2026 NPPES data Family Medicine Physician NPI 1619906245 MD
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Karl Heymann, MD

Family Medicine Physician in Rhinebeck, New York. 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
1K
Medicare Part D claims · 305 beneficiaries · Family Medicine Physician avg: 3K
Generic prescribing
90%
generic claims · 10% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
84.1/100
▲ 1 pts above national avg 83.1 · [object Object]

What the federal data shows

Karl Heymann, MD reported a CMS MIPS final score of 84.1/100 — above the 83.1 national average — and filed 1,426 Medicare Part D claims in 2023.

84.1/100
MIPS score · +1 vs avg
1K
Part D claims, 2023
90%
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.

Karl Heymann, MD's MIPS score vs every scored U.S. clinician

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

84 45th percentile higher than 45% 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%). This entry sits in this band. 90–100: 189,403 scored providers (40%). Above this entry. 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)

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

Near national average

NPI registry status

Active

Issued 07/03/2006

NPI 1619906245

Primary specialty

Family Medicine Physician

High-volume

147,640 US NPIs in this specialty

Medicare Part D claims

1,426 58% vs specialty avg

2023 prescription claims

Specialty avg: 3,418

MIPS final score

84.1/100 1 pts vs avg

Above neutral band

vs 83.1 national avg

Specialty distribution in New York

How Family Medicine Physician compares to other specialties among New York providers

New York providers

Family Medicine Physician share within New York

1. Family Medicine Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Family Medicine Physician share within New York

Medicare quality performance — MIPS

Karl Heymann, MD's 2023 MIPS final score plotted against the Family Medicine Physician national average

Near national average
MIPS Final Score
84.1/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Family Medicine Physician) — 84.1/100 vs national avg 83.1

0%100%National avg83%84.1%
MIPS final score (Family Medicine Physician) — 84.1/100 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).

Karl Heymann, MD appears in the CMS NPPES registry as a Family Medicine Physician provider holding MD credentials at 6734 ROUTE 9, Rhinebeck, NY, 12572, with a listed phone of (845) 231-5600. NPI 1619906245 was issued on 07/03/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what Heymann 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 1,426 prescription claims written by this provider, covering 305 Medicare beneficiaries and totaling roughly $144K in drug spend, split 10% brand-name and 90% 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 84.1/100 for the 2023 performance year (Quality 78.1, Cost 69.1), compared with the national average of 83.1.

Family Medicine Physician is a high-volume specialty nationwide, with 147,640 enrolled providers across 56 states and an average of 3,418 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

6734 ROUTE 9
Rhinebeck, NY 12572

Provider Details

NPI 1619906245
Specialty Family Medicine Physician
Credentials MD
Gender Male
NPI Issued 07/03/2006

CMS Quality Score (MIPS)

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

84.1496
Final Score
Avg: 83.1
78.1119
Quality
69.0533
Cost
100
Promoting Interoperability

Reporting: Group practice

License & disciplinary context — New York NYSBPMC 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 ~100K New York medical licensees in 2023 — they are NOT specific to Karl Heymann, MD. To verify Karl Heymann, MD's current license status, search the NYSBPMC public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

312
Total board actions, New York 2023
Across 302 cases
3.12
Actions per 1,000 licensees
New York statewide rate
probation
Most common action type
89 cases

NYSBPMC 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 New York disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Typical

Karl Heymann, MD — brand share 10.0%
Specialty average (est.)

10% brand-name claims vs 90% generic, on 1,426 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.

1,426
Total Claims
$144K
Total Drug Cost
305
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
3,691
Total Day Supply
110,355
Brand vs Generic
10% brand / 90% generic
Brand Drug Cost
$114K
Generic Drug Cost
$29K

Patient Demographics

Average Patient Age
74.9 years
Avg HCC Risk Score
1.21
Gender Split
34% female / 66% male
Age Distribution
<65: 21, 65-74: 134, 75-84: 100, 85+: 50

Top Prescribed Drugs (Medicare Part D)

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

What Karl Heymann, MD prescribes most

Top Medicare Part D drugs by claim count, 2023

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2023
Drug Claims
Rosuvastatin Calcium
159
Atorvastatin Calcium
105
Metformin Hcl
56
Levothyroxine Sodium
52
Omeprazole
49
Tamsulosin Hcl
49
Losartan Potassium
48
Metoprolol Succinate
47
Amlodipine Besylate
45
Simvastatin
41

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

Family Medicine Physician Overview

How Karl Heymann, MD fits within the Family Medicine Physician landscape nationally.

147,640
Family Medicine Physician Providers in US
56
States with Family Medicine Physician
3,418
Avg Claims per Provider

Karl Heymann, MD's 1,426 claims are below the specialty average of 3,418.

Nearby Family Medicine Physician Providers in New York

Other clinicians with the same primary specialty enrolled in New York, drawn from the same CMS NPPES roster as Heymann.

Compare Family Medicine Physician nationally: see state-by-state distribution →

Before you book an appointment

Use this federal record as your verification checklist, not as a recommendation.

  • Confirm the NPI record is current in the official CMS registry — providers update their own NPPES details, and moves can lag. Verify this NPI
  • Check the active license and any disciplinary history with the New York medical board — federal registration is not a license check. Credential verification guide
  • Weigh a second option: compare this provider with a nearby Family Medicine Physician peer on Medicare volume and prescribing patterns. Compare providers

Medicare Part D and MIPS figures describe practice patterns in federal programs only — they are not quality ratings, and PlainDoctor does not rate, rank, or recommend providers.

Frequently Asked Questions

What is Karl Heymann, MD's specialty?
Karl Heymann, MD specializes in Family Medicine Physician and practices in Rhinebeck, New York. Credentials: MD.
How much does Karl Heymann, MD prescribe under Medicare Part D?
In 2023, Karl Heymann, MD wrote 1,426 Medicare Part D claims totaling $144K in drug costs for 305 beneficiaries.
What is Karl Heymann, MD's Medicare quality score?
Karl Heymann, MD has a CMS MIPS Final Score of 84.1/100 (Quality: 78.1, Cost: 69.1). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Karl Heymann, MD located?
Karl Heymann, MD is located at 6734 ROUTE 9, Rhinebeck, NY, 12572. Phone: (845) 231-5600.
What is Karl Heymann, MD's NPI number?
Karl Heymann, MD's National Provider Identifier (NPI) is 1619906245, issued on 07/03/2006.
Does Karl Heymann, MD prescribe more brand-name or generic drugs?
Karl Heymann, MD's prescribing is 10% brand-name and 90% generic drugs by claim count, with $114K in brand drug costs.
How many Family Medicine Physician providers are there in the US?
There are 147,640 Family Medicine Physician providers across 56 states in the US. The average Family Medicine Physician provider writes 3,418 Medicare Part D claims per year.
What drugs does Karl Heymann, MD prescribe most often?
Based on 2023 Medicare Part D data, Karl Heymann, MD's most frequently prescribed drugs include Rosuvastatin Calcium, Atorvastatin Calcium, Metformin Hcl. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Karl Heymann, MD accept Medicare?
Karl Heymann, MD appears in CMS Medicare data with 1,426 Part D claims and 305 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Karl Heymann, MD's credentials?
Karl Heymann, MD's NPI is 1619906245 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