2026 NPPES data Interventional Pain Medicine Physician NPI 1689879959 MD MPH
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Hemant Kalia, MD MPH

Interventional Pain Medicine Physician in Rochester, New York. This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 1,528 in Interventional Pain Medicine 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
634
Medicare Part D claims · 166 beneficiaries · Interventional Pain Medicine Physician avg: 2K
Generic prescribing
95%
generic claims · 5% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
68/100
▼ 15 pts below national avg 83.1 · Mid-tier
Industry payments
$26.1K
71 payments · CMS Open Payments (Sunshine Act)
Compiled from official public sources by the PlainDoctor editorial team.

What the federal data shows

Hemant Kalia, MD MPH reported a CMS MIPS final score of 68/100 - below the 83.1 national average - and filed 634 Medicare Part D claims in 2023.

68/100
MIPS score · -15 vs avg
634
Part D claims, 2023
95%
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.

Hemant Kalia, MD MPH's MIPS score vs every scored U.S. clinician

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

68 7th percentile higher than 7% 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%). This entry sits in this band. 70–80: 118,074 scored providers (25%). Above this entry. 80–90: 129,887 scored providers (27%). Above this entry. 90+: 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

Where Hemant Kalia, MD MPH sits

This provider among interventional pain medicine physician peers

Across the 546 interventional pain medicine physician providers who report both Medicare Part D prescribing and a MIPS quality score, Hemant Kalia, MD MPH writes more Part D claims than 27% of them and scores higher on MIPS quality than 16% - placing this provider in the lower-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

Lower volume · High qualityHigh volume · High qualityLower volume · Lower qualityHigh volume · Lower quality0255075100024.448.873.297.7Part D claim volume, percentile in specialtyMIPS quality, percentilePart D claim volume, percentile in specialty: 2 · MIPS quality, percentile: 22Part D claim volume, percentile in specialty: 93 · MIPS quality, percentile: 37Part D claim volume, percentile in specialty: 88 · MIPS quality, percentile: 78Part D claim volume, percentile in specialty: 85 · MIPS quality, percentile: 62Part D claim volume, percentile in specialty: 53 · MIPS quality, percentile: 20Part D claim volume, percentile in specialty: 12 · MIPS quality, percentile: 67Part D claim volume, percentile in specialty: 32 · MIPS quality, percentile: 85Part D claim volume, percentile in specialty: 13 · MIPS quality, percentile: 3Part D claim volume, percentile in specialty: 62 · MIPS quality, percentile: 65Part D claim volume, percentile in specialty: 58 · MIPS quality, percentile: 55Part D claim volume, percentile in specialty: 57 · MIPS quality, percentile: 82Part D claim volume, percentile in specialty: 2 · MIPS quality, percentile: 60Part D claim volume, percentile in specialty: 30 · MIPS quality, percentile: 53Part D claim volume, percentile in specialty: 38 · MIPS quality, percentile: 25Part D claim volume, percentile in specialty: 70 · MIPS quality, percentile: 87Part D claim volume, percentile in specialty: 80 · MIPS quality, percentile: 25Part D claim volume, percentile in specialty: 5 · MIPS quality, percentile: 42Part D claim volume, percentile in specialty: 20 · MIPS quality, percentile: 88Part D claim volume, percentile in specialty: 25 · MIPS quality, percentile: 25Part D claim volume, percentile in specialty: 65 · MIPS quality, percentile: 70Part D claim volume, percentile in specialty: 73 · MIPS quality, percentile: 8Part D claim volume, percentile in specialty: 45 · MIPS quality, percentile: 93Part D claim volume, percentile in specialty: 97 · MIPS quality, percentile: 13Part D claim volume, percentile in specialty: 18 · MIPS quality, percentile: 45Part D claim volume, percentile in specialty: 40 · MIPS quality, percentile: 5Part D claim volume, percentile in specialty: 67 · MIPS quality, percentile: 68Part D claim volume, percentile in specialty: 68 · MIPS quality, percentile: 0Part D claim volume, percentile in specialty: 82 · MIPS quality, percentile: 33Part D claim volume, percentile in specialty: 78 · MIPS quality, percentile: 62Part D claim volume, percentile in specialty: 22 · MIPS quality, percentile: 15Part D claim volume, percentile in specialty: 72 · MIPS quality, percentile: 58Part D claim volume, percentile in specialty: 98 · MIPS quality, percentile: 17Part D claim volume, percentile in specialty: 43 · MIPS quality, percentile: 43Part D claim volume, percentile in specialty: 92 · MIPS quality, percentile: 93Part D claim volume, percentile in specialty: 48 · MIPS quality, percentile: 93Part D claim volume, percentile in specialty: 63 · MIPS quality, percentile: 0Part D claim volume, percentile in specialty: 87 · MIPS quality, percentile: 38Part D claim volume, percentile in specialty: 0 · MIPS quality, percentile: 57Part D claim volume, percentile in specialty: 10 · MIPS quality, percentile: 35Part D claim volume, percentile in specialty: 60 · MIPS quality, percentile: 7Part D claim volume, percentile in specialty: 35 · MIPS quality, percentile: 80Part D claim volume, percentile in specialty: 23 · MIPS quality, percentile: 47Part D claim volume, percentile in specialty: 42 · MIPS quality, percentile: 40Part D claim volume, percentile in specialty: 7 · MIPS quality, percentile: 18Part D claim volume, percentile in specialty: 27 · MIPS quality, percentile: 75Part D claim volume, percentile in specialty: 28 · MIPS quality, percentile: 93Part D claim volume, percentile in specialty: 8 · MIPS quality, percentile: 52Part D claim volume, percentile in specialty: 75 · MIPS quality, percentile: 73Part D claim volume, percentile in specialty: 32 · MIPS quality, percentile: 47Part D claim volume, percentile in specialty: 95 · MIPS quality, percentile: 72Part D claim volume, percentile in specialty: 52 · MIPS quality, percentile: 32Part D claim volume, percentile in specialty: 17 · MIPS quality, percentile: 22Part D claim volume, percentile in specialty: 90 · MIPS quality, percentile: 25Part D claim volume, percentile in specialty: 55 · MIPS quality, percentile: 12Part D claim volume, percentile in specialty: 47 · MIPS quality, percentile: 83Part D claim volume, percentile in specialty: 50 · MIPS quality, percentile: 50Part D claim volume, percentile in specialty: 77 · MIPS quality, percentile: 77Part D claim volume, percentile in specialty: 100 · MIPS quality, percentile: 90Part D claim volume, percentile in specialty: 15 · MIPS quality, percentile: 93Part D claim volume, percentile in specialty: 83 · MIPS quality, percentile: 92Hemant Kalia, MD MPH-Part D claim volume, percentile in specialty: 27 · MIPS quality, percentile: 16
Part D claim volume vs MIPS quality, by specialty percentile

Each dot is one interventional pain medicine physician peer from a representative sample of 60; the gold marker is Hemant Kalia, MD MPH. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.

Board certification likely (heuristic, not verified)

Hemant Kalia, MD MPH practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 3 hospital affiliations - 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 Hemant Kalia, MD MPH?

Below national average

NPI registry status

Active

Issued 06/18/2007

NPI 1689879959

Primary specialty

Interventional Pain Medicine Physician

Niche

1,528 US NPIs in this specialty

Medicare Part D claims

634 71% vs specialty avg

2023 prescription claims

Specialty avg: 2,197

MIPS final score

68/100 15.1 pts vs avg

Mid-tier band

vs 83.1 national avg

Specialty distribution in New York

How Interventional Pain Medicine Physician compares to other specialties among New York providers

New York providers
Student in an Organized Health Care Education/Training Program - 7.8%Student in an Organized Health Care Education/Training Program7.8%Registered Nurse - 5.2%Registered Nurse5.2%Clinical Social Worker - 4.9%Clinical Social Worker4.9%Social Worker - 4.5%Social Worker4.5%Speech-Language Pathologist - 4.5%Speech-Language Pathologist4.5%Licensed Practical Nurse - 4.3%Licensed Practical Nurse4.3%Interventional Pain Medicine Physician - 0%Interventional Pain Medicine Physician0%
Largest specialties in New York (% of in-state providers)

Medicare quality performance, MIPS

Hemant Kalia, MD MPH's 2023 MIPS final score plotted against the Interventional Pain Medicine Physician national average

Below national average
MIPS Final Score
68/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Interventional Pain Medicine Physician) - 68/100 vs national avg 83.1

0%100%National avg83%68%
MIPS final score (Interventional Pain Medicine Physician) - 68/100 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).

Hemant Kalia, MD MPH appears in the CMS NPPES registry as a Interventional Pain Medicine Physician provider holding MD MPH credentials at 500 HELENDALE RD STE LL20, Rochester, NY, 14609, with a listed phone of (585) 600-7246. NPI 1689879959 was issued on 06/18/2007. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what Kalia 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 634 prescription claims written by this provider, covering 166 Medicare beneficiaries and totaling roughly $31K in drug spend, split 5% brand-name and 95% generic by claim count, with an opioid prescribing rate of 28.2%. 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 68/100 for the 2023 performance year (Quality 67.2, Cost 39.6), compared with the national average of 83.1.

Interventional Pain Medicine Physician is a narrow specialty nationwide, with 1,528 enrolled providers across 53 states and an average of 2,197 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

500 HELENDALE RD STE LL20
Rochester, NY 14609

Provider Details

NPI 1689879959
Specialty Interventional Pain Medicine Physician
Credentials MD MPH
Gender Male
NPI Issued 06/18/2007

CMS Quality Score (MIPS)

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

68.0271
Final Score
Avg: 83.1
67.1921
Quality
39.565
Cost
64
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where Hemant Kalia, MD MPH 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.

According to CMS billing records, Hemant Kalia, MD MPH is affiliated with 3 Medicare-billing facilities.

Brain And Spine Medical Services PLLC
Williamsville, NY
Buffalo Spine Medicine And Rehab PLLC
Orchard Park, NY
Wyoming County
Warsaw, NY
Critical Access Hospitals
CMS CCN: 331323

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 Hemant Kalia, MD MPH. Source: openpaymentsdata.cms.gov.

Total received

$26.1K

Largest payer

Averitas Pharma Inc.

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 - New York NYSBPMC 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 ~100K New York medical licensees in 2023 - they are NOT specific to Hemant Kalia, MD MPH. To verify Hemant Kalia, MD MPH's current license status, search the NYSBPMC public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

312
Total board actions, New York 2023
Across 302 cases
3.12
Actions per 1,000 licensees
New York statewide rate
probation
Most common action type
89 cases

NYSBPMC 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 New York disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Generic-heavy

Hemant Kalia, MD MPH - brand share 5.0%
Interventional Pain Medicine Physician average

5% brand-name claims vs 95% generic, on 634 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.

634
Total Claims
$31K
Total Drug Cost
166
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
645
Total Day Supply
15,426
Brand vs Generic
5% brand / 95% generic
Brand Drug Cost
$15K
Generic Drug Cost
$16K
Opioid Claims
179 (28.2% rate)
Antibiotic Claims
13

Patient Demographics

Average Patient Age
67.5 years
Avg HCC Risk Score
1.53
Gender Split
63% female / 37% male
Age Distribution
<65: 55, 65-74: 73, 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 Hemant Kalia, MD MPH prescribes most

Top Medicare Part D drugs by claim count, 2023

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2023
Drug Claims
Celecoxib
81
Pregabalin
77
Gabapentin
51
Oxycodone Hcl
39
Duloxetine Hcl
35
Baclofen
31
Tizanidine Hcl
31
Morphine Sulfate
29
Methylprednisolone
28
Hydromorphone Hcl
19

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

Interventional Pain Medicine Physician Overview

How Hemant Kalia, MD MPH fits within the Interventional Pain Medicine Physician landscape nationally.

1,528
Interventional Pain Medicine Physician Providers in US
53
States with Interventional Pain Medicine Physician
2,197
Avg Claims per Provider

Hemant Kalia, MD MPH's 634 claims are below the specialty average of 2,197.

Nearby Interventional Pain Medicine Physician Providers in New York

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

Compare Interventional Pain Medicine 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 New York medical board, federal registration is not a license check. Credential verification guide
  • Weigh a second option: compare this provider with a nearby Interventional Pain Medicine 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.

Frequently Asked Questions

What is Hemant Kalia, MD MPH's specialty?
Hemant Kalia, MD MPH specializes in Interventional Pain Medicine Physician and practices in Rochester, New York. Credentials: MD MPH.
How much does Hemant Kalia, MD MPH prescribe under Medicare Part D?
In 2023, Hemant Kalia, MD MPH wrote 634 Medicare Part D claims totaling $31K in drug costs for 166 beneficiaries.
What is Hemant Kalia, MD MPH's Medicare quality score?
Hemant Kalia, MD MPH has a CMS MIPS Final Score of 68/100 (Quality: 67.2, Cost: 39.6). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Hemant Kalia, MD MPH located?
Hemant Kalia, MD MPH is located at 500 HELENDALE RD STE LL20, Rochester, NY, 14609. Phone: (585) 600-7246.
What is Hemant Kalia, MD MPH's NPI number?
Hemant Kalia, MD MPH's National Provider Identifier (NPI) is 1689879959, issued on 06/18/2007.
Does Hemant Kalia, MD MPH prescribe more brand-name or generic drugs?
Hemant Kalia, MD MPH's prescribing is 5% brand-name and 95% generic drugs by claim count, with $15K in brand drug costs.
Does Hemant Kalia, MD MPH prescribe opioids?
Yes, Hemant Kalia, MD MPH had 179 opioid claims in 2023 with an opioid prescribing rate of 28.2%.
How many Interventional Pain Medicine Physician providers are there in the US?
There are 1,528 Interventional Pain Medicine Physician providers across 53 states in the US. The average Interventional Pain Medicine Physician provider writes 2,197 Medicare Part D claims per year.
What drugs does Hemant Kalia, MD MPH prescribe most often?
Based on 2023 Medicare Part D data, Hemant Kalia, MD MPH's most frequently prescribed drugs include Celecoxib, Pregabalin, Gabapentin. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Hemant Kalia, MD MPH accept Medicare?
Hemant Kalia, MD MPH appears in CMS Medicare data with 634 Part D claims and 166 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Hemant Kalia, MD MPH's credentials?
Hemant Kalia, MD MPH's NPI is 1689879959 with credentials MD MPH. 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

Compiled from official public sources by the PlainDoctor editorial team.