2026 NPPES data Cardiovascular Disease Physician NPI 1942269311 MD
Verify on CMS →

JOHN BALACKO, MD

Cardiovascular Disease Physician in NATRONA HEIGHTS, 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
4K
Medicare Part D claims · 627 beneficiaries · Cardiovascular Disease Physician avg: 3K
Generic prescribing
77%
generic claims · 23% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
93.7848/100
▲ 11 pts above national avg 83.1 · [object Object]
Industry payments
$814.22
28 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

JOHN BALACKO, MD reported a CMS MIPS final score of 93.7848/100 — above the 83.1 national average — and filed 4,311 Medicare Part D claims in 2023.

93.7848/100
MIPS score · +11 vs avg
4K
Part D claims, 2023
77%
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.

JOHN BALACKO, MD's MIPS score vs every scored U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023 — the federal quality measure

94 Top 29% higher than 71% 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

Board certification likely (heuristic — not verified)

JOHN BALACKO, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 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 JOHN BALACKO, MD?

High performer (top quartile)

NPI registry status

Active

Issued 03/22/2006

NPI 1942269311

Primary specialty

Cardiovascular Disease Physician

Mid-sized

24,795 US NPIs in this specialty

Medicare Part D claims

4,311 42% vs specialty avg

2023 prescription claims

Specialty avg: 3,033

MIPS final score

93.7848/100 10.68480000000001% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Pennsylvania

How Cardiovascular Disease Physician compares to other specialties among Pennsylvania providers

Pennsylvania providers

Cardiovascular Disease Physician share within Pennsylvania

1. Cardiovascular Disease Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Cardiovascular Disease Physician share within Pennsylvania

Medicare quality performance — MIPS

JOHN BALACKO, MD's 2023 MIPS final score plotted against the Cardiovascular Disease Physician national average

High performer (top quartile)
MIPS Final Score
93.7848/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Cardiovascular Disease Physician) — 93.7848/100 vs national avg 83.1

0%100%National avg83%93.8%
MIPS final score (Cardiovascular Disease Physician) — 93.7848/100 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).

JOHN BALACKO, MD is a Cardiovascular Disease Physician provider practicing in NATRONA HEIGHTS, Pennsylvania, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: MD. NPI: 1942269311. This profile includes practice location, specialty classification, and organizational affiliations from the CMS provider registry. Provider information is self-reported to CMS and updated monthly.

JOHN BALACKO, MD appears in the CMS NPPES registry as a Cardiovascular Disease Physician provider holding MD credentials at 1624 PACIFIC AVE STE B, NATRONA HEIGHTS, PA, 15065, with a listed phone of (724) 226-3345. NPI 1942269311 was issued on 03/22/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BALACKO 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 4,311 prescription claims written by this provider, covering 627 Medicare beneficiaries and totaling roughly $815K in drug spend, split 23% brand-name and 77% 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. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 93.7848/100 for the 2023 performance year (Quality 85.0781), compared with the national average of 83.1.

Cardiovascular Disease Physician is a mid-sized specialty nationwide, with 24,795 enrolled providers across 54 states and an average of 3,033 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

1624 PACIFIC AVE STE B
NATRONA HEIGHTS, PA 15065

Provider Details

NPI 1942269311
Specialty Cardiovascular Disease Physician
Credentials MD
Gender Male
NPI Issued 03/22/2006

CMS Quality Score (MIPS)

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

93.7848
Final Score
Avg: 83.1
85.0781
Quality
100
Promoting Interoperability

Reporting: Alternative Payment Model

Hospital and facility affiliations

Facilities where JOHN BALACKO, 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.

ALLEGHENY CLINIC
NATRONA HEIGHTS, 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).

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 JOHN BALACKO, MD. Source: openpaymentsdata.cms.gov.

Total received

$814

Largest payer

Edwards Lifesciences Corporation

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.

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 JOHN BALACKO, MD. To verify JOHN BALACKO, MD'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 · Typical

JOHN BALACKO, MD — brand share 23.0%
Specialty average (est.)

23% brand-name claims vs 77% generic, on 4,311 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.

4,311
Total Claims
$815K
Total Drug Cost
627
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
8,854
Total Day Supply
263,602
Brand vs Generic
23% brand / 77% generic
Brand Drug Cost
$752K
Generic Drug Cost
$63K
Antibiotic Claims
14

Patient Demographics

Average Patient Age
76.2 years
Avg HCC Risk Score
1.65
Gender Split
47% female / 53% male
Age Distribution
<65: 27, 65-74: 257, 75-84: 217, 85+: 126

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Eliquis
Apixaban
480
Metoprolol Succinate
425
Rosuvastatin Calcium
271
Furosemide
239
Atorvastatin Calcium
235
Carvedilol
210
Metoprolol Tartrate
184
Valsartan
173
Amlodipine Besylate
166
Diltiazem 24hr Er (Cd)
Diltiazem Hcl
157

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

Cardiovascular Disease Physician Overview

How JOHN BALACKO, MD fits within the Cardiovascular Disease Physician landscape nationally.

24,795
Cardiovascular Disease Physician Providers in US
54
States with Cardiovascular Disease Physician
3,033
Avg Claims per Provider

JOHN BALACKO, MD's 4,311 claims are above the specialty average of 3,033.

Nearby Cardiovascular Disease Physician Providers in Pennsylvania

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

Compare Cardiovascular Disease Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is JOHN BALACKO, MD's specialty?
JOHN BALACKO, MD specializes in Cardiovascular Disease Physician and practices in NATRONA HEIGHTS, Pennsylvania. Credentials: MD.
How much does JOHN BALACKO, MD prescribe under Medicare Part D?
In 2023, JOHN BALACKO, MD wrote 4,311 Medicare Part D claims totaling $815K in drug costs for 627 beneficiaries.
What is JOHN BALACKO, MD's Medicare quality score?
JOHN BALACKO, MD has a CMS MIPS Final Score of 93.7848/100 (Quality: 85.0781). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is JOHN BALACKO, MD located?
JOHN BALACKO, MD is located at 1624 PACIFIC AVE STE B, NATRONA HEIGHTS, PA, 15065. Phone: (724) 226-3345.
What is JOHN BALACKO, MD's NPI number?
JOHN BALACKO, MD's National Provider Identifier (NPI) is 1942269311, issued on 03/22/2006.
Does JOHN BALACKO, MD prescribe more brand-name or generic drugs?
JOHN BALACKO, MD's prescribing is 23% brand-name and 77% generic drugs by claim count, with $752K in brand drug costs.
How many Cardiovascular Disease Physician providers are there in the US?
There are 24,795 Cardiovascular Disease Physician providers across 54 states in the US. The average Cardiovascular Disease Physician provider writes 3,033 Medicare Part D claims per year.
What drugs does JOHN BALACKO, MD prescribe most often?
Based on 2023 Medicare Part D data, JOHN BALACKO, MD's most frequently prescribed drugs include Eliquis, Metoprolol Succinate, Rosuvastatin Calcium. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does JOHN BALACKO, MD accept Medicare?
JOHN BALACKO, MD appears in CMS Medicare data with 4,311 Part D claims and 627 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify JOHN BALACKO, MD's credentials?
JOHN BALACKO, MD's NPI is 1942269311 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

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