2026 NPPES data Emergency Medicine Physician NPI 1265870091 DO
Verify on CMS →

KELLY DIFABIO, DO

Emergency Medicine Physician in WALL TOWNSHIP, New Jersey. 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
336
Medicare Part D claims · 248 beneficiaries · Emergency Medicine Physician avg: 352
MIPS score
75/100
▼ 8 pts below national avg 83.1 · [object Object]

What the federal data shows

KELLY DIFABIO, DO reported a CMS MIPS final score of 75/100 — below the 83.1 national average — and filed 336 Medicare Part D claims in 2023.

75/100
MIPS score · -8 vs avg
336
Part D claims, 2023
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.

KELLY DIFABIO, DO's MIPS score vs every scored U.S. clinician

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

75 15th percentile higher than 15% 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%). This entry sits in this band. 80–90: 129,887 scored providers (27%). Above this entry. 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)

KELLY DIFABIO, DO 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 KELLY DIFABIO, DO?

Below national average

NPI registry status

Active

Issued 06/14/2013

NPI 1265870091

Primary specialty

Emergency Medicine Physician

High-volume

64,398 US NPIs in this specialty

Medicare Part D claims

336 5% vs specialty avg

2023 prescription claims

Specialty avg: 352

MIPS final score

75/100 8.099999999999994% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in New Jersey

How Emergency Medicine Physician compares to other specialties among New Jersey providers

New Jersey providers

Emergency Medicine Physician share within New Jersey

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

Medicare quality performance — MIPS

KELLY DIFABIO, DO's 2023 MIPS final score plotted against the Emergency Medicine Physician national average

Below national average
MIPS Final Score
75/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Emergency Medicine Physician) — 75/100 vs national avg 83.1

0%100%National avg83%75%
MIPS final score (Emergency Medicine Physician) — 75/100 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).

KELLY DIFABIO, DO appears in the CMS NPPES registry as a Emergency Medicine Physician provider holding DO credentials at 1825 RTE 35, WALL TOWNSHIP, NJ, 07719, with a listed phone of (732) 280-2600. NPI 1265870091 was issued on 06/14/2013. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what DIFABIO 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 336 prescription claims written by this provider, covering 248 Medicare beneficiaries and totaling roughly $3K in drug spend, with an opioid prescribing rate of 24.1%. 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 75/100 for the 2023 performance year, compared with the national average of 83.1.

Emergency Medicine Physician is a high-volume specialty nationwide, with 64,398 enrolled providers across 56 states and an average of 352 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

1825 RTE 35
WALL TOWNSHIP, NJ 07719

Provider Details

NPI 1265870091
Specialty Emergency Medicine Physician
Credentials DO
Gender Female
NPI Issued 06/14/2013

CMS Quality Score (MIPS)

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

75
Final Score
Avg: 83.1

Reporting: Group practice

Medicare Part D Prescribing Data

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

336
Total Claims
$3K
Total Drug Cost
248
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
337
Total Day Supply
2,746
Generic Drug Cost
$3K
Opioid Claims
81 (24.1% rate)
Antibiotic Claims
90

Patient Demographics

Average Patient Age
72.7 years
Avg HCC Risk Score
1.71
Gender Split
58% female / 42% male
Age Distribution
<65: 38, 65-74: 89, 75-84: 95, 85+: 26

Top Prescribed Drugs (Medicare Part D)

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

What KELLY DIFABIO, DO 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
Oxycodone-Acetaminophen
Oxycodone Hcl/Acetaminophen
56
Cephalexin
23
Ondansetron Odt
Ondansetron
22
Cyclobenzaprine Hcl
21
Ibuprofen
17
Prednisone
17
Doxycycline Hyclate
15
Tramadol Hcl
15
Sulfamethoxazole-Trimethoprim
Sulfamethoxazole/Trimethoprim
13
Methylprednisolone
12

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

Emergency Medicine Physician Overview

How KELLY DIFABIO, DO fits within the Emergency Medicine Physician landscape nationally.

64,398
Emergency Medicine Physician Providers in US
56
States with Emergency Medicine Physician
352
Avg Claims per Provider

KELLY DIFABIO, DO's 336 claims are below the specialty average of 352.

Nearby Emergency Medicine Physician Providers in New Jersey

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

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

Frequently Asked Questions

What is KELLY DIFABIO, DO's specialty?
KELLY DIFABIO, DO specializes in Emergency Medicine Physician and practices in WALL TOWNSHIP, New Jersey. Credentials: DO.
How much does KELLY DIFABIO, DO prescribe under Medicare Part D?
In 2023, KELLY DIFABIO, DO wrote 336 Medicare Part D claims totaling $3K in drug costs for 248 beneficiaries.
What is KELLY DIFABIO, DO's Medicare quality score?
KELLY DIFABIO, DO has a CMS MIPS Final Score of 75/100. The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is KELLY DIFABIO, DO located?
KELLY DIFABIO, DO is located at 1825 RTE 35, WALL TOWNSHIP, NJ, 07719. Phone: (732) 280-2600.
What is KELLY DIFABIO, DO's NPI number?
KELLY DIFABIO, DO's National Provider Identifier (NPI) is 1265870091, issued on 06/14/2013.
Does KELLY DIFABIO, DO prescribe opioids?
Yes, KELLY DIFABIO, DO had 81 opioid claims in 2023 with an opioid prescribing rate of 24.1%.
How many Emergency Medicine Physician providers are there in the US?
There are 64,398 Emergency Medicine Physician providers across 56 states in the US. The average Emergency Medicine Physician provider writes 352 Medicare Part D claims per year.
What drugs does KELLY DIFABIO, DO prescribe most often?
Based on 2023 Medicare Part D data, KELLY DIFABIO, DO's most frequently prescribed drugs include Oxycodone-Acetaminophen, Cephalexin, Ondansetron Odt. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does KELLY DIFABIO, DO accept Medicare?
KELLY DIFABIO, DO appears in CMS Medicare data with 336 Part D claims and 248 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify KELLY DIFABIO, DO's credentials?
KELLY DIFABIO, DO's NPI is 1265870091 with credentials DO. 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