NPI registry status
Active
2026 NPPES data Retina Specialist (Ophthalmology) Physician NPI 1093906281 MD
Verify on CMS → Kapil Kapoor, MD
Retina Specialist (Ophthalmology) Physician in Norfolk, Virginia.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 983 in Retina Specialist (Ophthalmology) 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
1K
Medicare Part D claims · 448 beneficiaries · Retina Specialist (Ophthalmology) Physician avg: 593
Generic prescribing
65%
generic claims · 35% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
79.9/100
▼ 4 pts below national avg 83.5 · Above neutral
Industry payments
$132.4
3 payments · CMS Open Payments (Sunshine Act)
Source: CMS Medicare Part D Prescriber Public Use File, 2024
What the federal data shows
Kapil Kapoor, MD reported a CMS MIPS final score of 79.9/100 - below the 83.5 national average - and filed 1,324 Medicare Part D claims in 2024.
- 79.9/100
- MIPS score · -4 vs avg
- 1K
- Part D claims, 2024
- 65%
- 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 Kapil Kapoor, 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 1093906281), first enumerated 08/05/2007.
Source: CMS NPPES
- Reported
Medicare Part D participation
Filed 1,324 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 79.9/100 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
1 CMS Care Compare hospital affiliation on record — practice footprint from the Doctors and Clinicians file.
Source: CMS Care Compare
- Reported
Industry payment transparency
$132.4 in reported industry payments (3 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 1093906281 · Retina Specialist (Ophthalmology) Physician
NPI-10 · ENUM-MID · TAX-NARROW · MIPS-BELOW · RX-MID · BOOK-THIN · PHOTO-FINISH
- NPI-10 1093906281
- ENUM-MID 2007
- TAX-NARROW 983
- MIPS-BELOW 79.9/100
- RX-MID 1,324
- BOOK-THIN 24 in Virginia
- PHOTO-FINISH Paul Tlucek · ±0.0
MIPS final-score neighbourhood
Same-specialty nationwide peers by CMS final score, not geographic proximity
- John Alexander ·…
John Alexander
79.8 MIPS pts
- Kapoor · this pr…
Kapoor · this provider
79.9 MIPS pts
- Paul Tlucek · near
Paul Tlucek
79.9 MIPS pts
- Matthew Wood · h…
Matthew Wood
80 MIPS pts
- Daniel Chruscick…
Daniel Chruscicki
80 MIPS pts
What this shows Nearest measured MIPS peers for this NUCC specialty (2023 performance year).
Kapil Kapoor, 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.
80 ≥ 26th percentile 26% 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 Kapil Kapoor, MD sits
This provider among retina specialist (ophthalmology) physician peers
Across the 573 retina specialist (ophthalmology) physician providers who report both Medicare Part D prescribing and a MIPS quality score, Kapil Kapoor, MD writes more Part D claims than 91% of them and scores higher on MIPS quality than 16% - placing this provider in the high-volume, lower-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Each dot is one retina specialist (ophthalmology) physician peer from a representative sample of 60; the gold marker is Kapil Kapoor, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Kapil Kapoor, 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 Kapil Kapoor, MD?
Near national averagePrimary specialty
Retina Specialist (Ophthalmology) Physician
Medicare Part D claims
1,324 123% vs specialty avg
MIPS final score
79.9/100 3.6 pts vs avg
Specialty distribution in Virginia
How Retina Specialist (Ophthalmology) Physician compares to other specialties among Virginia providers
Medicare quality performance, MIPS
Kapil Kapoor, MD's 2023 MIPS final score plotted against the Retina Specialist (Ophthalmology) Physician national average
- MIPS Final Score
- 79.9/100
- 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 | 1093906281 |
|---|---|
| Specialty | Retina Specialist (Ophthalmology) Physician |
| Credentials | MD |
| Gender | Male |
| NPI Issued | 08/05/2007 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
79.912
Final Score
Measured-score avg: 83.5
100
Quality
33.04
Cost
Reporting: Group practice
Hospital and facility affiliations
Facilities where Kapil Kapoor, 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.
Retina And Vitreous Center PC
Elizabeth City, NC
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 Kapil Kapoor, MD. Source: openpaymentsdata.cms.gov.
Total received
$132
Largest payer
Bausch & Lomb Americas 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 · Above average
Kapil Kapoor, MD - brand share 35.0%
Retina Specialist (Ophthalmology) Physician average
35% brand-name claims vs 65% generic, on 1,324 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.
1,324
Total Claims
$85K
Total Drug Cost
448
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 2,463.3
- Total Day Supply
- 71,039
- Brand vs Generic
- 35% brand / 65% generic
- Brand Drug Cost
- $54K
- Generic Drug Cost
- $31K
- Antibiotic Claims
- 13
Patient Demographics
- Average Patient Age
- 74.8 years
- Avg HCC Risk Score
- 1.56
- Gender Split
- 58% female / 42% male
- Age Distribution
- <65: 34, 65-74: 197, 75-84: 149, 85+: 68
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2024. Based on Medicare Part D data only.
What Kapil Kapoor, MD prescribes most
Top Medicare Part D drugs by claim count, 2024
- Ketorolac Trometha…
Ketorolac Tromethamine
298 claims
- Prednisolone Acetate
Prednisolone Acetate
296 claims
- Brimonidine Tartrate 103
Brimonidine Tartrate
103 claims
- Dorzolamide-Timolol 94
Dorzolamide-Timolol
94 claims
- Latanoprost 88
Latanoprost
88 claims
- Spironolactone 47
Spironolactone
47 claims
- Timolol Maleate 46
Timolol Maleate
46 claims
- Eplerenone 42
Eplerenone
42 claims
| Drug | Claims |
|---|---|
| Ketorolac Tromethamine | 298 |
| Prednisolone Acetate | 296 |
| Brimonidine Tartrate | 103 |
| Dorzolamide-Timolol Dorzolamide Hcl/Timolol Maleat | 94 |
| Latanoprost | 88 |
| Spironolactone | 47 |
| Timolol Maleate | 46 |
| Eplerenone | 42 |
| Gentamicin Sulfate | 42 |
| Dorzolamide Hcl | 41 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
More Retina Specialist (Ophthalmology) Physician in VA →
All providers in Virginia →
Compare specialties →
Retina Specialist (Ophthalmology) Physician Overview
How Kapil Kapoor, MD fits within the Retina Specialist (Ophthalmology) Physician landscape nationally.
983
Retina Specialist (Ophthalmology) Physician Providers in US
48
States with Retina Specialist (Ophthalmology) Physician
593
Avg Claims per Provider
Kapil Kapoor, MD's 1,324 claims are above the specialty average of 593.
Nationwide Retina Specialist (Ophthalmology) Physician peers with similar MIPS or enrollment year
Two federal-record peer sets for Kapoor, both outside Virginia so the neighborhoods are not geographic containment.
Similar MIPS final score
Nearest same-specialty clinicians by CMS MIPS final score (79.9 here).
Same NPPES enumeration year (2007)
Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.
Nearby Retina Specialist (Ophthalmology) Physician Providers in Virginia
Other clinicians with the same primary specialty enrolled in Virginia, drawn from the same CMS NPPES roster as Kapoor.
One of 24 Retina Specialist (Ophthalmology) Physician providers enrolled in Virginia, 5 are shown here.
Dr. Juan Astruc
M.D.
Richmond, VA
Evan Berger
Norfolk, VA
Dr. Vikram Brar
MD
Richmond, VA
Dr. Timothy Byrnes
MD
Roanoke, VA
Dr. John Carter
M.D.
Winchester, VA
Compare Retina Specialist (Ophthalmology) Physician nationally: see state-by-state distribution →
Frequently Asked Questions
What is Kapil Kapoor, MD's specialty? ▼
Kapil Kapoor, MD specializes in Retina Specialist (Ophthalmology) Physician and practices in Norfolk, Virginia. Credentials: MD.
How much does Kapil Kapoor, MD prescribe under Medicare Part D? ▼
In 2024, Kapil Kapoor, MD wrote 1,324 Medicare Part D claims totaling $85K in drug costs for 448 beneficiaries.
What is Kapil Kapoor, MD's Medicare quality score? ▼
Kapil Kapoor, MD has a CMS MIPS Final Score of 79.9/100 (Quality: 100, Cost: 33). 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 Kapil Kapoor, MD located? ▼
Kapil Kapoor, MD is located at 6160 KEMPSVILLE CIR STE 120B, Norfolk, VA, 23502. Phone: (757) 481-4400.
What is Kapil Kapoor, MD's NPI number? ▼
Kapil Kapoor, MD's National Provider Identifier (NPI) is 1093906281, issued on 08/05/2007.
Does Kapil Kapoor, MD prescribe more brand-name or generic drugs? ▼
Kapil Kapoor, MD's prescribing is 35% brand-name and 65% generic drugs by claim count, with $54K in brand drug costs.
How many Retina Specialist (Ophthalmology) Physician providers are there in the US? ▼
There are 983 Retina Specialist (Ophthalmology) Physician providers across 48 states in the US. The average Retina Specialist (Ophthalmology) Physician provider writes 593 Medicare Part D claims per year.
What drugs does Kapil Kapoor, MD prescribe most often? ▼
Based on 2024 Medicare Part D data, Kapil Kapoor, MD's most frequently prescribed drugs include Ketorolac Tromethamine, Prednisolone Acetate, Brimonidine Tartrate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Kapil Kapoor, MD accept Medicare? ▼
Kapil Kapoor, MD appears in CMS Medicare data with 1,324 Part D claims and 448 Medicare beneficiaries in 2024. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Kapil Kapoor, MD's credentials? ▼
Kapil Kapoor, MD's NPI is 1093906281 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.