NPI registry status
Active
2026 NPPES data Sports Medicine (Orthopaedic Surgery) Physician NPI 1841295656 MD
Verify on CMS → James Bilbo, MD
Sports Medicine (Orthopaedic Surgery) Physician in Highland Heights, Kentucky.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 2,681 in Sports Medicine (Orthopaedic Surgery) 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
23
Medicare Part D claims · Sports Medicine (Orthopaedic Surgery) Physician avg: 278
MIPS score
90.4/100
▲ 7 pts above national avg 83.1 · Exceptional
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 Bilbo, MD reported a CMS MIPS final score of 90.4/100 - above the 83.1 national average - and filed 23 Medicare Part D claims in 2023.
- 90.4/100
- MIPS score · +7 vs avg
- 23
- 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 Bilbo, MD's MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
90 Top 40% higher than 60% 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 Bilbo, MD sits
This provider among sports medicine (orthopaedic surgery) physician peers
Across the 1,085 sports medicine (orthopaedic surgery) physician providers who report both Medicare Part D prescribing and a MIPS quality score, James Bilbo, MD writes more Part D claims than 4% of them and scores higher on MIPS quality than 75% - 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 sports medicine (orthopaedic surgery) physician peer from a representative sample of 60; the gold marker is James Bilbo, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
James Bilbo, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting - 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 Bilbo, MD?
High performer (top quartile)Primary specialty
Sports Medicine (Orthopaedic Surgery) Physician
Medicare Part D claims
23 92% vs specialty avg
MIPS final score
90.4/100 7.3 pts vs avg
Specialty distribution in Kentucky
How Sports Medicine (Orthopaedic Surgery) Physician compares to other specialties among Kentucky providers
Medicare quality performance, MIPS
James Bilbo, MD's 2023 MIPS final score plotted against the Sports Medicine (Orthopaedic Surgery) Physician national average
- MIPS Final Score
- 90.4/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Sports Medicine (Orthopaedic Surgery) Physician) - 90.4/100 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 Bilbo, MD appears in the CMS NPPES registry as a Sports Medicine (Orthopaedic Surgery) Physician provider holding MD credentials at 2626 ALEXANDRIA PIKE STE 100, Highland Heights, KY, 41076, with a listed phone of (859) 301-2663. NPI 1841295656 was issued on 06/17/2005.
Medicare Part D records for calendar year 2023 show 23 prescription claims written by this provider, covering N/A Medicare beneficiaries and totaling roughly $375 in drug spend. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 90.4/100 for the 2023 performance year (Quality 80.8), compared with the national average of 83.1.
Sports Medicine (Orthopaedic Surgery) Physician is a narrow specialty nationwide, with 2,681 enrolled providers across 53 states and an average of 278 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 | 1841295656 |
|---|---|
| Specialty | Sports Medicine (Orthopaedic Surgery) Physician |
| Credentials | MD |
| Gender | Male |
| NPI Issued | 06/17/2005 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
90.3837
Final Score
Avg: 83.1
80.7674
Quality
100
Promoting Interoperability
Reporting: Alternative Payment Model
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2023.
23
Total Claims
$375
Total Drug Cost
N/A
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 30
- Total Day Supply
- 873
- Brand Drug Cost
- $0
- Generic Drug Cost
- $375
Patient Demographics
- Average Patient Age
- 73.0 years
- Avg HCC Risk Score
- 1.10
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
| Drug | Claims |
|---|---|
| Meloxicam | 15 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
More Sports Medicine (Orthopaedic Surgery) Physician in KY →
All providers in Kentucky →
Compare specialties →
Sports Medicine (Orthopaedic Surgery) Physician Overview
How James Bilbo, MD fits within the Sports Medicine (Orthopaedic Surgery) Physician landscape nationally.
2,681
Sports Medicine (Orthopaedic Surgery) Physician Providers in US
53
States with Sports Medicine (Orthopaedic Surgery) Physician
278
Avg Claims per Provider
James Bilbo, MD's 23 claims are below the specialty average of 278.
Nearby Sports Medicine (Orthopaedic Surgery) Physician Providers in Kentucky
Other clinicians with the same primary specialty enrolled in Kentucky, drawn from the same CMS NPPES roster as Bilbo.
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 Kentucky medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Sports Medicine (Orthopaedic Surgery) 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 Bilbo, MD's specialty? ▼
James Bilbo, MD specializes in Sports Medicine (Orthopaedic Surgery) Physician and practices in Highland Heights, Kentucky. Credentials: MD.
How much does James Bilbo, MD prescribe under Medicare Part D? ▼
In 2023, James Bilbo, MD wrote 23 Medicare Part D claims totaling $375 in drug costs for N/A beneficiaries.
What is James Bilbo, MD's Medicare quality score? ▼
James Bilbo, MD has a CMS MIPS Final Score of 90.4/100 (Quality: 80.8). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is James Bilbo, MD located? ▼
James Bilbo, MD is located at 2626 ALEXANDRIA PIKE STE 100, Highland Heights, KY, 41076. Phone: (859) 301-2663.
What is James Bilbo, MD's NPI number? ▼
James Bilbo, MD's National Provider Identifier (NPI) is 1841295656, issued on 06/17/2005.
How many Sports Medicine (Orthopaedic Surgery) Physician providers are there in the US? ▼
There are 2,681 Sports Medicine (Orthopaedic Surgery) Physician providers across 53 states in the US. The average Sports Medicine (Orthopaedic Surgery) Physician provider writes 278 Medicare Part D claims per year.
What drugs does James Bilbo, MD prescribe most often? ▼
Based on 2023 Medicare Part D data, James Bilbo, MD's most frequently prescribed drugs include Meloxicam. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does James Bilbo, MD accept Medicare? ▼
James Bilbo, MD appears in CMS Medicare data with 23 Part D claims and N/A Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify James Bilbo, MD's credentials? ▼
James Bilbo, MD's NPI is 1841295656 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.