2026 NPPES data Otolaryngology Physician NPI 1659367258 M.D.
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JAMES MALONE, M.D.

Otolaryngology Physician in CAMP HILL, Pennsylvania. 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
464
Medicare Part D claims · 175 beneficiaries · Otolaryngology Physician avg: 509
Generic prescribing
94%
generic claims · 6% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
75/100
▼ 8 pts below national avg 83.1 · [object Object]
Industry payments
$177.02
7 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

JAMES MALONE, M.D. reported a CMS MIPS final score of 75/100 — below the 83.1 national average — and filed 464 Medicare Part D claims in 2023.

75/100
MIPS score · -8 vs avg
464
Part D claims, 2023
94%
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 MALONE, M.D.'s MIPS score vs every scored U.S. clinician

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

75 15th percentile higher than 15% 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%). This entry sits in this band. 80–90: 129,887 scored providers (27%). Above this entry. 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 MALONE, M.D. 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 MALONE, M.D.?

Below national average

NPI registry status

Active

Issued 09/20/2005

NPI 1659367258

Primary specialty

Otolaryngology Physician

Mid-sized

10,895 US NPIs in this specialty

Medicare Part D claims

464 9% vs specialty avg

2023 prescription claims

Specialty avg: 509

MIPS final score

75/100 8.099999999999994% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in Pennsylvania

How Otolaryngology Physician compares to other specialties among Pennsylvania providers

Pennsylvania providers

Otolaryngology Physician share within Pennsylvania

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

Medicare quality performance — MIPS

JAMES MALONE, M.D.'s 2023 MIPS final score plotted against the Otolaryngology Physician national average

Below national average
MIPS Final Score
75/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Otolaryngology Physician) — 75/100 vs national avg 83.1

0%100%National avg83%75%
MIPS final score (Otolaryngology Physician) — 75/100 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 MALONE, M.D. appears in the CMS NPPES registry as a Otolaryngology Physician provider holding M.D. credentials at 875 POPLAR CHURCH RD, CAMP HILL, PA, 17011, with a listed phone of (717) 763-7400. NPI 1659367258 was issued on 09/20/2005. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what MALONE 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 464 prescription claims written by this provider, covering 175 Medicare beneficiaries and totaling roughly $20K in drug spend, split 6% brand-name and 94% generic by claim count, with an opioid prescribing rate of 10.6%. 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 75/100 for the 2023 performance year, compared with the national average of 83.1.

Otolaryngology Physician is a mid-sized specialty nationwide, with 10,895 enrolled providers across 54 states and an average of 509 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

875 POPLAR CHURCH RD
CAMP HILL, PA 17011

Provider Details

NPI 1659367258
Specialty Otolaryngology Physician
Credentials M.D.
Gender Male
NPI Issued 09/20/2005

CMS Quality Score (MIPS)

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

75
Final Score
Avg: 83.1

Reporting: Individual

Hospital and facility affiliations

Facilities where JAMES MALONE, M.D. 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.

AOP, INC.
HERSHEY, 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 MALONE, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$177

Largest payer

Optinose US, 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.

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 MALONE, M.D.. To verify JAMES MALONE, M.D.'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 · Generic-heavy

JAMES MALONE, M.D. — brand share 6.0%
Specialty average (est.)

6% brand-name claims vs 94% generic, on 464 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.

464
Total Claims
$20K
Total Drug Cost
175
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
779
Total Day Supply
19,059
Brand vs Generic
6% brand / 94% generic
Brand Drug Cost
$8K
Generic Drug Cost
$12K
Opioid Claims
49 (10.6% rate)
Antibiotic Claims
68

Patient Demographics

Average Patient Age
72.1 years
Avg HCC Risk Score
1.24
Gender Split
46% female / 54% 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 MALONE, M.D. 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
Famotidine
56
Pantoprazole Sodium
52
Levothyroxine Sodium
43
Amoxicillin-Clavulanate Potass
Amoxicillin/Potassium Clav
37
Oxycodone-Acetaminophen
Oxycodone Hcl/Acetaminophen
29
Azelastine Hcl
20
Methylprednisolone
15
Chlorhexidine Gluconate
14
Ipratropium Bromide
14
Fluticasone Propionate
11

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

Otolaryngology Physician Overview

How JAMES MALONE, M.D. fits within the Otolaryngology Physician landscape nationally.

10,895
Otolaryngology Physician Providers in US
54
States with Otolaryngology Physician
509
Avg Claims per Provider

JAMES MALONE, M.D.'s 464 claims are below the specialty average of 509.

Nearby Otolaryngology Physician Providers in Pennsylvania

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

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

Frequently Asked Questions

What is JAMES MALONE, M.D.'s specialty?
JAMES MALONE, M.D. specializes in Otolaryngology Physician and practices in CAMP HILL, Pennsylvania. Credentials: M.D..
How much does JAMES MALONE, M.D. prescribe under Medicare Part D?
In 2023, JAMES MALONE, M.D. wrote 464 Medicare Part D claims totaling $20K in drug costs for 175 beneficiaries.
What is JAMES MALONE, M.D.'s Medicare quality score?
JAMES MALONE, M.D. has a CMS MIPS Final Score of 75/100. The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is JAMES MALONE, M.D. located?
JAMES MALONE, M.D. is located at 875 POPLAR CHURCH RD, CAMP HILL, PA, 17011. Phone: (717) 763-7400.
What is JAMES MALONE, M.D.'s NPI number?
JAMES MALONE, M.D.'s National Provider Identifier (NPI) is 1659367258, issued on 09/20/2005.
Does JAMES MALONE, M.D. prescribe more brand-name or generic drugs?
JAMES MALONE, M.D.'s prescribing is 6% brand-name and 94% generic drugs by claim count, with $8K in brand drug costs.
Does JAMES MALONE, M.D. prescribe opioids?
Yes, JAMES MALONE, M.D. had 49 opioid claims in 2023 with an opioid prescribing rate of 10.6%.
How many Otolaryngology Physician providers are there in the US?
There are 10,895 Otolaryngology Physician providers across 54 states in the US. The average Otolaryngology Physician provider writes 509 Medicare Part D claims per year.
What drugs does JAMES MALONE, M.D. prescribe most often?
Based on 2023 Medicare Part D data, JAMES MALONE, M.D.'s most frequently prescribed drugs include Famotidine, Pantoprazole Sodium, Levothyroxine Sodium. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does JAMES MALONE, M.D. accept Medicare?
JAMES MALONE, M.D. appears in CMS Medicare data with 464 Part D claims and 175 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify JAMES MALONE, M.D.'s credentials?
JAMES MALONE, M.D.'s NPI is 1659367258 with credentials M.D.. 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