2026 NPPES data Psychiatry Physician NPI 1134245954 M.D.
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JAMES WHALEN, M.D.

Psychiatry Physician in LINCOLN, Rhode Island. 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
4K
Medicare Part D claims · 252 beneficiaries · Psychiatry Physician avg: 1K
Generic prescribing
91%
generic claims · 9% brand-name · higher generic rates reduce patient out-of-pocket costs

What the federal data shows

JAMES WHALEN, M.D. filed 3,569 Medicare Part D claims in 2023 as a Psychiatry Physician in LINCOLN, Rhode Island, prescribing 91% generic.

4K
Part D claims, 2023
91%
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 WHALEN, M.D.'s Medicare Part D volume vs every U.S. prescriber

Total Medicare Part D claims, 2023 — across all CMS prescribers nationally

3,569 Top 10% higher than 90% of 1,370,886 prescribers

0–200: 670,926 prescribers (49%). Below this entry. 200–400: 182,923 prescribers (13%). Below this entry. 400–600: 90,619 prescribers (7%). Below this entry. 600–800: 56,224 prescribers (4%). Below this entry. 800–1,000: 40,919 prescribers (3%). Below this entry. 1,000–1,200: 31,827 prescribers (2%). Below this entry. 1,200–1,400: 26,224 prescribers (2%). Below this entry. 1,400–1,600: 21,710 prescribers (2%). Below this entry. 1,600–1,800: 19,072 prescribers (1%). Below this entry. 1,800–2,000: 16,451 prescribers (1%). Below this entry. 2,000–2,200: 213,991 prescribers (16%). This entry sits in this band. This provider 0 2K+ every Part D prescriber (claims/yr), bucketed by value

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.

Source CMS Medicare Part D Prescriber Public Use File · 2023

Board certification likely (heuristic — not verified)

JAMES WHALEN, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + 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 WHALEN, M.D.?

Quality data not reported

NPI registry status

Active

Issued 03/22/2007

NPI 1134245954

Primary specialty

Psychiatry Physician

High-volume

53,104 US NPIs in this specialty

Medicare Part D claims

3,569 244% vs specialty avg

2023 prescription claims

Specialty avg: 1,038

Specialty distribution in Rhode Island

How Psychiatry Physician compares to other specialties among Rhode Island providers

Rhode Island providers

Psychiatry Physician share within Rhode Island

1. Psychiatry Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Psychiatry Physician share within Rhode Island

Specialty board-certification context

Estimated specialty board-certified rate — Psychiatry Physician (ABMS / AOA reference)

Quality data not reported
Est. board-certified rate
78%
Psychiatry Physician ABMS/AOA estimate

Est. board-certified rate (Psychiatry Physician) — ABMS / AOA estimate

0%100%78%
Est. board-certified rate (Psychiatry Physician) — ABMS / AOA estimate

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 WHALEN, M.D. appears in the CMS NPPES registry as a Psychiatry Physician provider holding M.D. credentials at 6 BLACKSTONE VALLEY PL, LINCOLN, RI, 02865, with a listed phone of (401) 333-3435. NPI 1134245954 was issued on 03/22/2007. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what WHALEN 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 3,569 prescription claims written by this provider, covering 252 Medicare beneficiaries and totaling roughly $1.1 million in drug spend, split 9% brand-name and 91% generic by claim count. 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.

Psychiatry Physician is a high-volume specialty nationwide, with 53,104 enrolled providers across 56 states and an average of 1,038 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

6 BLACKSTONE VALLEY PL
LINCOLN, RI 02865

Provider Details

NPI 1134245954
Specialty Psychiatry Physician
Credentials M.D.
Gender Male
NPI Issued 03/22/2007

Hospital and facility affiliations

Facilities where JAMES WHALEN, 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.

GATEWAY HEALTHCARE INC
PAWTUCKET, RI

Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).

Brand vs generic prescribing mix · Generic-heavy

JAMES WHALEN, M.D. — brand share 9.0%
Specialty average (est.)

9% brand-name claims vs 91% generic, on 3,569 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.

3,569
Total Claims
$1.1M
Total Drug Cost
252
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
3,937
Total Day Supply
101,573
Brand vs Generic
9% brand / 91% generic
Brand Drug Cost
$950K
Generic Drug Cost
$122K

Patient Demographics

Average Patient Age
55.0 years
Avg HCC Risk Score
1.41
Gender Split
59% female / 41% male
Age Distribution
<65: 192, 65-74: 44, 75-84: N/A, 85+: N/A

Top Prescribed Drugs (Medicare Part D)

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

What JAMES WHALEN, 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
Trazodone Hcl
201
Buspirone Hcl
182
Benztropine Mesylate
162
Clozapine
149
Quetiapine Fumarate
148
Duloxetine Hcl
143
Hydroxyzine Hcl
134
Invega Sustenna
Paliperidone Palmitate
125
Gabapentin
123
Olanzapine
118

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

Psychiatry Physician Overview

How JAMES WHALEN, M.D. fits within the Psychiatry Physician landscape nationally.

53,104
Psychiatry Physician Providers in US
56
States with Psychiatry Physician
1,038
Avg Claims per Provider

JAMES WHALEN, M.D.'s 3,569 claims are above the specialty average of 1,038.

Nearby Psychiatry Physician Providers in Rhode Island

Other clinicians with the same primary specialty enrolled in Rhode Island, drawn from the same CMS NPPES roster as WHALEN.

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

Frequently Asked Questions

What is JAMES WHALEN, M.D.'s specialty?
JAMES WHALEN, M.D. specializes in Psychiatry Physician and practices in LINCOLN, Rhode Island. Credentials: M.D..
How much does JAMES WHALEN, M.D. prescribe under Medicare Part D?
In 2023, JAMES WHALEN, M.D. wrote 3,569 Medicare Part D claims totaling $1.1M in drug costs for 252 beneficiaries.
Where is JAMES WHALEN, M.D. located?
JAMES WHALEN, M.D. is located at 6 BLACKSTONE VALLEY PL, LINCOLN, RI, 02865. Phone: (401) 333-3435.
What is JAMES WHALEN, M.D.'s NPI number?
JAMES WHALEN, M.D.'s National Provider Identifier (NPI) is 1134245954, issued on 03/22/2007.
Does JAMES WHALEN, M.D. prescribe more brand-name or generic drugs?
JAMES WHALEN, M.D.'s prescribing is 9% brand-name and 91% generic drugs by claim count, with $950K in brand drug costs.
How many Psychiatry Physician providers are there in the US?
There are 53,104 Psychiatry Physician providers across 56 states in the US. The average Psychiatry Physician provider writes 1,038 Medicare Part D claims per year.
What drugs does JAMES WHALEN, M.D. prescribe most often?
Based on 2023 Medicare Part D data, JAMES WHALEN, M.D.'s most frequently prescribed drugs include Trazodone Hcl, Buspirone Hcl, Benztropine Mesylate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does JAMES WHALEN, M.D. accept Medicare?
JAMES WHALEN, M.D. appears in CMS Medicare data with 3,569 Part D claims and 252 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify JAMES WHALEN, M.D.'s credentials?
JAMES WHALEN, M.D.'s NPI is 1134245954 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.
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