2026 NPPES data Optometrist NPI 1457909616 OD
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KATELYN BALANCIO, OD

Optometrist in STOCKTON, California. 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
23
Medicare Part D claims · 18 beneficiaries · Optometrist avg: 257
MIPS score
80.9568/100
▼ 2 pts below national avg 83.1 · [object Object]
Industry payments
$108.71
4 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

KATELYN BALANCIO, OD reported a CMS MIPS final score of 80.9568/100 — below the 83.1 national average — and filed 23 Medicare Part D claims in 2023.

80.9568/100
MIPS score · -2 vs avg
23
Part D claims, 2023
$108.71
industry payments (Sunshine Act)

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.

KATELYN BALANCIO, OD's MIPS score vs every scored U.S. clinician

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

81 33rd percentile higher than 33% 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

What does the federal data show about KATELYN BALANCIO, OD?

Near national average

NPI registry status

Active

Issued 08/30/2019

NPI 1457909616

Primary specialty

Optometrist

High-volume

60,463 US NPIs in this specialty

Medicare Part D claims

23 91% vs specialty avg

2023 prescription claims

Specialty avg: 257

MIPS final score

80.9568/100 2.143199999999993% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in California

How Optometrist compares to other specialties among California providers

California providers

Optometrist share within California

1. Optometrist42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Optometrist share within California

Medicare quality performance — MIPS

KATELYN BALANCIO, OD's 2023 MIPS final score plotted against the Optometrist national average

Near national average
MIPS Final Score
80.9568/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Optometrist) — 80.9568/100 vs national avg 83.1

0%100%National avg83%81%
MIPS final score (Optometrist) — 80.9568/100 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).

KATELYN BALANCIO, OD is a Optometrist provider practicing in STOCKTON, California, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: OD. NPI: 1457909616. 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.

KATELYN BALANCIO, OD appears in the CMS NPPES registry as a Optometrist provider holding OD credentials at 4950 PACIFIC AVE, STOCKTON, CA, 95207, with a listed phone of (209) 477-4114. NPI 1457909616 was issued on 08/30/2019. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BALANCIO 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 23 prescription claims written by this provider, covering 18 Medicare beneficiaries and totaling roughly $3K in drug spend. 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 80.9568/100 for the 2023 performance year (Quality 100, Cost 19.856), compared with the national average of 83.1.

Optometrist is a high-volume specialty nationwide, with 60,463 enrolled providers across 56 states and an average of 257 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

4950 PACIFIC AVE
STOCKTON, CA 95207

Provider Details

NPI 1457909616
Specialty Optometrist
Credentials OD
Gender Female
NPI Issued 08/30/2019

CMS Quality Score (MIPS)

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

80.9568
Final Score
Avg: 83.1
100
Quality
19.856
Cost

Reporting: Group practice

Hospital and facility affiliations

Facilities where KATELYN BALANCIO, OD 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.

ZEITER EYE MEDICAL GROUP INC
STOCKTON, CA

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 KATELYN BALANCIO, OD. Source: openpaymentsdata.cms.gov.

Total received

$109

Largest payer

ABBVIE 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 — California MBC 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 ~150K California medical licensees in 2023 — they are NOT specific to KATELYN BALANCIO, OD. To verify KATELYN BALANCIO, OD's current license status, search the MBC public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

576
Total board actions, California 2023
Across 556 cases
3.84
Actions per 1,000 licensees
California statewide rate
probation
Most common action type
186 cases

MBC 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 California disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

23
Total Claims
$3K
Total Drug Cost
18
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
26
Total Day Supply
642
Generic Drug Cost
$931

Patient Demographics

Average Patient Age
70.9 years
Avg HCC Risk Score
1.27

Optometrist Overview

How KATELYN BALANCIO, OD fits within the Optometrist landscape nationally.

60,463
Optometrist Providers in US
56
States with Optometrist
257
Avg Claims per Provider

KATELYN BALANCIO, OD's 23 claims are below the specialty average of 257.

Nearby Optometrist Providers in California

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

Compare Optometrist nationally: see state-by-state distribution →

Frequently Asked Questions

What is KATELYN BALANCIO, OD's specialty?
KATELYN BALANCIO, OD specializes in Optometrist and practices in STOCKTON, California. Credentials: OD.
How much does KATELYN BALANCIO, OD prescribe under Medicare Part D?
In 2023, KATELYN BALANCIO, OD wrote 23 Medicare Part D claims totaling $3K in drug costs for 18 beneficiaries.
What is KATELYN BALANCIO, OD's Medicare quality score?
KATELYN BALANCIO, OD has a CMS MIPS Final Score of 80.9568/100 (Quality: 100, Cost: 19.856). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is KATELYN BALANCIO, OD located?
KATELYN BALANCIO, OD is located at 4950 PACIFIC AVE, STOCKTON, CA, 95207. Phone: (209) 477-4114.
What is KATELYN BALANCIO, OD's NPI number?
KATELYN BALANCIO, OD's National Provider Identifier (NPI) is 1457909616, issued on 08/30/2019.
How many Optometrist providers are there in the US?
There are 60,463 Optometrist providers across 56 states in the US. The average Optometrist provider writes 257 Medicare Part D claims per year.
Does KATELYN BALANCIO, OD accept Medicare?
KATELYN BALANCIO, OD appears in CMS Medicare data with 23 Part D claims and 18 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify KATELYN BALANCIO, OD's credentials?
KATELYN BALANCIO, OD's NPI is 1457909616 with credentials OD. 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