-volume, lower-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Part D claim volume vs MIPS quality, by specialty percentile
Each dot is one nephrology physician peer from a representative sample of 60; the gold marker is Harold Helton, M.D.. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Harold Helton, 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 Harold Helton, M.D.?
Below national averagePrimary specialty
Nephrology Physician
Medicare Part D claims
1,188 18% vs specialty avg
MIPS final score
65.8/100 17.3 pts vs avg
Specialty distribution in Kentucky
How Nephrology Physician compares to other specialties among Kentucky providers
Medicare quality performance, MIPS
Harold Helton, M.D.'s 2023 MIPS final score plotted against the Nephrology Physician national average
- MIPS Final Score
- 65.8/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Nephrology Physician) - 65.8/100 vs national avg 83.1
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).
Harold Helton, M.D. appears in the CMS NPPES registry as a Nephrology Physician provider holding M.D. credentials at 104 HARDIN LN STE A, Somerset, KY, 42503, with a listed phone of (606) 678-2063. NPI 1063404481 was issued on 08/22/2005.
Medicare Part D records for calendar year 2023 show 1,188 prescription claims written by this provider, covering 231 Medicare beneficiaries and totaling roughly $532K in drug spend, split 26% brand-name and 74% generic by claim count. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 65.8/100 for the 2023 performance year (Quality 49.7), compared with the national average of 83.1.
Nephrology Physician is a mid-sized specialty nationwide, with 10,569 enrolled providers across 55 states and an average of 1,454 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
Provider Details
| NPI | 1063404481 |
|---|---|
| Specialty | Nephrology Physician |
| Credentials | M.D. |
| Gender | Male |
| NPI Issued | 08/22/2005 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
65.847
Final Score
Avg: 83.1
49.7403
Quality
Reporting: Alternative Payment Model
Brand vs generic prescribing mix · Above average
Harold Helton, M.D. - brand share 26.0%
Nephrology Physician average
26% brand-name claims vs 74% generic, on 1,188 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.
1,188
Total Claims
$532K
Total Drug Cost
231
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 2,081
- Total Day Supply
- 61,786
- Brand vs Generic
- 26% brand / 74% generic
- Brand Drug Cost
- $463K
- Generic Drug Cost
- $69K
- Antibiotic Claims
- 12
Patient Demographics
- Average Patient Age
- 66.4 years
- Avg HCC Risk Score
- 5.69
- Gender Split
- 45% female / 55% male
- Age Distribution
- <65: 79, 65-74: 98, 75-84: N/A, 85+: N/A
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Harold Helton, M.D. prescribes most
Top Medicare Part D drugs by claim count, 2023
- Losartan Potassium
Losartan Potassium
164 claims
- Calcium Acetate
Calcium Acetate
147 claims
- Furosemide
Furosemide
104 claims
- Sevelamer Carbonate
Sevelamer Carbonate
97 claims
- Auryxia
Auryxia
79 claims
- Spironolactone
Spironolactone
79 claims
- Amlodipine Besylate 62
Amlodipine Besylate
62 claims
- Torsemide 45
Torsemide
45 claims
| Drug | Claims |
|---|---|
| Losartan Potassium | 164 |
| Calcium Acetate | 147 |
| Furosemide | 104 |
| Sevelamer Carbonate | 97 |
| Auryxia Ferric Citrate | 79 |
| Spironolactone | 79 |
| Amlodipine Besylate | 62 |
| Torsemide | 45 |
| Farxiga Dapagliflozin Propanediol | 33 |
| Carvedilol | 31 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Nephrology Physician Overview
How Harold Helton, M.D. fits within the Nephrology Physician landscape nationally.
10,569
Nephrology Physician Providers in US
55
States with Nephrology Physician
1,454
Avg Claims per Provider
Harold Helton, M.D.'s 1,188 claims are below the specialty average of 1,454.
Nearby Nephrology Physician Providers in Kentucky
Other clinicians with the same primary specialty enrolled in Kentucky, drawn from the same CMS NPPES roster as Helton.
Dr. Shafic Abdul Wahab El Hindi
M.D.
Louisville, KY
Hisham Abu Farsak
Paducah, KY
Dr. Alexander Afanasyev
MD
Louisville, KY
Dr. Sadiq Ahmed
M.D.
Lexington, KY
Dr. Rizwan Akhtar
M.D.
Richmond, KY
Compare Nephrology Physician nationally: see state-by-state distribution →
Before you book an appointment
Use this federal record as your verification checklist, not as a recommendation.
- Confirm the NPI record is current in the official CMS registry, providers update their own NPPES details, and moves can lag. Verify this NPI
- Check the active license and any disciplinary history with the Kentucky medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Nephrology Physician peer on Medicare volume and prescribing patterns. Compare providers
Medicare Part D and MIPS figures describe practice patterns in federal programs only, they are not quality ratings, and PlainDoctor does not rate, rank, or recommend providers.
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Frequently Asked Questions
What is Harold Helton, M.D.'s specialty? ▼
Harold Helton, M.D. specializes in Nephrology Physician and practices in Somerset, Kentucky. Credentials: M.D..
How much does Harold Helton, M.D. prescribe under Medicare Part D? ▼
In 2023, Harold Helton, M.D. wrote 1,188 Medicare Part D claims totaling $532K in drug costs for 231 beneficiaries.
What is Harold Helton, M.D.'s Medicare quality score? ▼
Harold Helton, M.D. has a CMS MIPS Final Score of 65.8/100 (Quality: 49.7). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Harold Helton, M.D. located? ▼
Harold Helton, M.D. is located at 104 HARDIN LN STE A, Somerset, KY, 42503. Phone: (606) 678-2063.
What is Harold Helton, M.D.'s NPI number? ▼
Harold Helton, M.D.'s National Provider Identifier (NPI) is 1063404481, issued on 08/22/2005.
Does Harold Helton, M.D. prescribe more brand-name or generic drugs? ▼
Harold Helton, M.D.'s prescribing is 26% brand-name and 74% generic drugs by claim count, with $463K in brand drug costs.
How many Nephrology Physician providers are there in the US? ▼
There are 10,569 Nephrology Physician providers across 55 states in the US. The average Nephrology Physician provider writes 1,454 Medicare Part D claims per year.
What drugs does Harold Helton, M.D. prescribe most often? ▼
Based on 2023 Medicare Part D data, Harold Helton, M.D.'s most frequently prescribed drugs include Losartan Potassium, Calcium Acetate, Furosemide. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Harold Helton, M.D. accept Medicare? ▼
Harold Helton, M.D. appears in CMS Medicare data with 1,188 Part D claims and 231 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Harold Helton, M.D.'s credentials? ▼
Harold Helton, M.D.'s NPI is 1063404481 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
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
Compiled from official public sources by the PlainDoctor editorial team.
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.