2026 NPPES data Nurse Practitioner NPI 1396269742
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HEATHER BAUM

Nurse Practitioner in WEST READING, 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
516
Medicare Part D claims · 130 beneficiaries · Nurse Practitioner avg: 1K
Generic prescribing
48%
generic claims · 52% brand-name · higher generic rates reduce patient out-of-pocket costs
Industry payments
$1.3K
18 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: HEATHER BAUM is a Nurse Practitioner ([object Object]) practicing in WEST READING, Pennsylvania with a Medicare Part D prescribing footprint of 516 claims across 130 beneficiaries — 52% brand-name prescribing . Industry payments of $1.3K across 18 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: HEATHER BAUM filed 516 Medicare Part D claims in 2023 across WEST READING, Pennsylvania. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

HEATHER BAUM at a glance

Quality data not reported

NPI registry status

Active

Issued 07/27/2017

NPI 1396269742

Primary specialty

Nurse Practitioner

High-volume

87,227 US NPIs in this specialty

Medicare Part D claims

516 52% vs specialty avg

2023 prescription claims

Specialty avg: 1,084

Specialty distribution in Pennsylvania

How Nurse Practitioner compares to other specialties among Pennsylvania providers

Pennsylvania providers

Nurse Practitioner share within Pennsylvania

1. Nurse Practitioner42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Nurse Practitioner share within Pennsylvania

Specialty board-certification context

Estimated specialty board-certified rate — Nurse Practitioner (ABMS / AOA reference)

Quality data not reported
Est. board-certified rate
78%
Nurse Practitioner ABMS/AOA estimate

Est. board-certified rate (Nurse Practitioner) — ABMS / AOA estimate

0%100%78%
Est. board-certified rate (Nurse Practitioner) — ABMS / AOA estimate

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).

HEATHER BAUM is a Nurse Practitioner provider practicing in WEST READING, Pennsylvania, according to the CMS National Plan and Provider Enumeration System (NPPES). NPI: 1396269742. 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.

HEATHER BAUM appears in the CMS NPPES registry as a Nurse Practitioner provider at 420 S 5TH AVE, WEST READING, PA, 19611, with a listed phone of (484) 628-5455. NPI 1396269742 was issued on 07/27/2017. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BAUM 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 516 prescription claims written by this provider, covering 130 Medicare beneficiaries and totaling roughly $327K in drug spend, split 52% brand-name and 48% 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.

Nurse Practitioner is a high-volume specialty nationwide, with 87,227 enrolled providers across 56 states and an average of 1,084 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

420 S 5TH AVE
WEST READING, PA 19611

Provider Details

NPI 1396269742
Specialty Nurse Practitioner
Gender Female
NPI Issued 07/27/2017

Hospital and facility affiliations

Facilities where HEATHER BAUM 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.

READING HOSPITAL
★★★★☆ 4/5
WYOMISSING, PA
Acute Care Hospitals
CMS CCN: 390044

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 HEATHER BAUM. Source: openpaymentsdata.cms.gov.

Total received

$1.3K

Largest payer

Lilly USA, 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.

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 HEATHER BAUM. To verify HEATHER BAUM'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 · Brand-heavy

HEATHER BAUM — brand share 52.0%
Specialty average (est.)

52% brand-name claims vs 48% generic, on 516 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.

516
Total Claims
$327K
Total Drug Cost
130
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
751
Total Day Supply
21,835
Brand vs Generic
52% brand / 48% generic
Brand Drug Cost
$322K
Generic Drug Cost
$3K

Patient Demographics

Average Patient Age
58.8 years
Avg HCC Risk Score
1.22
Gender Split
84% female / 16% male
Age Distribution
<65: 77, 65-74: 43, 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.

Drug Claims
Ozempic
Semaglutide
132
Trulicity
Dulaglutide
78
Topiramate
77
Metformin Hcl Er
Metformin Hcl
47
Mounjaro
Tirzepatide
35
Metformin Hcl
34
Omeprazole
27
Victoza 3-Pak
Liraglutide
20
Pantoprazole Sodium
11

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

Nurse Practitioner Overview

How HEATHER BAUM fits within the Nurse Practitioner landscape nationally.

87,227
Nurse Practitioner Providers in US
56
States with Nurse Practitioner
1,084
Avg Claims per Provider

HEATHER BAUM's 516 claims are below the specialty average of 1,084.

Nearby Nurse Practitioner Providers in Pennsylvania

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

Compare Nurse Practitioner nationally: see state-by-state distribution →

Frequently Asked Questions

What is HEATHER BAUM's specialty?
HEATHER BAUM specializes in Nurse Practitioner and practices in WEST READING, Pennsylvania.
How much does HEATHER BAUM prescribe under Medicare Part D?
In 2023, HEATHER BAUM wrote 516 Medicare Part D claims totaling $327K in drug costs for 130 beneficiaries.
Where is HEATHER BAUM located?
HEATHER BAUM is located at 420 S 5TH AVE, WEST READING, PA, 19611. Phone: (484) 628-5455.
What is HEATHER BAUM's NPI number?
HEATHER BAUM's National Provider Identifier (NPI) is 1396269742, issued on 07/27/2017.
Does HEATHER BAUM prescribe more brand-name or generic drugs?
HEATHER BAUM's prescribing is 52% brand-name and 48% generic drugs by claim count, with $322K in brand drug costs.
How many Nurse Practitioner providers are there in the US?
There are 87,227 Nurse Practitioner providers across 56 states in the US. The average Nurse Practitioner provider writes 1,084 Medicare Part D claims per year.
What drugs does HEATHER BAUM prescribe most often?
Based on 2023 Medicare Part D data, HEATHER BAUM's most frequently prescribed drugs include Ozempic, Trulicity, Topiramate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does HEATHER BAUM accept Medicare?
HEATHER BAUM appears in CMS Medicare data with 516 Part D claims and 130 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify HEATHER BAUM's credentials?
HEATHER BAUM's NPI is 1396269742. 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.
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