2026 NPPES data Ophthalmic Plastic and Reconstructive Surgery Physician NPI 1093791121 M.D.
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JOHN HEFFERNAN, M.D.

Ophthalmic Plastic and Reconstructive Surgery Physician in TACOMA, Washington. 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
309
Medicare Part D claims · 194 beneficiaries · Ophthalmic Plastic and Reconstructive Surgery Physician avg: 624
Generic prescribing
78%
generic claims · 22% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
100/100
▲ 17 pts above national avg 83.1 · [object Object]
Industry payments
$67.3
4 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: JOHN HEFFERNAN, M.D. is a Ophthalmic Plastic and Reconstructive Surgery Physician ([object Object]) practicing in TACOMA, Washington with a Medicare Part D prescribing footprint of 309 claims across 194 beneficiaries — 22% brand-name prescribing . Their CMS MIPS Final Score of 100/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $67.3 across 4 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: JOHN HEFFERNAN, M.D. reported a CMS MIPS final score of 100 out of 100, above the 83.1 national average, and filed 309 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

Board certification likely (heuristic — not verified)

JOHN HEFFERNAN, M.D. 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).

JOHN HEFFERNAN, M.D. at a glance

High performer (top quartile)

NPI registry status

Active

Issued 12/20/2005

NPI 1093791121

Primary specialty

Ophthalmic Plastic and Reconstructive Surgery Physician

Rare

291 US NPIs in this specialty

Medicare Part D claims

309 50% vs specialty avg

2023 prescription claims

Specialty avg: 624

MIPS final score

100/100 16.900000000000006% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Washington

How Ophthalmic Plastic and Reconstructive Surgery Physician compares to other specialties among Washington providers

Washington providers

Ophthalmic Plastic and Reconstructive Surgery Physician share within Washington

1. Ophthalmic Plastic and Reconstructive Surgery Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Ophthalmic Plastic and Reconstructive Surgery Physician share within Washington

Medicare quality performance — MIPS

JOHN HEFFERNAN, M.D.'s 2023 MIPS final score plotted against the Ophthalmic Plastic and Reconstructive Surgery Physician national average

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

MIPS final score (Ophthalmic Plastic and Reconstructive Surgery Physician) — 100/100 vs national avg 83.1

0%100%National avg83%99%
MIPS final score (Ophthalmic Plastic and Reconstructive Surgery Physician) — 100/100 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 HEFFERNAN, M.D. is a Ophthalmic Plastic and Reconstructive Surgery Physician provider practicing in TACOMA, Washington, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: M.D.. NPI: 1093791121. 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 HEFFERNAN, M.D. appears in the CMS NPPES registry as a Ophthalmic Plastic and Reconstructive Surgery Physician provider holding M.D. credentials at 502 S M ST, TACOMA, WA, 98405, with a listed phone of (206) 212-2100. NPI 1093791121 was issued on 12/20/2005. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what HEFFERNAN 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 309 prescription claims written by this provider, covering 194 Medicare beneficiaries and totaling roughly $684K in drug spend, split 22% brand-name and 78% generic by claim count, with an opioid prescribing rate of 18.1%. 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 100/100 for the 2023 performance year (Quality 100), compared with the national average of 83.1.

Ophthalmic Plastic and Reconstructive Surgery Physician is a narrow specialty nationwide, with 291 enrolled providers across 46 states and an average of 624 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

502 S M ST
TACOMA, WA 98405

Provider Details

NPI 1093791121
Specialty Ophthalmic Plastic and Reconstructive Surgery Physician
Credentials M.D.
Gender Male
NPI Issued 12/20/2005

CMS Quality Score (MIPS)

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

100
Final Score
Avg: 83.1
100
Quality

Reporting: Group practice

Hospital and facility affiliations

Facilities where JOHN HEFFERNAN, 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.

EVERGREEN EYE CENTER PLLC
TACOMA, WA

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 HEFFERNAN, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$67

Largest payer

Amgen 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.

License & disciplinary context — Washington WMC 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 ~34K Washington medical licensees in 2023 — they are NOT specific to JOHN HEFFERNAN, M.D.. To verify JOHN HEFFERNAN, M.D.'s current license status, search the WMC public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

88
Total board actions, Washington 2023
Across 85 cases
2.59
Actions per 1,000 licensees
Washington statewide rate
probation
Most common action type
31 cases

WMC 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 Washington disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Typical

JOHN HEFFERNAN, M.D. — brand share 22.0%
Specialty average (est.)

22% brand-name claims vs 78% generic, on 309 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.

309
Total Claims
$684K
Total Drug Cost
194
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
360
Total Day Supply
6,640
Brand vs Generic
22% brand / 78% generic
Brand Drug Cost
$678K
Generic Drug Cost
$7K
Opioid Claims
56 (18.1% rate)

Patient Demographics

Average Patient Age
74.4 years
Avg HCC Risk Score
1.15
Gender Split
62% female / 38% male

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Erythromycin
Erythromycin Base
103
Tobramycin-Dexamethasone
Tobramycin/Dexamethasone
97
Hydrocodone-Acetaminophen
Hydrocodone/Acetaminophen
49

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

Ophthalmic Plastic and Reconstructive Surgery Physician Overview

How JOHN HEFFERNAN, M.D. fits within the Ophthalmic Plastic and Reconstructive Surgery Physician landscape nationally.

291
Ophthalmic Plastic and Reconstructive Surgery Physician Providers in US
46
States with Ophthalmic Plastic and Reconstructive Surgery Physician
624
Avg Claims per Provider

JOHN HEFFERNAN, M.D.'s 309 claims are below the specialty average of 624.

Nearby Ophthalmic Plastic and Reconstructive Surgery Physician Providers in Washington

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

Compare Ophthalmic Plastic and Reconstructive Surgery Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is JOHN HEFFERNAN, M.D.'s specialty?
JOHN HEFFERNAN, M.D. specializes in Ophthalmic Plastic and Reconstructive Surgery Physician and practices in TACOMA, Washington. Credentials: M.D..
How much does JOHN HEFFERNAN, M.D. prescribe under Medicare Part D?
In 2023, JOHN HEFFERNAN, M.D. wrote 309 Medicare Part D claims totaling $684K in drug costs for 194 beneficiaries.
What is JOHN HEFFERNAN, M.D.'s Medicare quality score?
JOHN HEFFERNAN, M.D. has a CMS MIPS Final Score of 100/100 (Quality: 100). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is JOHN HEFFERNAN, M.D. located?
JOHN HEFFERNAN, M.D. is located at 502 S M ST, TACOMA, WA, 98405. Phone: (206) 212-2100.
What is JOHN HEFFERNAN, M.D.'s NPI number?
JOHN HEFFERNAN, M.D.'s National Provider Identifier (NPI) is 1093791121, issued on 12/20/2005.
Does JOHN HEFFERNAN, M.D. prescribe more brand-name or generic drugs?
JOHN HEFFERNAN, M.D.'s prescribing is 22% brand-name and 78% generic drugs by claim count, with $678K in brand drug costs.
Does JOHN HEFFERNAN, M.D. prescribe opioids?
Yes, JOHN HEFFERNAN, M.D. had 56 opioid claims in 2023 with an opioid prescribing rate of 18.1%.
How many Ophthalmic Plastic and Reconstructive Surgery Physician providers are there in the US?
There are 291 Ophthalmic Plastic and Reconstructive Surgery Physician providers across 46 states in the US. The average Ophthalmic Plastic and Reconstructive Surgery Physician provider writes 624 Medicare Part D claims per year.
What drugs does JOHN HEFFERNAN, M.D. prescribe most often?
Based on 2023 Medicare Part D data, JOHN HEFFERNAN, M.D.'s most frequently prescribed drugs include Erythromycin, Tobramycin-Dexamethasone, Hydrocodone-Acetaminophen. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does JOHN HEFFERNAN, M.D. accept Medicare?
JOHN HEFFERNAN, M.D. appears in CMS Medicare data with 309 Part D claims and 194 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify JOHN HEFFERNAN, M.D.'s credentials?
JOHN HEFFERNAN, M.D.'s NPI is 1093791121 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