NPI registry status
Active
2026 NPPES data Pulmonary Disease Physician NPI 1437192697 MD
Verify on CMS → Mark Lipham, MD
Pulmonary Disease Physician in Carrollton, Georgia.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 9,647 in Pulmonary Disease 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
38K
Medicare Part D claims · 678 beneficiaries · Pulmonary Disease Physician avg: 1K
Generic prescribing
88%
generic claims · 12% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
46.9/100
▼ 37 pts below national avg 83.5 · Below average
Industry payments
$154.69
9 payments · CMS Open Payments (Sunshine Act)
Source: CMS Medicare Part D Prescriber Public Use File, 2024
What the federal data shows
Mark Lipham, MD reported a CMS MIPS final score of 46.9/100 - below the 83.5 national average - and filed 37,747 Medicare Part D claims in 2024.
- 46.9/100
- MIPS score · -37 vs avg
- 38K
- Part D claims, 2024
- 88%
- 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 Mark Lipham, 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 1437192697), first enumerated 06/14/2006.
Source: CMS NPPES
- Reported
Medicare Part D participation
Filed 37,747 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 46.9/100 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
Industry payment transparency
$154.69 in reported industry payments (9 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 1437192697 · Pulmonary Disease Physician
NPI-10 · ENUM-LEGACY · TAX-MID · MIPS-LOW · RX-HEAVY · BOOK-THIN · PHOTO-FINISH
- NPI-10 1437192697
- ENUM-LEGACY 2006
- TAX-MID 10K Pulmonary Disease
- MIPS-LOW 46.9/100
- RX-HEAVY 38K claims
- BOOK-THIN 265 in Georgia
- PHOTO-FINISH Mehrdad Ghaffari, M.D. · ±0.1
MIPS final-score neighbourhood
Same-specialty nationwide peers by CMS final score, not geographic proximity
- Mehrdad Ghaffari…
Mehrdad Ghaffari, M.D.
46.8 MIPS pts
- George Zlupko · …
George Zlupko
46.8 MIPS pts
- Michael Zlupko ·…
Michael Zlupko
46.8 MIPS pts
- Lipham · this pr…
Lipham · this provider
46.9 MIPS pts
- Juan Garcia, MD …
Juan Garcia, MD
47.4 MIPS pts
What this shows Nearest measured MIPS peers for this NUCC specialty (2023 performance year).
Mark Lipham, 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.
47 ≥ 4th percentile 4% 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 Mark Lipham, MD sits
This provider among pulmonary disease physician peers
Across the 2,467 pulmonary disease physician providers who report both Medicare Part D prescribing and a MIPS quality score, Mark Lipham, MD writes more Part D claims than 100% of them and scores higher on MIPS quality than 7% - 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 pulmonary disease physician peer from a representative sample of 60; the gold marker is Mark Lipham, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Mark Lipham, 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 Mark Lipham, MD?
Below national averagePrimary specialty
Pulmonary Disease Physician
Medicare Part D claims
37,747 25× vs specialty avg
MIPS final score
46.9/100 36.6 pts vs avg
Specialty distribution in Georgia
How Pulmonary Disease Physician compares to other specialties among Georgia providers
Medicare quality performance, MIPS
Mark Lipham, MD's 2023 MIPS final score plotted against the Pulmonary Disease Physician national average
- MIPS Final Score
- 46.9/100
- 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 | 1437192697 |
|---|---|
| Specialty | Pulmonary Disease Physician |
| Credentials | MD |
| Gender | Male |
| NPI Issued | 06/14/2006 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
46.9453
Final Score
Measured-score avg: 83.5
30
Quality
83.1509
Cost
Reporting: Individual
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 Mark Lipham, MD. Source: openpaymentsdata.cms.gov.
Total received
$155
Largest payer
AstraZeneca Pharmaceuticals LP
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 · Typical
Mark Lipham, MD - brand share 12.0%
Pulmonary Disease Physician average
12% brand-name claims vs 88% generic, on 37,747 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.
37,747
Total Claims
$1.9M
Total Drug Cost
678
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 42,187.767
- Total Day Supply
- 785,773
- Brand vs Generic
- 12% brand / 88% generic
- Brand Drug Cost
- $1.4M
- Generic Drug Cost
- $522K
- Opioid Claims
- 1,267 (3.4% rate)
- Antibiotic Claims
- 753
Patient Demographics
- Average Patient Age
- 77.1 years
- Avg HCC Risk Score
- 2.06
- Gender Split
- 62% female / 38% male
- Age Distribution
- <65: 59, 65-74: 200, 75-84: 258, 85+: 161
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2024. Based on Medicare Part D data only.
What Mark Lipham, MD prescribes most
Top Medicare Part D drugs by claim count, 2024
- Amlodipine Besylate
Amlodipine Besylate
1,410 claims
- Atorvastatin Calcium
Atorvastatin Calcium
1,381 claims
- Omeprazole
Omeprazole
1,124 claims
- Eliquis
Eliquis
1,072 claims
- Gabapentin
Gabapentin
1,007 claims
- Levothyroxine Sodium
Levothyroxine Sodium
955 claims
- Lisinopril
Lisinopril
831 claims
- Furosemide
Furosemide
820 claims
| Drug | Claims |
|---|---|
| Amlodipine Besylate | 1,410 |
| Atorvastatin Calcium | 1,381 |
| Omeprazole | 1,124 |
| Eliquis Apixaban | 1,072 |
| Gabapentin | 1,007 |
| Levothyroxine Sodium | 955 |
| Lisinopril | 831 |
| Furosemide | 820 |
| Tamsulosin Hcl | 778 |
| Pravastatin Sodium | 721 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Pulmonary Disease Physician Overview
How Mark Lipham, MD fits within the Pulmonary Disease Physician landscape nationally.
9,647
Pulmonary Disease Physician Providers in US
53
States with Pulmonary Disease Physician
1,498
Avg Claims per Provider
Mark Lipham, MD's 37,747 claims are above the specialty average of 1,498.
Nationwide Pulmonary Disease Physician peers with similar MIPS or enrollment year
Two federal-record peer sets for Lipham, both outside Georgia so the neighborhoods are not geographic containment.
Similar MIPS final score
Nearest same-specialty clinicians by CMS MIPS final score (46.9 here).
Same NPPES enumeration year (2006)
Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.
Nearby Pulmonary Disease Physician Providers in Georgia
Other clinicians with the same primary specialty enrolled in Georgia, drawn from the same CMS NPPES roster as Lipham.
One of 265 Pulmonary Disease Physician providers enrolled in Georgia, 5 are shown here.
Dr. Israel Acosta Sanchez
M.D.
Augusta, GA
Dr. Umama Adil
MD
Dalton, GA
Dr. Samuel Aguayo
M.D.
Decatur, GA
Dr. Masood Ahmed
M. D.
Savannah, GA
Dr. Sisir Akkineni
M.D.
Atlanta, GA
Compare Pulmonary Disease Physician nationally: see state-by-state distribution →
Frequently Asked Questions
What is Mark Lipham, MD's specialty? ▼
Mark Lipham, MD specializes in Pulmonary Disease Physician and practices in Carrollton, Georgia. Credentials: MD.
How much does Mark Lipham, MD prescribe under Medicare Part D? ▼
In 2024, Mark Lipham, MD wrote 37,747 Medicare Part D claims totaling $1.9M in drug costs for 678 beneficiaries.
What is Mark Lipham, MD's Medicare quality score? ▼
Mark Lipham, MD has a CMS MIPS Final Score of 46.9/100 (Quality: 30, Cost: 83.2). 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 Mark Lipham, MD located? ▼
Mark Lipham, MD is located at 105 DOCTORS DRIVE, Carrollton, GA, 30117. Phone: (770) 832-0012.
What is Mark Lipham, MD's NPI number? ▼
Mark Lipham, MD's National Provider Identifier (NPI) is 1437192697, issued on 06/14/2006.
Does Mark Lipham, MD prescribe more brand-name or generic drugs? ▼
Mark Lipham, MD's prescribing is 12% brand-name and 88% generic drugs by claim count, with $1.4M in brand drug costs.
Does Mark Lipham, MD prescribe opioids? ▼
Yes, Mark Lipham, MD had 1,267 opioid claims in 2024 with an opioid prescribing rate of 3.4%.
How many Pulmonary Disease Physician providers are there in the US? ▼
There are 9,647 Pulmonary Disease Physician providers across 53 states in the US. The average Pulmonary Disease Physician provider writes 1,498 Medicare Part D claims per year.
What drugs does Mark Lipham, MD prescribe most often? ▼
Based on 2024 Medicare Part D data, Mark Lipham, MD's most frequently prescribed drugs include Amlodipine Besylate, Atorvastatin Calcium, Omeprazole. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Mark Lipham, MD accept Medicare? ▼
Mark Lipham, MD appears in CMS Medicare data with 37,747 Part D claims and 678 Medicare beneficiaries in 2024. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Mark Lipham, MD's credentials? ▼
Mark Lipham, MD's NPI is 1437192697 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.