2026 NPPES data Plastic Surgery Physician NPI 1801087044 MD
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JAMES BANICH, MD

Plastic Surgery Physician in COLORADO SPRINGS, Colorado. 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
547
Medicare Part D claims · 303 beneficiaries · Plastic Surgery Physician avg: 84
MIPS score
92.9455/100
▲ 10 pts above national avg 83.1 · [object Object]

What the federal data shows

JAMES BANICH, MD reported a CMS MIPS final score of 92.9455/100 — above the 83.1 national average — and filed 547 Medicare Part D claims in 2023.

92.9455/100
MIPS score · +10 vs avg
547
Part D claims, 2023
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.

JAMES BANICH, MD's MIPS score vs every scored U.S. clinician

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

93 Top 32% higher than 68% 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%). Below this entry. 70–80: 118,074 scored providers (25%). Below this entry. 80–90: 129,887 scored providers (27%). Below this entry. 90–100: 189,403 scored providers (40%). This entry sits in this band. 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

Board certification likely (heuristic — not verified)

JAMES BANICH, MD 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).

What does the federal data show about JAMES BANICH, MD?

High performer (top quartile)

NPI registry status

Active

Issued 08/05/2007

NPI 1801087044

Primary specialty

Plastic Surgery Physician

Mid-sized

5,316 US NPIs in this specialty

Medicare Part D claims

547 551% vs specialty avg

2023 prescription claims

Specialty avg: 84

MIPS final score

92.9455/100 9.845500000000001% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Colorado

How Plastic Surgery Physician compares to other specialties among Colorado providers

Colorado providers

Plastic Surgery Physician share within Colorado

1. Plastic Surgery Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Plastic Surgery Physician share within Colorado

Medicare quality performance — MIPS

JAMES BANICH, MD's 2023 MIPS final score plotted against the Plastic Surgery Physician national average

High performer (top quartile)
MIPS Final Score
92.9455/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Plastic Surgery Physician) — 92.9455/100 vs national avg 83.1

0%100%National avg83%92.9%
MIPS final score (Plastic Surgery Physician) — 92.9455/100 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).

JAMES BANICH, MD appears in the CMS NPPES registry as a Plastic Surgery Physician provider holding MD credentials at 9348 GRAND CORDERA PKWY STE 160, COLORADO SPRINGS, CO, 80924, with a listed phone of (719) 355-1585. NPI 1801087044 was issued on 08/05/2007. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BANICH 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 547 prescription claims written by this provider, covering 303 Medicare beneficiaries and totaling roughly $4K in drug spend, with an opioid prescribing rate of 34.7%. 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 92.9455/100 for the 2023 performance year (Quality 88.0357, Cost 88.4494), compared with the national average of 83.1.

Plastic Surgery Physician is a mid-sized specialty nationwide, with 5,316 enrolled providers across 52 states and an average of 84 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

9348 GRAND CORDERA PKWY STE 160
COLORADO SPRINGS, CO 80924

Provider Details

NPI 1801087044
Specialty Plastic Surgery Physician
Credentials MD
Gender Male
NPI Issued 08/05/2007

CMS Quality Score (MIPS)

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

92.9455
Final Score
Avg: 83.1
88.0357
Quality
88.4494
Cost
100
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where JAMES BANICH, MD 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.

VANGUARD MEDICAL SPECIALISTS, LLC
COLORADO SPRINGS, CO

Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

547
Total Claims
$4K
Total Drug Cost
303
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
548
Total Day Supply
3,362
Generic Drug Cost
$4K
Opioid Claims
190 (34.7% rate)
Antibiotic Claims
296

Patient Demographics

Average Patient Age
74.5 years
Avg HCC Risk Score
1.15
Gender Split
47% female / 53% male
Age Distribution
<65: 12, 65-74: 141, 75-84: 129, 85+: 21

Top Prescribed Drugs (Medicare Part D)

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

What JAMES BANICH, MD 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
Hydrocodone-Acetaminophen
Hydrocodone/Acetaminophen
146
Cephalexin
135
Doxycycline Hyclate
104
Celecoxib
27
Oxycodone Hcl
23
Clindamycin Hcl
20
Tramadol Hcl
19
Ondansetron Odt
Ondansetron
14

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

Plastic Surgery Physician Overview

How JAMES BANICH, MD fits within the Plastic Surgery Physician landscape nationally.

5,316
Plastic Surgery Physician Providers in US
52
States with Plastic Surgery Physician
84
Avg Claims per Provider

JAMES BANICH, MD's 547 claims are above the specialty average of 84.

Nearby Plastic Surgery Physician Providers in Colorado

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

Compare Plastic Surgery Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is JAMES BANICH, MD's specialty?
JAMES BANICH, MD specializes in Plastic Surgery Physician and practices in COLORADO SPRINGS, Colorado. Credentials: MD.
How much does JAMES BANICH, MD prescribe under Medicare Part D?
In 2023, JAMES BANICH, MD wrote 547 Medicare Part D claims totaling $4K in drug costs for 303 beneficiaries.
What is JAMES BANICH, MD's Medicare quality score?
JAMES BANICH, MD has a CMS MIPS Final Score of 92.9455/100 (Quality: 88.0357, Cost: 88.4494). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is JAMES BANICH, MD located?
JAMES BANICH, MD is located at 9348 GRAND CORDERA PKWY STE 160, COLORADO SPRINGS, CO, 80924. Phone: (719) 355-1585.
What is JAMES BANICH, MD's NPI number?
JAMES BANICH, MD's National Provider Identifier (NPI) is 1801087044, issued on 08/05/2007.
Does JAMES BANICH, MD prescribe opioids?
Yes, JAMES BANICH, MD had 190 opioid claims in 2023 with an opioid prescribing rate of 34.7%.
How many Plastic Surgery Physician providers are there in the US?
There are 5,316 Plastic Surgery Physician providers across 52 states in the US. The average Plastic Surgery Physician provider writes 84 Medicare Part D claims per year.
What drugs does JAMES BANICH, MD prescribe most often?
Based on 2023 Medicare Part D data, JAMES BANICH, MD's most frequently prescribed drugs include Hydrocodone-Acetaminophen, Cephalexin, Doxycycline Hyclate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does JAMES BANICH, MD accept Medicare?
JAMES BANICH, MD appears in CMS Medicare data with 547 Part D claims and 303 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify JAMES BANICH, MD's credentials?
JAMES BANICH, MD's NPI is 1801087044 with credentials MD. 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