NPI registry status
Active
2026 NPPES data Surgical Physician Assistant NPI 1225089071 PA
Verify on CMS → James Matthews, PA
Surgical Physician Assistant in Milwaukee, Wisconsin.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 16,119 in Surgical Physician Assistant, 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
744
Medicare Part D claims · 196 beneficiaries · Surgical Physician Assistant avg: 316
Generic prescribing
84%
generic claims · 14% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
80.5/100
▼ 3 pts below national avg 83.1 · Above neutral
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 Matthews, PA reported a CMS MIPS final score of 80.5/100 - below the 83.1 national average - and filed 744 Medicare Part D claims in 2023.
- 80.5/100
- MIPS score · -3 vs avg
- 744
- Part D claims, 2023
- 84%
- generic prescribing
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 Matthews, PA's MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
81 33rd percentile higher than 33% 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 Matthews, PA sits
This provider among surgical physician assistant peers
Across the 3,708 surgical physician assistant providers who report both Medicare Part D prescribing and a MIPS quality score, James Matthews, PA writes more Part D claims than 90% of them and scores higher on MIPS quality than 30% - placing this provider in the high-volume, lower-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 surgical physician assistant peer from a representative sample of 60; the gold marker is James Matthews, PA. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
What does the federal data show about James Matthews, PA?
Near national averagePrimary specialty
Surgical Physician Assistant
Medicare Part D claims
744 135% vs specialty avg
MIPS final score
80.5/100 2.6 pts vs avg
Specialty distribution in Wisconsin
How Surgical Physician Assistant compares to other specialties among Wisconsin providers
Medicare quality performance, MIPS
James Matthews, PA's 2023 MIPS final score plotted against the Surgical Physician Assistant national average
- MIPS Final Score
- 80.5/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Surgical Physician Assistant) - 80.5/100 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 Matthews, PA appears in the CMS NPPES registry as a Surgical Physician Assistant provider holding PA credentials at 9200 W WISCONSIN AVE, Milwaukee, WI, 53226, with a listed phone of (414) 805-0805. NPI 1225089071 was issued on 05/15/2006.
Medicare Part D records for calendar year 2023 show 744 prescription claims written by this provider, covering 196 Medicare beneficiaries and totaling roughly $80K in drug spend, split 14% brand-name and 84% generic by claim count. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 80.5/100 for the 2023 performance year (Quality 66.2, Cost 68.6), compared with the national average of 83.1.
Surgical Physician Assistant is a mid-sized specialty nationwide, with 16,119 enrolled providers across 54 states and an average of 316 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 | 1225089071 |
|---|---|
| Specialty | Surgical Physician Assistant |
| Credentials | PA |
| Gender | Male |
| NPI Issued | 05/15/2006 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
80.4671
Final Score
Avg: 83.1
66.2426
Quality
68.6477
Cost
100
Promoting Interoperability
Reporting: Group practice
Brand vs generic prescribing mix · Typical
James Matthews, PA - brand share 14.0%
Surgical Physician Assistant average
14% brand-name claims vs 84% generic, on 744 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.
744
Total Claims
$80K
Total Drug Cost
196
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 1,638
- Total Day Supply
- 47,804
- Brand vs Generic
- 14% brand / 84% generic
- Brand Drug Cost
- $54K
- Generic Drug Cost
- $26K
- Antibiotic Claims
- 28
Patient Demographics
- Average Patient Age
- 74.3 years
- Avg HCC Risk Score
- 1.67
- Age Distribution
- <65: 17, 65-74: 81, 75-84: 74, 85+: 24
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What James Matthews, PA prescribes most
Top Medicare Part D drugs by claim count, 2023
- Tamsulosin Hcl
Tamsulosin Hcl
214 claims
- Finasteride
Finasteride
175 claims
- Alfuzosin Hcl Er 61
Alfuzosin Hcl Er
61 claims
- Myrbetriq 44
Myrbetriq
44 claims
- Dutasteride 39
Dutasteride
39 claims
- Testosterone 35
Testosterone
35 claims
- Gemtesa 34
Gemtesa
34 claims
- Doxazosin Mesylate 18
Doxazosin Mesylate
18 claims
| Drug | Claims |
|---|---|
| Tamsulosin Hcl | 214 |
| Finasteride | 175 |
| Alfuzosin Hcl Er Alfuzosin Hcl | 61 |
| Myrbetriq Mirabegron | 44 |
| Dutasteride | 39 |
| Testosterone | 35 |
| Gemtesa Vibegron | 34 |
| Doxazosin Mesylate | 18 |
| Oxybutynin Chloride Er Oxybutynin Chloride | 17 |
| Ciprofloxacin Hcl | 12 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Surgical Physician Assistant Overview
How James Matthews, PA fits within the Surgical Physician Assistant landscape nationally.
16,119
Surgical Physician Assistant Providers in US
54
States with Surgical Physician Assistant
316
Avg Claims per Provider
James Matthews, PA's 744 claims are above the specialty average of 316.
Nearby Surgical Physician Assistant Providers in Wisconsin
Other clinicians with the same primary specialty enrolled in Wisconsin, drawn from the same CMS NPPES roster as Matthews.
Dr. Brad Allar
PA
Eau Claire, WI
Dr. Isabelle Anderson
PA-C
Madison, WI
Dr. Alexis Austin
PAC
Madison, WI
Dr. Leah Baldwin
PA
La Crosse, WI
Dr. Elani Balis
PA-C
Madison, WI
Compare Surgical Physician Assistant nationally: see state-by-state distribution →
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 Wisconsin medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Surgical Physician Assistant 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 Matthews, PA's specialty? ▼
James Matthews, PA specializes in Surgical Physician Assistant and practices in Milwaukee, Wisconsin. Credentials: PA.
How much does James Matthews, PA prescribe under Medicare Part D? ▼
In 2023, James Matthews, PA wrote 744 Medicare Part D claims totaling $80K in drug costs for 196 beneficiaries.
What is James Matthews, PA's Medicare quality score? ▼
James Matthews, PA has a CMS MIPS Final Score of 80.5/100 (Quality: 66.2, Cost: 68.6). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is James Matthews, PA located? ▼
James Matthews, PA is located at 9200 W WISCONSIN AVE, Milwaukee, WI, 53226. Phone: (414) 805-0805.
What is James Matthews, PA's NPI number? ▼
James Matthews, PA's National Provider Identifier (NPI) is 1225089071, issued on 05/15/2006.
Does James Matthews, PA prescribe more brand-name or generic drugs? ▼
James Matthews, PA's prescribing is 14% brand-name and 84% generic drugs by claim count, with $54K in brand drug costs.
How many Surgical Physician Assistant providers are there in the US? ▼
There are 16,119 Surgical Physician Assistant providers across 54 states in the US. The average Surgical Physician Assistant provider writes 316 Medicare Part D claims per year.
What drugs does James Matthews, PA prescribe most often? ▼
Based on 2023 Medicare Part D data, James Matthews, PA's most frequently prescribed drugs include Tamsulosin Hcl, Finasteride, Alfuzosin Hcl Er. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does James Matthews, PA accept Medicare? ▼
James Matthews, PA appears in CMS Medicare data with 744 Part D claims and 196 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify James Matthews, PA's credentials? ▼
James Matthews, PA's NPI is 1225089071 with credentials PA. 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.