NPI registry status
Active
2026 NPPES data Dermatopathology Physician NPI 1386619203 MD
Verify on CMS → James Wharton, MD
Dermatopathology Physician in Lexington, Kentucky.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 577 in Dermatopathology Physician, 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
874
Medicare Part D claims · 421 beneficiaries · Dermatopathology Physician avg: 695
Generic prescribing
91%
generic claims · 9% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
94.2/100
▲ 11 pts above national avg 83.5 · Exceptional
Industry payments
$119.4K
199 payments · CMS Open Payments (Sunshine Act)
Source: CMS Medicare Part D Prescriber Public Use File, 2024
What the federal data shows
James Wharton, MD reported a CMS MIPS final score of 94.2/100 - above the 83.5 national average - and filed 874 Medicare Part D claims in 2024.
- 94.2/100
- MIPS score · +11 vs avg
- 874
- Part D claims, 2024
- 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.
Federal trust snapshot
What official records show about James Wharton, MD
Federal records show an active NPI with both Medicare prescribing volume and a measured CMS quality score — objective registry data, not patient reviews.
- Verified
NPI registry status
Active listing in the CMS National Provider Identifier Registry (NPI 1386619203), first enumerated 02/22/2006.
Source: CMS NPPES
- Reported
Medicare Part D participation
Filed 874 Medicare Part D prescription claims in the 2023 CMS public use file — indicates active Medicare prescribing participation.
Source: CMS Part D Prescriber PUF
- Reported
CMS quality reporting (MIPS)
Reported a CMS MIPS final score of 94.2/100 in the Quality Payment Program — a federal quality measure, not a patient review.
Source: CMS Quality Payment Program
- Reported
Board certification signal
Heuristic suggests board-certified status based on ABMS-eligible specialty taxonomy plus active CMS participation signals — not a direct ABMS verification.
- Reported
Hospital affiliations
3 CMS Care Compare hospital affiliations on record — practice footprint from the Doctors and Clinicians file.
Source: CMS Care Compare
- Reported
Industry payment transparency
$119.4K in reported industry payments (199 transfers) in 2024 under the federal Sunshine Act — disclosed transfers of value, not a quality rating.
Source: CMS Open Payments
- Not in federal data
Individual sanction lookup
PlainDoctor does not publish per-provider disciplinary determinations. Confirm current license and any individual actions through the state medical board or FSMB verification service.
Source: State medical board / FSMB
This trust snapshot summarizes only what appears in federal CMS/NPPES public records. It is not a composite score, star rating, patient review, or clinical recommendation. PlainDoctor never fabricates reviews or AggregateRating schema.
CMS NPPES provider registry desk
NPI 1386619203 · Dermatopathology Physician
NPI-10 · ENUM-LEGACY · TAX-NARROW · MIPS-ELITE · RX-LIGHT · BOOK-THIN · PHOTO-FINISH
- NPI-10 1386619203
- ENUM-LEGACY 2006
- TAX-NARROW 577
- MIPS-ELITE 94.2/100
- RX-LIGHT 874
- BOOK-THIN 10 in Kentucky
- PHOTO-FINISH Christine Stanko · ±0.0
MIPS final-score neighbourhood
Same-specialty nationwide peers by CMS final score, not geographic proximity
- Joan Guitart · l…
Joan Guitart
94.1 MIPS pts
- Spencer Ng · near
Spencer Ng
94.1 MIPS pts
- Wharton · this p…
Wharton · this provider
94.2 MIPS pts
- Christine Stanko…
Christine Stanko
94.2 MIPS pts
- Rouba Hadi · hig…
Rouba Hadi
94.3 MIPS pts
What this shows Nearest measured MIPS peers for this NUCC specialty (2023 performance year).
James Wharton, MD's MIPS score vs every measured U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure. Clinicians whose score CMS assigned without scoring any category are excluded.
94 ≥ 73rd percentile 73% of 454,083 measured providers are in lower value bands
Each bar is a band; taller bars hold more measured 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.
The percentile is a conservative whole-score-point band: it counts only measured clinicians in lower score bands. A CMS MIPS metric is not a recommendation or a clinical-quality rating by PlainDoctor. See methodology § corpus placement.
Source CMS Merit-based Incentive Payment System (MIPS) · 2023
Where James Wharton, MD sits
This provider among dermatopathology physician peers
Across the 185 dermatopathology physician providers who report both Medicare Part D prescribing and a MIPS quality score, James Wharton, MD writes more Part D claims than 74% of them and scores higher on MIPS quality than 60% - placing this provider in the high-volume, high-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Each dot is one dermatopathology physician peer from a representative sample of 60; the gold marker is James Wharton, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
James Wharton, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 3 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 Wharton, MD?
High performer (top quartile)Primary specialty
Dermatopathology Physician
Medicare Part D claims
874 26% vs specialty avg
MIPS final score
94.2/100 10.7 pts vs avg
Specialty distribution in Kentucky
How Dermatopathology Physician compares to other specialties among Kentucky providers
Medicare quality performance, MIPS
James Wharton, MD's 2023 MIPS final score plotted against the Dermatopathology Physician national average
- MIPS Final Score
- 94.2/100
- vs 83.5 national avg · 2023 performance year
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).
Practice Address
Provider Details
| NPI | 1386619203 |
|---|---|
| Specialty | Dermatopathology Physician |
| Credentials | MD |
| Gender | Male |
| NPI Issued | 02/22/2006 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
94.1667
Final Score
Measured-score avg: 83.5
88.3333
Quality
Reporting: Individual
Hospital and facility affiliations
Facilities where James Wharton, MD 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.
According to CMS billing records, James Wharton, MD is affiliated with 3 Medicare-billing facilities.
Kentucky Medical Services Foundation, Inc
Lexington, KY
Modern Dermatology OF Kentucky LLC
Lexington, KY
Vitalskin Medical Group IL PLLC
Louisville, KY
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 Wharton, MD. Source: openpaymentsdata.cms.gov.
Total received
$119.4K
Largest payer
SUN PHARMACEUTICAL INDUSTRIES 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.
Brand vs generic prescribing mix · Generic-heavy
James Wharton, MD - brand share 9.0%
Dermatopathology Physician average
9% brand-name claims vs 91% generic, on 874 2024 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 2024.
874
Total Claims
$357K
Total Drug Cost
421
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 1,007
- Total Day Supply
- 26,167
- Brand vs Generic
- 9% brand / 91% generic
- Brand Drug Cost
- $336K
- Generic Drug Cost
- $21K
- Antibiotic Claims
- 116
Patient Demographics
- Average Patient Age
- 76.0 years
- Avg HCC Risk Score
- 1.02
- Gender Split
- 33% female / 67% male
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2024. Based on Medicare Part D data only.
What James Wharton, MD prescribes most
Top Medicare Part D drugs by claim count, 2024
- Triamcinolone Acet…
Triamcinolone Acetonide
158 claims
- Fluorouracil
Fluorouracil
79 claims
- Ketoconazole
Ketoconazole
74 claims
- Hydrocortisone
Hydrocortisone
69 claims
- Clobetasol Propion…
Clobetasol Propionate
64 claims
- Cephalexin 47
Cephalexin
47 claims
- Minocycline Hcl 40
Minocycline Hcl
40 claims
- Otezla 39
Otezla
39 claims
| Drug | Claims |
|---|---|
| Triamcinolone Acetonide | 158 |
| Fluorouracil | 79 |
| Ketoconazole | 74 |
| Hydrocortisone | 69 |
| Clobetasol Propionate | 64 |
| Cephalexin | 47 |
| Minocycline Hcl | 40 |
| Otezla Apremilast | 39 |
| Metronidazole | 29 |
| Desonide | 25 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Dermatopathology Physician Overview
How James Wharton, MD fits within the Dermatopathology Physician landscape nationally.
577
Dermatopathology Physician Providers in US
48
States with Dermatopathology Physician
695
Avg Claims per Provider
James Wharton, MD's 874 claims are above the specialty average of 695.
Nationwide Dermatopathology Physician peers with similar MIPS or enrollment year
Two federal-record peer sets for Wharton, both outside Kentucky so the neighborhoods are not geographic containment.
Similar MIPS final score
Nearest same-specialty clinicians by CMS MIPS final score (94.2 here).
Same NPPES enumeration year (2006)
Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.
Nearby Dermatopathology Physician Providers in Kentucky
Other clinicians with the same primary specialty enrolled in Kentucky, drawn from the same CMS NPPES roster as Wharton.
One of 10 Dermatopathology Physician providers enrolled in Kentucky, 5 are shown here.
Dr. Harty Ashby
D.O.
Pikeville, KY
Dr. Soon Bahrami
M.D.
Louisville, KY
Dr. Leigh Ann Beard
M.D.
Lexington, KY
Dr. Vilma Fabre
M.D.
Louisville, KY
Dr. Jacqueline Granese
M.D.
Bowling Green, KY
Compare Dermatopathology Physician nationally: see state-by-state distribution →
Frequently Asked Questions
What is James Wharton, MD's specialty? ▼
James Wharton, MD specializes in Dermatopathology Physician and practices in Lexington, Kentucky. Credentials: MD.
How much does James Wharton, MD prescribe under Medicare Part D? ▼
In 2024, James Wharton, MD wrote 874 Medicare Part D claims totaling $357K in drug costs for 421 beneficiaries.
What is James Wharton, MD's Medicare quality score? ▼
James Wharton, MD has a CMS MIPS Final Score of 94.2/100 (Quality: 88.3). The average MIPS Final Score across the 454,083 clinicians with at least one published category score is 83.5; clinicians whose score CMS assigned without scoring any category are excluded from that average. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is James Wharton, MD located? ▼
James Wharton, MD is located at 2195 HARRODSBURG RD STE 2, Lexington, KY, 40504. Phone: (859) 323-3376.
What is James Wharton, MD's NPI number? ▼
James Wharton, MD's National Provider Identifier (NPI) is 1386619203, issued on 02/22/2006.
Does James Wharton, MD prescribe more brand-name or generic drugs? ▼
James Wharton, MD's prescribing is 9% brand-name and 91% generic drugs by claim count, with $336K in brand drug costs.
How many Dermatopathology Physician providers are there in the US? ▼
There are 577 Dermatopathology Physician providers across 48 states in the US. The average Dermatopathology Physician provider writes 695 Medicare Part D claims per year.
What drugs does James Wharton, MD prescribe most often? ▼
Based on 2024 Medicare Part D data, James Wharton, MD's most frequently prescribed drugs include Triamcinolone Acetonide, Fluorouracil, Ketoconazole. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does James Wharton, MD accept Medicare? ▼
James Wharton, MD appears in CMS Medicare data with 874 Part D claims and 421 Medicare beneficiaries in 2024. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify James Wharton, MD's credentials? ▼
James Wharton, MD's NPI is 1386619203 with credentials MD. 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 (2024). 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 August 2026 (NPPES) / 2024 (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
Every figure on PlainDoctor is rendered directly from the federal CMS NPPES registry, Medicare Part D, MIPS, and Open Payments records, no number is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of August 2026.