2026 NPPES data Otolaryngology Physician NPI 1972502573 M.D.
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JAMES RESTREPO, M.D.

Otolaryngology Physician in WYOMISSING, 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
609
Medicare Part D claims · 223 beneficiaries · Otolaryngology Physician avg: 509
Generic prescribing
98%
generic claims · 2% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
88.9309/100
▲ 6 pts above national avg 83.1 · [object Object]

What the federal data shows

JAMES RESTREPO, M.D. reported a CMS MIPS final score of 88.9309/100 — above the 83.1 national average — and filed 609 Medicare Part D claims in 2023.

88.9309/100
MIPS score · +6 vs avg
609
Part D claims, 2023
98%
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 RESTREPO, 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

89 Top 44% higher than 56% 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 RESTREPO, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 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 RESTREPO, M.D.?

High performer (top quartile)

NPI registry status

Active

Issued 07/18/2005

NPI 1972502573

Primary specialty

Otolaryngology Physician

Mid-sized

10,895 US NPIs in this specialty

Medicare Part D claims

609 20% vs specialty avg

2023 prescription claims

Specialty avg: 509

MIPS final score

88.9309/100 5.8309% 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 RESTREPO, M.D.'s 2023 MIPS final score plotted against the Otolaryngology Physician national average

High performer (top quartile)
MIPS Final Score
88.9309/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Otolaryngology Physician) — 88.9309/100 vs national avg 83.1

0%100%National avg83%88.9%
MIPS final score (Otolaryngology Physician) — 88.9309/100 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 RESTREPO, M.D. appears in the CMS NPPES registry as a Otolaryngology Physician provider holding M.D. credentials at 985 BERKSHIRE BLVD, WYOMISSING, PA, 19610, with a listed phone of (610) 374-5599. NPI 1972502573 was issued on 07/18/2005. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what RESTREPO 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 609 prescription claims written by this provider, covering 223 Medicare beneficiaries and totaling roughly $17K in drug spend, split 2% brand-name and 98% generic by claim count, with an opioid prescribing rate of 3.6%. 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 88.9309/100 for the 2023 performance year (Quality 100, Cost 63.103), 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

985 BERKSHIRE BLVD
WYOMISSING, PA 19610

Provider Details

NPI 1972502573
Specialty Otolaryngology Physician
Credentials M.D.
Gender Male
NPI Issued 07/18/2005

CMS Quality Score (MIPS)

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

88.9309
Final Score
Avg: 83.1
100
Quality
63.103
Cost
100
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where JAMES RESTREPO, 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.

ENT HEAD AND NECK SPECIALISTS, PC
WYOMISSING, 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).

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 RESTREPO, M.D.. To verify JAMES RESTREPO, 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 RESTREPO, M.D. — brand share 2.0%
Specialty average (est.)

2% brand-name claims vs 98% generic, on 609 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.

609
Total Claims
$17K
Total Drug Cost
223
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
873
Total Day Supply
21,140
Brand vs Generic
2% brand / 98% generic
Brand Drug Cost
$3K
Generic Drug Cost
$15K
Opioid Claims
22 (3.6% rate)
Antibiotic Claims
66

Patient Demographics

Average Patient Age
71.9 years
Avg HCC Risk Score
1.20
Gender Split
63% female / 37% male
Age Distribution
<65: 28, 65-74: 105, 75-84: 71, 85+: 19

Top Prescribed Drugs (Medicare Part D)

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

What JAMES RESTREPO, 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
Azelastine Hcl
94
Fluticasone Propionate
61
Ipratropium Bromide
60
Levothyroxine Sodium
49
Gabapentin
41
Methylprednisolone
39
Triamterene-Hydrochlorothiazid
Triamterene/Hydrochlorothiazid
25
Cefdinir
20
Mupirocin
19
Ofloxacin
19

* 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 RESTREPO, 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 RESTREPO, M.D.'s 609 claims are above 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 RESTREPO.

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

Frequently Asked Questions

What is JAMES RESTREPO, M.D.'s specialty?
JAMES RESTREPO, M.D. specializes in Otolaryngology Physician and practices in WYOMISSING, Pennsylvania. Credentials: M.D..
How much does JAMES RESTREPO, M.D. prescribe under Medicare Part D?
In 2023, JAMES RESTREPO, M.D. wrote 609 Medicare Part D claims totaling $17K in drug costs for 223 beneficiaries.
What is JAMES RESTREPO, M.D.'s Medicare quality score?
JAMES RESTREPO, M.D. has a CMS MIPS Final Score of 88.9309/100 (Quality: 100, Cost: 63.103). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is JAMES RESTREPO, M.D. located?
JAMES RESTREPO, M.D. is located at 985 BERKSHIRE BLVD, WYOMISSING, PA, 19610. Phone: (610) 374-5599.
What is JAMES RESTREPO, M.D.'s NPI number?
JAMES RESTREPO, M.D.'s National Provider Identifier (NPI) is 1972502573, issued on 07/18/2005.
Does JAMES RESTREPO, M.D. prescribe more brand-name or generic drugs?
JAMES RESTREPO, M.D.'s prescribing is 2% brand-name and 98% generic drugs by claim count, with $3K in brand drug costs.
Does JAMES RESTREPO, M.D. prescribe opioids?
Yes, JAMES RESTREPO, M.D. had 22 opioid claims in 2023 with an opioid prescribing rate of 3.6%.
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 RESTREPO, M.D. prescribe most often?
Based on 2023 Medicare Part D data, JAMES RESTREPO, M.D.'s most frequently prescribed drugs include Azelastine Hcl, Fluticasone Propionate, Ipratropium Bromide. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does JAMES RESTREPO, M.D. accept Medicare?
JAMES RESTREPO, M.D. appears in CMS Medicare data with 609 Part D claims and 223 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify JAMES RESTREPO, M.D.'s credentials?
JAMES RESTREPO, M.D.'s NPI is 1972502573 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