2026 NPPES data Ophthalmology Physician NPI 1760936819 MD
Verify on CMS →

JAMES BAVINGER, MD

Ophthalmology Physician in FREDERICKSBURG, Virginia. 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
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
91.2999/100
▲ 8 pts above national avg 83.1 · [object Object]
Industry payments
$728.4
21 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

JAMES BAVINGER, MD reported a CMS MIPS final score of 91.2999/100 — above the 83.1 national average — and filed 305 Medicare Part D claims in 2023.

91.2999/100
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

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 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)

NPI registry status

Active

Issued 08/06/2016

NPI 1760936819

Primary specialty

Ophthalmology Physician

Mid-sized

22,090 US NPIs in this specialty

Medicare Part D claims

305 79% vs specialty avg

2023 prescription claims

Specialty avg: 1,420

MIPS final score

91.2999/100 8.1999% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Virginia

How Ophthalmology Physician compares to other specialties among Virginia providers

Virginia providers

Ophthalmology Physician share within Virginia

1. Ophthalmology Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Ophthalmology Physician share within Virginia

Medicare quality performance — MIPS

JAMES BAVINGER, MD's 2023 MIPS final score plotted against the Ophthalmology Physician national average

High performer (top quartile)
MIPS Final Score
91.2999/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Ophthalmology Physician) — 91.2999/100 vs national avg 83.1

0%100%National avg83%91.3%
MIPS final score (Ophthalmology Physician) — 91.2999/100 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 BAVINGER, MD is a Ophthalmology Physician provider practicing in FREDERICKSBURG, Virginia, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: MD. NPI: 1760936819. 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.

JAMES BAVINGER, MD appears in the CMS NPPES registry as a 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. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BAVINGER 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 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. 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 91.2999/100 for the 2023 performance year (Quality 82.5998), compared with the national average of 83.1.

Ophthalmology Physician is a mid-sized specialty nationwide, with 22,090 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

1500 DIXON ST STE 204
FREDERICKSBURG, VA 22401

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%
Specialty average (est.)

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.

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.

22,090
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.

Compare Ophthalmology Physician nationally: see state-by-state distribution →

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 91.2999/100 (Quality: 82.5998). 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 22,090 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

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