2026 NPPES data Specialist NPI 1861521460 M.D.
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JAMES PAVELKA, M.D.

Specialist in CINCINNATI, Ohio. 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
297
Medicare Part D claims · 102 beneficiaries · Specialist avg: 1K
MIPS score
90.3837/100
▲ 7 pts above national avg 83.1 · [object Object]

What the federal data shows

JAMES PAVELKA, M.D. reported a CMS MIPS final score of 90.3837/100 — above the 83.1 national average — and filed 297 Medicare Part D claims in 2023.

90.3837/100
MIPS score · +7 vs avg
297
Part D claims, 2023

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 PAVELKA, 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

90 Top 40% higher than 60% 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%). Below this entry. 90–100: 189,403 scored providers (40%). This entry sits in this band. 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

What does the federal data show about JAMES PAVELKA, M.D.?

High performer (top quartile)

NPI registry status

Active

Issued 03/02/2007

NPI 1861521460

Primary specialty

Specialist

High-volume

69,658 US NPIs in this specialty

Medicare Part D claims

297 80% vs specialty avg

2023 prescription claims

Specialty avg: 1,474

MIPS final score

90.3837/100 7.28370000000001% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Ohio

How Specialist compares to other specialties among Ohio providers

Ohio providers

Specialist share within Ohio

1. Specialist42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Specialist share within Ohio

Medicare quality performance — MIPS

JAMES PAVELKA, M.D.'s 2023 MIPS final score plotted against the Specialist national average

High performer (top quartile)
MIPS Final Score
90.3837/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Specialist) — 90.3837/100 vs national avg 83.1

0%100%National avg83%90.4%
MIPS final score (Specialist) — 90.3837/100 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 PAVELKA, M.D. appears in the CMS NPPES registry as a Specialist provider holding M.D. credentials at 3219 CLIFTON AVE, CINCINNATI, OH, 45220, with a listed phone of (513) 862-1888. NPI 1861521460 was issued on 03/02/2007. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what PAVELKA 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 297 prescription claims written by this provider, covering 102 Medicare beneficiaries and totaling roughly $428K in drug spend, with an opioid prescribing rate of 10.1%. 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 90.3837/100 for the 2023 performance year (Quality 80.7674), compared with the national average of 83.1.

Specialist is a high-volume specialty nationwide, with 69,658 enrolled providers across 55 states and an average of 1,474 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

3219 CLIFTON AVE
CINCINNATI, OH 45220

Provider Details

NPI 1861521460
Specialty Specialist
Credentials M.D.
Gender Male
NPI Issued 03/02/2007

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

Hospital and facility affiliations

Facilities where JAMES PAVELKA, 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.

ST ELIZABETH MEDICAL CENTER, INC
EDGEWOOD, KY
TRIHEALTH H LLC
MONTGOMERY, OH

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 — Ohio OMB 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 ~48K Ohio medical licensees in 2023 — they are NOT specific to JAMES PAVELKA, M.D.. To verify JAMES PAVELKA, M.D.'s current license status, search the OMB public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

158
Total board actions, Ohio 2023
Across 154 cases
3.29
Actions per 1,000 licensees
Ohio statewide rate
probation
Most common action type
56 cases

OMB 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 Ohio disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

297
Total Claims
$428K
Total Drug Cost
102
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
377
Total Day Supply
8,375
Generic Drug Cost
$9K
Opioid Claims
30 (10.1% rate)
Antibiotic Claims
14

Patient Demographics

Average Patient Age
70.8 years
Avg HCC Risk Score
2.10
Gender Split
100% female / 0% 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 PAVELKA, 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
Prochlorperazine Maleate
39
Oxycodone Hcl
20
Dexamethasone
17
Duloxetine Hcl
15
Eliquis
Apixaban
13
Ondansetron Hcl
12
Xarelto
Rivaroxaban
11

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

Specialist Overview

How JAMES PAVELKA, M.D. fits within the Specialist landscape nationally.

69,658
Specialist Providers in US
55
States with Specialist
1,474
Avg Claims per Provider

JAMES PAVELKA, M.D.'s 297 claims are below the specialty average of 1,474.

Nearby Specialist Providers in Ohio

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

Compare Specialist nationally: see state-by-state distribution →

Frequently Asked Questions

What is JAMES PAVELKA, M.D.'s specialty?
JAMES PAVELKA, M.D. specializes in Specialist and practices in CINCINNATI, Ohio. Credentials: M.D..
How much does JAMES PAVELKA, M.D. prescribe under Medicare Part D?
In 2023, JAMES PAVELKA, M.D. wrote 297 Medicare Part D claims totaling $428K in drug costs for 102 beneficiaries.
What is JAMES PAVELKA, M.D.'s Medicare quality score?
JAMES PAVELKA, M.D. has a CMS MIPS Final Score of 90.3837/100 (Quality: 80.7674). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is JAMES PAVELKA, M.D. located?
JAMES PAVELKA, M.D. is located at 3219 CLIFTON AVE, CINCINNATI, OH, 45220. Phone: (513) 862-1888.
What is JAMES PAVELKA, M.D.'s NPI number?
JAMES PAVELKA, M.D.'s National Provider Identifier (NPI) is 1861521460, issued on 03/02/2007.
Does JAMES PAVELKA, M.D. prescribe opioids?
Yes, JAMES PAVELKA, M.D. had 30 opioid claims in 2023 with an opioid prescribing rate of 10.1%.
How many Specialist providers are there in the US?
There are 69,658 Specialist providers across 55 states in the US. The average Specialist provider writes 1,474 Medicare Part D claims per year.
What drugs does JAMES PAVELKA, M.D. prescribe most often?
Based on 2023 Medicare Part D data, JAMES PAVELKA, M.D.'s most frequently prescribed drugs include Prochlorperazine Maleate, Oxycodone Hcl, Dexamethasone. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does JAMES PAVELKA, M.D. accept Medicare?
JAMES PAVELKA, M.D. appears in CMS Medicare data with 297 Part D claims and 102 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify JAMES PAVELKA, M.D.'s credentials?
JAMES PAVELKA, M.D.'s NPI is 1861521460 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