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 9,323 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
40K
Medicare Part D claims · 743 beneficiaries · Pulmonary Disease Physician avg: 1K
Generic prescribing
87%
generic claims · 13% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
46.9/100
▼ 36 pts below national avg 83.1 · Below average
Industry payments
$154.69
9 payments · CMS Open Payments (Sunshine Act)
Source: CMS Medicare Part D Prescriber Public Use File, 2023
Compiled from official public sources by the PlainDoctor editorial team.
What the federal data shows
Mark Lipham, MD reported a CMS MIPS final score of 46.9/100 - below the 83.1 national average - and filed 39,774 Medicare Part D claims in 2023.
- 46.9/100
- MIPS score · -36 vs avg
- 40K
- Part D claims, 2023
- 87%
- 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.
Mark Lipham, MD's MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
47 4th percentile higher than 4% of 477,587 scored providers
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
Where Mark Lipham, MD sits
This provider among pulmonary disease physician peers
Across the 2,676 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.
Part D claim volume vs MIPS quality, by specialty percentile
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
39,774 27× vs specialty avg
MIPS final score
46.9/100 36.2 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 83.1 national avg · 2023 performance year
MIPS final score (Pulmonary Disease Physician) - 46.9/100 vs national avg 83.1
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).
Mark Lipham, MD appears in the CMS NPPES registry as a Pulmonary Disease Physician provider holding MD credentials at 105 DOCTORS DRIVE, Carrollton, GA, 30117, with a listed phone of (770) 832-0012. NPI 1437192697 was issued on 06/14/2006.
Medicare Part D records for calendar year 2023 show 39,774 prescription claims written by this provider, covering 743 Medicare beneficiaries and totaling roughly $2.2 million in drug spend, split 13% brand-name and 87% generic by claim count, with an opioid prescribing rate of 3.7%. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 46.9/100 for the 2023 performance year (Quality 30, Cost 83.2), compared with the national average of 83.1.
Pulmonary Disease Physician is a mid-sized specialty nationwide, with 9,323 enrolled providers across 53 states and an average of 1,457 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
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
Avg: 83.1
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 13.0%
Pulmonary Disease Physician average
13% brand-name claims vs 87% generic, on 39,774 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.
39,774
Total Claims
$2.2M
Total Drug Cost
743
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 44,558
- Total Day Supply
- 822,257
- Brand vs Generic
- 13% brand / 87% generic
- Brand Drug Cost
- $1.6M
- Generic Drug Cost
- $612K
- Opioid Claims
- 1,482 (3.7% rate)
- Antibiotic Claims
- 699
Patient Demographics
- Average Patient Age
- 76.7 years
- Avg HCC Risk Score
- 2.03
- Gender Split
- 61% female / 39% male
- Age Distribution
- <65: 74, 65-74: 211, 75-84: 294, 85+: 164
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Mark Lipham, MD prescribes most
Top Medicare Part D drugs by claim count, 2023
- Amlodipine Besylate
Amlodipine Besylate
1,444 claims
- Atorvastatin Calcium
Atorvastatin Calcium
1,352 claims
- Gabapentin
Gabapentin
1,144 claims
- Eliquis
Eliquis
1,036 claims
- Omeprazole
Omeprazole
1,026 claims
- Pravastatin Sodium
Pravastatin Sodium
958 claims
- Furosemide
Furosemide
882 claims
- Levothyroxine Sodium
Levothyroxine Sodium
876 claims
| Drug | Claims |
|---|---|
| Amlodipine Besylate | 1,444 |
| Atorvastatin Calcium | 1,352 |
| Gabapentin | 1,144 |
| Eliquis Apixaban | 1,036 |
| Omeprazole | 1,026 |
| Pravastatin Sodium | 958 |
| Furosemide | 882 |
| Levothyroxine Sodium | 876 |
| Lisinopril | 862 |
| Potassium Chloride | 813 |
* 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.
9,323
Pulmonary Disease Physician Providers in US
53
States with Pulmonary Disease Physician
1,457
Avg Claims per Provider
Mark Lipham, MD's 39,774 claims are above the specialty average of 1,457.
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.
Dr. Israel Acosta Sanchez
M.D.
Augusta, GA
Dr. Samuel Aguayo
M.D.
Decatur, GA
Dr. Masood Ahmed
M. D.
Savannah, GA
Dr. Sisir Akkineni
M.D.
Atlanta, GA
Dr. Igor Aksenov
M.D.
Savannah, GA
Compare Pulmonary Disease 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 Georgia medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Pulmonary Disease 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.
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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 2023, Mark Lipham, MD wrote 39,774 Medicare Part D claims totaling $2.2M in drug costs for 743 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 national average MIPS Final Score is 83.1. 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 13% brand-name and 87% generic drugs by claim count, with $1.6M in brand drug costs.
Does Mark Lipham, MD prescribe opioids? ▼
Yes, Mark Lipham, MD had 1,482 opioid claims in 2023 with an opioid prescribing rate of 3.7%.
How many Pulmonary Disease Physician providers are there in the US? ▼
There are 9,323 Pulmonary Disease Physician providers across 53 states in the US. The average Pulmonary Disease Physician provider writes 1,457 Medicare Part D claims per year.
What drugs does Mark Lipham, MD prescribe most often? ▼
Based on 2023 Medicare Part D data, Mark Lipham, MD's most frequently prescribed drugs include Amlodipine Besylate, Atorvastatin Calcium, Gabapentin. 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 39,774 Part D claims and 743 Medicare beneficiaries in 2023. 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 (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
Compiled from official public sources by the PlainDoctor editorial team.