NPI registry status
Active
2026 NPPES data Pulmonary Disease Physician NPI 1093210171 MD
Verify on CMS → JOHN GILBOY, MD
Pulmonary Disease Physician in SOUTH PORTLAND, Maine. 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
128
Medicare Part D claims · 35 beneficiaries · Pulmonary Disease Physician avg: 1K
Generic prescribing
30%
generic claims · 70% brand-name · higher generic rates reduce patient out-of-pocket costs
What the federal data shows
JOHN GILBOY, MD filed 128 Medicare Part D claims in 2023 as a Pulmonary Disease Physician in SOUTH PORTLAND, Maine, prescribing 30% generic.
- 128
- Part D claims, 2023
- 30%
- 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 GILBOY, MD's Medicare Part D volume vs every U.S. prescriber
Total Medicare Part D claims, 2023 — across all CMS prescribers nationally
128 35th percentile higher than 35% of 1,370,886 prescribers
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)
JOHN GILBOY, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + 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 JOHN GILBOY, MD?
Quality data not reportedPrimary specialty
Pulmonary Disease Physician
Medicare Part D claims
128 91% vs specialty avg
Specialty distribution in Maine
How Pulmonary Disease Physician compares to other specialties among Maine providers
Pulmonary Disease Physician share within Maine
Specialty board-certification context
Estimated specialty board-certified rate — Pulmonary Disease Physician (ABMS / AOA reference)
- Est. board-certified rate
- 78%
- Pulmonary Disease Physician ABMS/AOA estimate
Est. board-certified rate (Pulmonary Disease 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).
JOHN GILBOY, MD appears in the CMS NPPES registry as a Pulmonary Disease Physician provider holding MD credentials at CHEST MEDICINE ASSOCIATES, SOUTH PORTLAND, ME, 04106, with a listed phone of (207) 828-1122. NPI 1093210171 was issued on 03/29/2018. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what GILBOY 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 128 prescription claims written by this provider, covering 35 Medicare beneficiaries and totaling roughly $53K in drug spend, split 70% brand-name and 30% 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.
Pulmonary Disease Physician is a mid-sized specialty nationwide, with 9,271 enrolled providers across 53 states and an average of 1,457 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
Provider Details
| NPI | 1093210171 |
|---|---|
| Specialty | Pulmonary Disease Physician |
| Credentials | MD |
| Gender | Male |
| NPI Issued | 03/29/2018 |
Hospital and facility affiliations
Facilities where JOHN GILBOY, 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.
CHEST MEDICINE ASSOCIATES PA
SOUTH PORTLAND, ME
MERCY HOSPITAL
PORTLAND, ME
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 · Brand-heavy
JOHN GILBOY, MD — brand share 70.0%
Specialty average (est.)
70% brand-name claims vs 30% generic, on 128 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.
128
Total Claims
$53K
Total Drug Cost
35
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 161
- Total Day Supply
- 4,549
- Brand vs Generic
- 70% brand / 30% generic
- Brand Drug Cost
- $52K
- Generic Drug Cost
- $443
Patient Demographics
- Average Patient Age
- 74.7 years
- Avg HCC Risk Score
- 1.59
- Gender Split
- 63% female / 37% male
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What JOHN GILBOY, MD prescribes most
Top Medicare Part D drugs by claim count, 2023
- Trelegy Ellipta
Trelegy Ellipta
28 claims
- Incruse Ellipta 11
Incruse Ellipta
11 claims
- Prednisone 11
Prednisone
11 claims
| Drug | Claims |
|---|---|
| Trelegy Ellipta Fluticasone/Umeclidin/Vilanter | 28 |
| Incruse Ellipta Umeclidinium Bromide | 11 |
| Prednisone | 11 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Pulmonary Disease Physician Overview
How JOHN GILBOY, MD fits within the Pulmonary Disease Physician landscape nationally.
9,271
Pulmonary Disease Physician Providers in US
53
States with Pulmonary Disease Physician
1,457
Avg Claims per Provider
JOHN GILBOY, MD's 128 claims are below the specialty average of 1,457.
Nearby Pulmonary Disease Physician Providers in Maine
Other clinicians with the same primary specialty enrolled in Maine, drawn from the same CMS NPPES roster as GILBOY.
Dr. PETER BAGLEY
M.D.
ROCKPORT, ME
Dr. PETER BATES
M.D.
SOUTH PORTLAND, ME
Dr. RICHARD BEASLEY
DO
PORTLAND, ME
Dr. GEORGE BOCCIA
M.D.
AUGUSTA, ME
Dr. GEORGE BOKINSKY
M.D.
SOUTH PORTLAND, ME
Compare Pulmonary Disease Physician nationally: see state-by-state distribution →
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Frequently Asked Questions
What is JOHN GILBOY, MD's specialty? ▼
JOHN GILBOY, MD specializes in Pulmonary Disease Physician and practices in SOUTH PORTLAND, Maine. Credentials: MD.
How much does JOHN GILBOY, MD prescribe under Medicare Part D? ▼
In 2023, JOHN GILBOY, MD wrote 128 Medicare Part D claims totaling $53K in drug costs for 35 beneficiaries.
Where is JOHN GILBOY, MD located? ▼
JOHN GILBOY, MD is located at CHEST MEDICINE ASSOCIATES, SOUTH PORTLAND, ME, 04106. Phone: (207) 828-1122.
What is JOHN GILBOY, MD's NPI number? ▼
JOHN GILBOY, MD's National Provider Identifier (NPI) is 1093210171, issued on 03/29/2018.
Does JOHN GILBOY, MD prescribe more brand-name or generic drugs? ▼
JOHN GILBOY, MD's prescribing is 70% brand-name and 30% generic drugs by claim count, with $52K in brand drug costs.
How many Pulmonary Disease Physician providers are there in the US? ▼
There are 9,271 Pulmonary Disease Physician providers across 53 states in the US. The average Pulmonary Disease Physician provider writes 1,457 Medicare Part D claims per year.
What drugs does JOHN GILBOY, MD prescribe most often? ▼
Based on 2023 Medicare Part D data, JOHN GILBOY, MD's most frequently prescribed drugs include Trelegy Ellipta, Incruse Ellipta, Prednisone. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does JOHN GILBOY, MD accept Medicare? ▼
JOHN GILBOY, MD appears in CMS Medicare data with 128 Part D claims and 35 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify JOHN GILBOY, MD's credentials? ▼
JOHN GILBOY, MD's NPI is 1093210171 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.
- 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