NPI registry status
Active
2026 NPPES data Ophthalmology Physician NPI 1760936819 MD
Verify on CMS → James Bavinger, MD
Ophthalmology Physician in Fredericksburg, Virginia.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 22,082 in Ophthalmology 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
305
Medicare Part D claims · 80 beneficiaries · Ophthalmology Physician avg: 1K
Generic prescribing
71%
generic claims · 29% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
91.3/100
▲ 8 pts above national avg 83.1 · Exceptional
Industry payments
$728.4
21 payments · CMS Open Payments (Sunshine Act)
Source: CMS Medicare Part D Prescriber Public Use File, 2023
Compiled from official public sources by the PlainDoctor editorial team.
What the federal data shows
James Bavinger, MD reported a CMS MIPS final score of 91.3/100 - above the 83.1 national average - and filed 305 Medicare Part D claims in 2023.
- 91.3/100
- MIPS score · +8 vs avg
- 305
- Part D claims, 2023
- 71%
- 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.
James Bavinger, MD's MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
91 Top 37% higher than 63% of 477,587 scored providers
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 James Bavinger, MD sits
This provider among ophthalmology physician peers
Across the 9,866 ophthalmology physician providers who report both Medicare Part D prescribing and a MIPS quality score, James Bavinger, MD writes more Part D claims than 16% of them and scores higher on MIPS quality than 61% - placing this provider in the lower-volume, high-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
Each dot is one ophthalmology physician peer from a representative sample of 60; the gold marker is James Bavinger, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
James Bavinger, 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 Bavinger, MD?
High performer (top quartile)Primary specialty
Ophthalmology Physician
Medicare Part D claims
305 79% vs specialty avg
MIPS final score
91.3/100 8.2 pts vs avg
Specialty distribution in Virginia
How Ophthalmology Physician compares to other specialties among Virginia providers
Medicare quality performance, MIPS
James Bavinger, MD's 2023 MIPS final score plotted against the Ophthalmology Physician national average
- MIPS Final Score
- 91.3/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Ophthalmology Physician) - 91.3/100 vs national avg 83.1
How MIPS and board certification work
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 Bavinger, MD appears in the CMS NPPES registry as an Ophthalmology Physician provider holding MD credentials at 1500 DIXON ST STE 204, Fredericksburg, VA, 22401, with a listed phone of (540) 654-5333. NPI 1760936819 was issued on 08/06/2016.
Medicare Part D records for calendar year 2023 show 305 prescription claims written by this provider, covering 80 Medicare beneficiaries and totaling roughly $13K in drug spend, split 29% brand-name and 71% generic by claim count. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 91.3/100 for the 2023 performance year (Quality 82.6), compared with the national average of 83.1.
Ophthalmology Physician is a mid-sized specialty nationwide, with 22,082 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
Provider Details
| NPI | 1760936819 |
|---|---|
| Specialty | Ophthalmology Physician |
| Credentials | MD |
| Gender | Male |
| NPI Issued | 08/06/2016 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
91.2999
Final Score
Avg: 83.1
82.5998
Quality
Reporting: Group practice
Hospital and facility affiliations
Facilities where James Bavinger, 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.
The Retina Group OF Washington PLLC
Fredericksburg, VA
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 James Bavinger, MD. Source: openpaymentsdata.cms.gov.
Total received
$728
Largest payer
ABBVIE 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 · Above average
James Bavinger, MD - brand share 29.0%
Ophthalmology Physician average
29% brand-name claims vs 71% generic, on 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.
305
Total Claims
$13K
Total Drug Cost
80
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 385
- Total Day Supply
- 10,107
- Brand vs Generic
- 29% brand / 71% generic
- Brand Drug Cost
- $7K
- Generic Drug Cost
- $6K
Patient Demographics
- Average Patient Age
- 74.8 years
- Avg HCC Risk Score
- 1.34
- Gender Split
- 41% female / 59% male
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What James Bavinger, MD prescribes most
Top Medicare Part D drugs by claim count, 2023
- Prednisolone Acetate
Prednisolone Acetate
70 claims
- Erythromycin
Erythromycin
45 claims
- Atropine Sulfate
Atropine Sulfate
33 claims
- Moxifloxacin
Moxifloxacin
33 claims
- Latanoprost 22
Latanoprost
22 claims
- Ketorolac Trometha… 20
Ketorolac Tromethamine
20 claims
- Brimonidine Tartrate 15
Brimonidine Tartrate
15 claims
- Dorzolamide Hcl 14
Dorzolamide Hcl
14 claims
| Drug | Claims |
|---|---|
| Prednisolone Acetate | 70 |
| Erythromycin Erythromycin Base | 45 |
| Atropine Sulfate | 33 |
| Moxifloxacin Moxifloxacin Hcl | 33 |
| Latanoprost | 22 |
| Ketorolac Tromethamine | 20 |
| Brimonidine Tartrate | 15 |
| Dorzolamide Hcl | 14 |
| Polymyxin B Sul-Trimethoprim Polymyxin B Sulf/Trimethoprim | 13 |
| Dorzolamide-Timolol Dorzolamide Hcl/Timolol Maleat | 12 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Ophthalmology Physician Overview
How James Bavinger, MD fits within the Ophthalmology Physician landscape nationally.
22,082
Ophthalmology Physician Providers in US
56
States with Ophthalmology Physician
1,420
Avg Claims per Provider
James Bavinger, MD's 305 claims are below the specialty average of 1,420.
Nearby Ophthalmology Physician Providers in Virginia
Other clinicians with the same primary specialty enrolled in Virginia, drawn from the same CMS NPPES roster as Bavinger.
Dr. Benjamin Abramowitz
MD
Manassas, VA
Dr. Eric Adams
MD
Norfolk, VA
Dr. Rohit Adyanthaya
MD
Norfolk, VA
Dr. George Agritellis
M.D.
Winchester, VA
Dr. Sameer Ahmad
M.D.
Herndon, VA
Compare Ophthalmology 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 Virginia medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Ophthalmology 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.
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Frequently Asked Questions
What is James Bavinger, MD's specialty? ▼
James Bavinger, MD specializes in Ophthalmology Physician and practices in Fredericksburg, Virginia. Credentials: MD.
How much does James Bavinger, MD prescribe under Medicare Part D? ▼
In 2023, James Bavinger, MD wrote 305 Medicare Part D claims totaling $13K in drug costs for 80 beneficiaries.
What is James Bavinger, MD's Medicare quality score? ▼
James Bavinger, MD has a CMS MIPS Final Score of 91.3/100 (Quality: 82.6). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is James Bavinger, MD located? ▼
James Bavinger, MD is located at 1500 DIXON ST STE 204, Fredericksburg, VA, 22401. Phone: (540) 654-5333.
What is James Bavinger, MD's NPI number? ▼
James Bavinger, MD's National Provider Identifier (NPI) is 1760936819, issued on 08/06/2016.
Does James Bavinger, MD prescribe more brand-name or generic drugs? ▼
James Bavinger, MD's prescribing is 29% brand-name and 71% generic drugs by claim count, with $7K in brand drug costs.
How many Ophthalmology Physician providers are there in the US? ▼
There are 22,082 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 James Bavinger, MD prescribe most often? ▼
Based on 2023 Medicare Part D data, James Bavinger, MD's most frequently prescribed drugs include Prednisolone Acetate, Erythromycin, Atropine Sulfate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does James Bavinger, MD accept Medicare? ▼
James Bavinger, MD appears in CMS Medicare data with 305 Part D claims and 80 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify James Bavinger, MD's credentials? ▼
James Bavinger, MD's NPI is 1760936819 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
View source datasets and methodology notes
- 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.
Every figure on PlainDoctor is rendered directly from the federal CMS NPPES registry, Medicare Part D, MIPS, and Open Payments records, no number is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of May 2026.