HIRAL BADIWALA, O.D.
Pediatric Optometrist in ELIZABETHTOWN, Kentucky. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.
What stands out: HIRAL BADIWALA, O.D. filed 38 Medicare Part D claims in 2023 across ELIZABETHTOWN, Kentucky. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.
HIRAL BADIWALA, O.D. at a glance
Quality data not reportedPrimary specialty
Medicare Part D claims
Specialty distribution in Kentucky
How Pediatric Optometrist compares to other specialties among Kentucky providers
Pediatric Optometrist share within Kentucky
Pediatric Optometrist is one of the more visible NUCC categories in Kentucky
Each bar reflects the share of in-state providers whose primary NUCC taxonomy matches the specialty. Long tail of ~690 NUCC codes folded into "Other" to keep the comparison legible.
Specialty board-certification context
Estimated specialty board-certified rate — Pediatric Optometrist (ABMS / AOA reference)
- Est. board-certified rate
- 78%
- Pediatric Optometrist ABMS/AOA estimate
Est. board-certified rate (Pediatric Optometrist) — ABMS / AOA estimate
Verify credentials
- Verify via ABMS free public lookup
- Verify via AOA osteopathic boards
- Specialty volume Pediatric Optometrist US NPIs
Specialty board-certified rate — Pediatric Optometrist estimate
Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus Maintenance of Certification cycles. CMS does not publish a per-provider board-certification field; the figure shown is the specialty-level estimated rate from ABMS / AOA reference data.
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).
HIRAL BADIWALA, O.D. is a Pediatric Optometrist provider practicing in ELIZABETHTOWN, Kentucky, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: O.D.. NPI: 1750713103. 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.
HIRAL BADIWALA, O.D. appears in the CMS NPPES registry as a Pediatric Optometrist provider holding O.D. credentials at 2618 RING RD STE 108, ELIZABETHTOWN, KY, 42701, with a listed phone of (270) 765-1128. NPI 1750713103 was issued on 08/07/2013. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BADIWALA 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 38 prescription claims written by this provider, covering 19 Medicare beneficiaries and totaling roughly $5K in drug spend, split 50% brand-name and 50% 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.
Pediatric Optometrist is a narrow specialty nationwide, with 316 enrolled providers across 43 states and an average of 184 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 | 1750713103 |
|---|---|
| Specialty | Pediatric Optometrist |
| Credentials | O.D. |
| Gender | Female |
| NPI Issued | 08/07/2013 |
Verify this provider's license
PlainDoctor pulls this profile from the CMS NPPES public registry. Confirm HIRAL BADIWALA, O.D.'s current license status, disciplinary history, and board certifications with the Kentucky Board of Medical Licensure in Kentucky before relying on this page for a clinical or care decision.
How we sourced this profile
Hospital and facility affiliations
Facilities where HIRAL BADIWALA, O.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.
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 HIRAL BADIWALA, O.D.. Source: openpaymentsdata.cms.gov.
Total received
$259
Largest payer
Johnson & Johnson Vision Care, 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.
Brand vs generic prescribing mix · Brand-heavy
50% brand-name claims vs 50% generic, on 38 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.
Prescribing Breakdown
- 30-Day Fills
- 54
- Total Day Supply
- 1,455
- Brand vs Generic
- 50% brand / 50% generic
- Brand Drug Cost
- $5K
- Generic Drug Cost
- $356
Patient Demographics
- Average Patient Age
- 68.9 years
- Avg HCC Risk Score
- 0.89
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 | 19 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Pediatric Optometrist Overview
How HIRAL BADIWALA, O.D. fits within the Pediatric Optometrist landscape nationally.
HIRAL BADIWALA, O.D.'s 38 claims are below the specialty average of 184.
Nearby Pediatric Optometrist Providers in Kentucky
Other clinicians with the same primary specialty enrolled in Kentucky, drawn from the same CMS NPPES roster as BADIWALA.
Compare Pediatric Optometrist nationally: see state-by-state distribution →
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Frequently Asked Questions
What is HIRAL BADIWALA, O.D.'s specialty? ▼
How much does HIRAL BADIWALA, O.D. prescribe under Medicare Part D? ▼
Where is HIRAL BADIWALA, O.D. located? ▼
What is HIRAL BADIWALA, O.D.'s NPI number? ▼
Does HIRAL BADIWALA, O.D. prescribe more brand-name or generic drugs? ▼
How many Pediatric Optometrist providers are there in the US? ▼
What drugs does HIRAL BADIWALA, O.D. prescribe most often? ▼
Does HIRAL BADIWALA, O.D. accept Medicare? ▼
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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