2026 NPPES data Ophthalmology Physician NPI 1215000369 M.D.
Verify on CMS →

HEATH LEMLEY, M.D.

Ophthalmology Physician in MORGANTOWN, West Virginia. 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
4K
Medicare Part D claims · 937 beneficiaries · Ophthalmology Physician avg: 1K
Generic prescribing
68%
generic claims · 32% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
76.4503/100
▼ 7 pts below national avg 83.1 · [object Object]
Industry payments
$472.52
20 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: HEATH LEMLEY, M.D. is a Ophthalmology Physician ([object Object]) practicing in MORGANTOWN, West Virginia with a Medicare Part D prescribing footprint of 4K claims across 937 beneficiaries — 32% brand-name prescribing . Their CMS MIPS Final Score of 76.4503/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $472.52 across 20 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: HEATH LEMLEY, M.D. reported a CMS MIPS final score of 76.4503 out of 100, below the 83.1 national average, and filed 4,305 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

Board certification likely (heuristic — not verified)

HEATH LEMLEY, M.D. 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).

HEATH LEMLEY, M.D. at a glance

Below national average

NPI registry status

Active

Issued 11/16/2006

NPI 1215000369

Primary specialty

Ophthalmology Physician

Mid-sized

22,090 US NPIs in this specialty

Medicare Part D claims

4,305 203% vs specialty avg

2023 prescription claims

Specialty avg: 1,420

MIPS final score

76.4503/100 6.649699999999996% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in West Virginia

How Ophthalmology Physician compares to other specialties among West Virginia providers

West Virginia providers

Ophthalmology Physician share within West Virginia

1. Ophthalmology Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Ophthalmology Physician share within West Virginia

Medicare quality performance — MIPS

HEATH LEMLEY, M.D.'s 2023 MIPS final score plotted against the Ophthalmology Physician national average

Below national average
MIPS Final Score
76.4503/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Ophthalmology Physician) — 76.4503/100 vs national avg 83.1

0%100%National avg83%76.5%
MIPS final score (Ophthalmology Physician) — 76.4503/100 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).

HEATH LEMLEY, M.D. is a Ophthalmology Physician provider practicing in MORGANTOWN, West Virginia, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: M.D.. NPI: 1215000369. 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.

HEATH LEMLEY, M.D. appears in the CMS NPPES registry as a Ophthalmology Physician provider holding M.D. credentials at 1255 PINEVIEW DR, MORGANTOWN, WV, 26505, with a listed phone of (304) 598-3301. NPI 1215000369 was issued on 11/16/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what LEMLEY 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 4,305 prescription claims written by this provider, covering 937 Medicare beneficiaries and totaling roughly $410K in drug spend, split 32% brand-name and 68% 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 76.4503/100 for the 2023 performance year (Quality 100, Cost 21.501), 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

1255 PINEVIEW DR
MORGANTOWN, WV 26505

Provider Details

NPI 1215000369
Specialty Ophthalmology Physician
Credentials M.D.
Gender Male
NPI Issued 11/16/2006

CMS Quality Score (MIPS)

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

76.4503
Final Score
Avg: 83.1
100
Quality
21.501
Cost
100
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where HEATH LEMLEY, M.D. 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.

REGIONAL EYE ASSOCIATES INC
MORGANTOWN, WV

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 HEATH LEMLEY, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$473

Largest payer

Alcon Vision 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.

Brand vs generic prescribing mix · Above average

HEATH LEMLEY, M.D. — brand share 32.0%
Specialty average (est.)

32% brand-name claims vs 68% generic, on 4,305 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.

4,305
Total Claims
$410K
Total Drug Cost
937
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
6,588
Total Day Supply
180,633
Brand vs Generic
32% brand / 68% generic
Brand Drug Cost
$343K
Generic Drug Cost
$68K
Antibiotic Claims
51

Patient Demographics

Average Patient Age
75.9 years
Avg HCC Risk Score
1.20
Gender Split
63% female / 37% male
Age Distribution
<65: 44, 65-74: 362, 75-84: 392, 85+: 139

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Latanoprost
1,227
Prednisolone Acetate
587
Ketorolac Tromethamine
372
Brimonidine Tartrate
370
Timolol Maleate
279
Ofloxacin
262
Erythromycin
Erythromycin Base
169
Dorzolamide-Timolol
Dorzolamide Hcl/Timolol Maleat
144
Restasis
Cyclosporine
108
Dorzolamide Hcl
84

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

Ophthalmology Physician Overview

How HEATH LEMLEY, M.D. 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

HEATH LEMLEY, M.D.'s 4,305 claims are above the specialty average of 1,420.

Nearby Ophthalmology Physician Providers in West Virginia

Other clinicians with the same primary specialty enrolled in West Virginia, drawn from the same CMS NPPES roster as LEMLEY.

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

Frequently Asked Questions

What is HEATH LEMLEY, M.D.'s specialty?
HEATH LEMLEY, M.D. specializes in Ophthalmology Physician and practices in MORGANTOWN, West Virginia. Credentials: M.D..
How much does HEATH LEMLEY, M.D. prescribe under Medicare Part D?
In 2023, HEATH LEMLEY, M.D. wrote 4,305 Medicare Part D claims totaling $410K in drug costs for 937 beneficiaries.
What is HEATH LEMLEY, M.D.'s Medicare quality score?
HEATH LEMLEY, M.D. has a CMS MIPS Final Score of 76.4503/100 (Quality: 100, Cost: 21.501). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is HEATH LEMLEY, M.D. located?
HEATH LEMLEY, M.D. is located at 1255 PINEVIEW DR, MORGANTOWN, WV, 26505. Phone: (304) 598-3301.
What is HEATH LEMLEY, M.D.'s NPI number?
HEATH LEMLEY, M.D.'s National Provider Identifier (NPI) is 1215000369, issued on 11/16/2006.
Does HEATH LEMLEY, M.D. prescribe more brand-name or generic drugs?
HEATH LEMLEY, M.D.'s prescribing is 32% brand-name and 68% generic drugs by claim count, with $343K 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 HEATH LEMLEY, M.D. prescribe most often?
Based on 2023 Medicare Part D data, HEATH LEMLEY, M.D.'s most frequently prescribed drugs include Latanoprost, Prednisolone Acetate, Ketorolac Tromethamine. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does HEATH LEMLEY, M.D. accept Medicare?
HEATH LEMLEY, M.D. appears in CMS Medicare data with 4,305 Part D claims and 937 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify HEATH LEMLEY, M.D.'s credentials?
HEATH LEMLEY, M.D.'s NPI is 1215000369 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