NPI registry status
Active
2026 NPPES data Family Medicine Physician NPI 1194766162 MD
Verify on CMS → James Gardner, MD
Family Medicine Physician in New Wilmington, Pennsylvania.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 147,760 in Family Medicine 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
23K
Medicare Part D claims · 975 beneficiaries · Family Medicine Physician avg: 3K
Generic prescribing
88%
generic claims · 11% brand-name · higher generic rates reduce patient out-of-pocket costs
Industry payments
$3.0K
152 payments · CMS Open Payments (Sunshine Act)
Source: CMS Medicare Part D Prescriber Public Use File, 2023
What the federal data shows
James Gardner, MD filed 22,575 Medicare Part D claims in 2023 as a Family Medicine Physician in New Wilmington, Pennsylvania, prescribing 88% generic.
- 23K
- Part D claims, 2023
- 88%
- generic prescribing
- Likely
- board-certified (heuristic)
- ≥98th
- pct by Part D claim volume (lower-bound band)
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.
CMS NPPES provider registry desk
NPI 1194766162 · Family Medicine Physician
NPI-10 · ENUM-LEGACY · TAX-MEGA · RX-HEAVY · BOOK-MID · PHOTO-ENUM
- NPI-10 1194766162
- ENUM-LEGACY 2006
- TAX-MEGA 148K Family Medicine
- RX-HEAVY 23K claims
- BOOK-MID 7,200 in Pennsylvania
- PHOTO-ENUM Robert Rollo · 2006
James Gardner, MD's Medicare Part D volume vs every U.S. prescriber
Total Medicare Part D claims, 2023, across all CMS prescribers nationally
22,575 ≥ 98th percentile 98% of 1,370,886 prescribers are in lower value bands
Each bar is a band; taller bars hold more prescribers. 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.
The percentile is a conservative 100-claim band: it counts only prescribers in lower claim-volume bands. Medicare Part D claim volume is activity context, not a quality measure or recommendation. See methodology § corpus placement.
Source CMS Medicare Part D Prescriber Public Use File · 2023
✓
Board certification likely (heuristic, not verified)
James Gardner, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + 2 hospital affiliations - 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 Gardner, MD?
Quality data not reportedPrimary specialty
Family Medicine Physician
Medicare Part D claims
22,575 7× vs specialty avg
Specialty distribution in Pennsylvania
How Family Medicine Physician compares to other specialties among Pennsylvania providers
Board certification
Not published by CMS
CMS does not publish a per-provider board-certification field in NPPES. PlainDoctor does not have a reliable per-specialty certification rate to show for Family Medicine Physician. Verify directly:
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).
Practice Address
Provider Details
| NPI | 1194766162 |
|---|---|
| Specialty | Family Medicine Physician |
| Credentials | MD |
| Gender | Male |
| NPI Issued | 06/09/2006 |
Hospital and facility affiliations
Facilities where James Gardner, 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.
Family Medical Care OF Lawrence County,inc
New Wilmington, PA
Phoenix Rehabilitation And Health Services Inc
Cranberry Township, PA
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 Gardner, MD. Source: openpaymentsdata.cms.gov.
Total received
$3.0K
Largest payer
AstraZeneca Pharmaceuticals LP
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.
License & disciplinary context - Pennsylvania PA-BOM 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 ~45K Pennsylvania medical licensees in 2023 - they are NOT specific to James Gardner, MD. To verify James Gardner, MD's current license status, search the PA-BOM public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.
133
Total board actions, Pennsylvania 2023
Across 129 cases
2.96
Actions per 1,000 licensees
Pennsylvania statewide rate
probation
Most common action type
48 cases
PA-BOM 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 Pennsylvania disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.
Brand vs generic prescribing mix · Typical
James Gardner, MD - brand share 11.0%
Family Medicine Physician average
11% brand-name claims vs 88% generic, on 22,575 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.
22,575
Total Claims
$1.7M
Total Drug Cost
975
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 37,361
- Total Day Supply
- 890,673
- Brand vs Generic
- 11% brand / 88% generic
- Brand Drug Cost
- $1.4M
- Generic Drug Cost
- $292K
- Opioid Claims
- 199 (0.9% rate)
- Antibiotic Claims
- 295
Patient Demographics
- Average Patient Age
- 77.2 years
- Avg HCC Risk Score
- 1.24
- Gender Split
- 52% female / 48% male
- Age Distribution
- <65: 36, 65-74: 362, 75-84: 368, 85+: 209
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What James Gardner, MD prescribes most
Top Medicare Part D drugs by claim count, 2023
- Levothyroxine Sodium
Levothyroxine Sodium
1,300 claims
- Atorvastatin Calcium
Atorvastatin Calcium
1,142 claims
- Amlodipine Besylate
Amlodipine Besylate
884 claims
- Losartan Potassium
Losartan Potassium
640 claims
- Furosemide
Furosemide
638 claims
- Potassium Chloride
Potassium Chloride
601 claims
- Metoprolol Succinate
Metoprolol Succinate
565 claims
- Lisinopril
Lisinopril
544 claims
| Drug | Claims |
|---|---|
| Levothyroxine Sodium | 1,300 |
| Atorvastatin Calcium | 1,142 |
| Amlodipine Besylate | 884 |
| Losartan Potassium | 640 |
| Furosemide | 638 |
| Potassium Chloride | 601 |
| Metoprolol Succinate | 565 |
| Lisinopril | 544 |
| Omeprazole | 500 |
| Simvastatin | 487 |
* 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 Gardner, MD fits within the Family Medicine Physician landscape nationally.
147,760
Family Medicine Physician Providers in US
56
States with Family Medicine Physician
3,418
Avg Claims per Provider
James Gardner, MD's 22,575 claims are above the specialty average of 3,418.
Nationwide Family Medicine Physician peers with similar MIPS or enrollment year
Two federal-record peer sets for Gardner, both outside Pennsylvania so the neighborhoods are not geographic containment.
Same NPPES enumeration year (2006)
Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.
Nearby Family Medicine Physician Providers in Pennsylvania
Other clinicians with the same primary specialty enrolled in Pennsylvania, drawn from the same CMS NPPES roster as Gardner.
One of 7,200 Family Medicine Physician providers enrolled in Pennsylvania, 5 are shown here.
Christopher Aaron
Cresson, PA
Dr. Jose Abad
MD
Pittsburgh, PA
Dr. Ray Abarintos
MD
Philadelphia, PA
Dr. Jasim Abbasi
DO
Erie, PA
Dr. Alyssa Abbott
CRNP
Hermitage, PA
Compare Family Medicine Physician nationally: see state-by-state distribution →
Frequently Asked Questions
What is James Gardner, MD's specialty? ▼
James Gardner, MD specializes in Family Medicine Physician and practices in New Wilmington, Pennsylvania. Credentials: MD.
How much does James Gardner, MD prescribe under Medicare Part D? ▼
In 2023, James Gardner, MD wrote 22,575 Medicare Part D claims totaling $1.7M in drug costs for 975 beneficiaries.
Where is James Gardner, MD located? ▼
James Gardner, MD is located at 1995 MERCER NEW WILMINGTON RD, New Wilmington, PA, 16142. Phone: (724) 946-3564.
What is James Gardner, MD's NPI number? ▼
James Gardner, MD's National Provider Identifier (NPI) is 1194766162, issued on 06/09/2006.
Does James Gardner, MD prescribe more brand-name or generic drugs? ▼
James Gardner, MD's prescribing is 11% brand-name and 88% generic drugs by claim count, with $1.4M in brand drug costs.
Does James Gardner, MD prescribe opioids? ▼
Yes, James Gardner, MD had 199 opioid claims in 2023 with an opioid prescribing rate of 0.9%.
How many Family Medicine Physician providers are there in the US? ▼
There are 147,760 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 Gardner, MD prescribe most often? ▼
Based on 2023 Medicare Part D data, James Gardner, MD's most frequently prescribed drugs include Levothyroxine Sodium, Atorvastatin Calcium, Amlodipine Besylate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does James Gardner, MD accept Medicare? ▼
James Gardner, MD appears in CMS Medicare data with 22,575 Part D claims and 975 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify James Gardner, MD's credentials? ▼
James Gardner, MD's NPI is 1194766162 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.
- 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
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.