2026 NPPES data Family Medicine Physician NPI 1205368602 MD
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JAMES FAHEY, MD

Family Medicine Physician in EDINBURG, Texas. 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
599
Medicare Part D claims · 54 beneficiaries · Family Medicine Physician avg: 3K
Generic prescribing
91%
generic claims · 9% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
81.4423/100
▼ 2 pts below national avg 83.1 · [object Object]

What the federal data shows

JAMES FAHEY, MD reported a CMS MIPS final score of 81.4423/100 — below the 83.1 national average — and filed 599 Medicare Part D claims in 2023.

81.4423/100
MIPS score · -2 vs avg
599
Part D claims, 2023
91%
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 FAHEY, MD's MIPS score vs every scored U.S. clinician

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

81 36th percentile higher than 36% 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%). This entry sits in this band. 90–100: 189,403 scored providers (40%). Above this entry. 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 FAHEY, 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 FAHEY, MD?

Near national average

NPI registry status

Active

Issued 04/03/2017

NPI 1205368602

Primary specialty

Family Medicine Physician

High-volume

147,640 US NPIs in this specialty

Medicare Part D claims

599 82% vs specialty avg

2023 prescription claims

Specialty avg: 3,418

MIPS final score

81.4423/100 1.6576999999999913% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in Texas

How Family Medicine Physician compares to other specialties among Texas providers

Texas providers

Family Medicine Physician share within Texas

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

Medicare quality performance — MIPS

JAMES FAHEY, MD's 2023 MIPS final score plotted against the Family Medicine Physician national average

Near national average
MIPS Final Score
81.4423/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Family Medicine Physician) — 81.4423/100 vs national avg 83.1

0%100%National avg83%81.4%
MIPS final score (Family Medicine Physician) — 81.4423/100 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 FAHEY, MD appears in the CMS NPPES registry as a Family Medicine Physician provider holding MD credentials at 3804 S JACKSON RD STE 2, EDINBURG, TX, 78539, with a listed phone of (956) 296-3021. NPI 1205368602 was issued on 04/03/2017. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what FAHEY 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 599 prescription claims written by this provider, covering 54 Medicare beneficiaries and totaling roughly $50K in drug spend, split 9% brand-name and 91% 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 81.4423/100 for the 2023 performance year (Quality 65.8349, Cost 49.2365), compared with the national average of 83.1.

Family Medicine Physician is a high-volume specialty nationwide, with 147,640 enrolled providers across 56 states and an average of 3,418 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

3804 S JACKSON RD STE 2
EDINBURG, TX 78539

Provider Details

NPI 1205368602
Specialty Family Medicine Physician
Credentials MD
Gender Male
NPI Issued 04/03/2017

CMS Quality Score (MIPS)

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

81.4423
Final Score
Avg: 83.1
65.8349
Quality
49.2365
Cost
98
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where JAMES FAHEY, 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.

UNIVERSITY OF TEXAS RIO GRANDE VALLEY
EDINBURG, TX

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

License & disciplinary context — Texas TMB 2023 annual report

Aggregate state board data only — NOT a determination of any individual provider's status. The figures below describe statewide disciplinary activity across all ~77K Texas medical licensees in 2023 — they are NOT specific to JAMES FAHEY, MD. To verify JAMES FAHEY, MD's current license status, search the TMB public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

344
Total board actions, Texas 2023
Across 334 cases
4.47
Actions per 1,000 licensees
Texas statewide rate
probation
Most common action type
94 cases

TMB publishes annual disciplinary statistics as part of public-record reporting under each state's Administrative Procedure Act. See the full breakdown by action type and year on the Texas disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Generic-heavy

JAMES FAHEY, MD — brand share 9.0%
Specialty average (est.)

9% brand-name claims vs 91% generic, on 599 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.

599
Total Claims
$50K
Total Drug Cost
54
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
1,308
Total Day Supply
37,803
Brand vs Generic
9% brand / 91% generic
Brand Drug Cost
$39K
Generic Drug Cost
$10K
Antibiotic Claims
21

Patient Demographics

Average Patient Age
67.9 years
Avg HCC Risk Score
2.52
Gender Split
54% female / 46% male
Age Distribution
<65: 15, 65-74: 25, 75-84: N/A, 85+: N/A

Top Prescribed Drugs (Medicare Part D)

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

What JAMES FAHEY, 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
Atorvastatin Calcium
45
Amlodipine Besylate
29
Lisinopril
29
Metformin Hcl Er
Metformin Hcl
21
Metoprolol Succinate
17
Cyclobenzaprine Hcl
16
Duloxetine Hcl
16
Gabapentin
15
Fluticasone Propionate
14
Levothyroxine Sodium
14

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

Family Medicine Physician Overview

How JAMES FAHEY, MD fits within the Family Medicine Physician landscape nationally.

147,640
Family Medicine Physician Providers in US
56
States with Family Medicine Physician
3,418
Avg Claims per Provider

JAMES FAHEY, MD's 599 claims are below the specialty average of 3,418.

Nearby Family Medicine Physician Providers in Texas

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

Compare Family Medicine Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is JAMES FAHEY, MD's specialty?
JAMES FAHEY, MD specializes in Family Medicine Physician and practices in EDINBURG, Texas. Credentials: MD.
How much does JAMES FAHEY, MD prescribe under Medicare Part D?
In 2023, JAMES FAHEY, MD wrote 599 Medicare Part D claims totaling $50K in drug costs for 54 beneficiaries.
What is JAMES FAHEY, MD's Medicare quality score?
JAMES FAHEY, MD has a CMS MIPS Final Score of 81.4423/100 (Quality: 65.8349, Cost: 49.2365). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is JAMES FAHEY, MD located?
JAMES FAHEY, MD is located at 3804 S JACKSON RD STE 2, EDINBURG, TX, 78539. Phone: (956) 296-3021.
What is JAMES FAHEY, MD's NPI number?
JAMES FAHEY, MD's National Provider Identifier (NPI) is 1205368602, issued on 04/03/2017.
Does JAMES FAHEY, MD prescribe more brand-name or generic drugs?
JAMES FAHEY, MD's prescribing is 9% brand-name and 91% generic drugs by claim count, with $39K in brand drug costs.
How many Family Medicine Physician providers are there in the US?
There are 147,640 Family Medicine Physician providers across 56 states in the US. The average Family Medicine Physician provider writes 3,418 Medicare Part D claims per year.
What drugs does JAMES FAHEY, MD prescribe most often?
Based on 2023 Medicare Part D data, JAMES FAHEY, MD's most frequently prescribed drugs include Atorvastatin Calcium, Amlodipine Besylate, Lisinopril. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does JAMES FAHEY, MD accept Medicare?
JAMES FAHEY, MD appears in CMS Medicare data with 599 Part D claims and 54 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify JAMES FAHEY, MD's credentials?
JAMES FAHEY, MD's NPI is 1205368602 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