2026 NPPES data Internal Medicine Physician NPI 1497296685 MD
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Matthew Ballenberger, MD

Internal Medicine Physician in Riverside, Rhode Island.

This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 172,858 in Internal Medicine 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.
MIPS score
91.3/100
▲ 8 pts above national avg 83.1 · Exceptional
Industry payments
$339.44
4 payments · CMS Open Payments (Sunshine Act)
Compiled from official public sources by the PlainDoctor editorial team.

What the federal data shows

Matthew Ballenberger, MD reported a CMS MIPS final score of 91.3/100 - above the 83.1 national average.

91.3/100
MIPS score · +8 vs avg
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.

Matthew Ballenberger, MD's MIPS score vs every scored U.S. clinician

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

91 Top 37% higher than 63% 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%). Below this entry. 90+: 189,403 scored providers (40%). This entry sits in this band. 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)

Matthew Ballenberger, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 4 hospital affiliations - 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 Matthew Ballenberger, MD?

High performer (top quartile)

NPI registry status

Active

Issued 03/20/2017

NPI 1497296685

Primary specialty

Internal Medicine Physician

High-volume

172,858 US NPIs in this specialty

MIPS final score

91.3/100 8.2 pts vs avg

Exceptional band

vs 83.1 national avg

Specialty distribution in Rhode Island

How Internal Medicine Physician compares to other specialties among Rhode Island providers

Rhode Island providers
Clinical Social Worker - 8.9%Clinical Social Worker8.9%Mental Health Counselor - 5.3%Mental Health Counselor5.3%Physical Therapist - 4.8%Physical Therapist4.8%Internal Medicine Physician - 4.4%Internal Medicine Physician4.4%Student in an Organized Health Care Education/Training Program - 4.1%Student in an Organized Health Care Education/Training Program4.1%Pharmacist - 4.1%Pharmacist4.1%
Largest specialties in Rhode Island (% of in-state providers)

Medicare quality performance, MIPS

Matthew Ballenberger, MD's 2023 MIPS final score plotted against the Internal Medicine Physician national average

High performer (top quartile)
MIPS Final Score
91.3/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Internal Medicine Physician) - 91.3/100 vs national avg 83.1

0%100%National avg83%91.3%
MIPS final score (Internal Medicine Physician) - 91.3/100 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).

Matthew Ballenberger, MD appears in the CMS NPPES registry as a Internal Medicine Physician provider holding MD credentials at 375 WAMPANOAG TRL, Riverside, RI, 02915, with a listed phone of (401) 649-4070. NPI 1497296685 was issued on 03/20/2017.

Medicare Part D prescribing data is not currently published for this NPI, which typically means the provider either wrote fewer than 11 Part D claims in the most recent reporting year, does not participate in Medicare, or practices in a specialty that rarely prescribes outpatient drugs. Absence of prescribing data is not a quality signal, many Internal Medicine Physician providers operate outside Part D entirely. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 91.3/100 for the 2023 performance year (Quality 74.9), compared with the national average of 83.1.

Internal Medicine Physician is a high-volume specialty nationwide, with 172,858 enrolled providers across 56 states and an average of 2,716 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

375 WAMPANOAG TRL
Riverside, RI 02915

Provider Details

NPI 1497296685
Specialty Internal Medicine Physician
Credentials MD
Gender Male
NPI Issued 03/20/2017

CMS Quality Score (MIPS)

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

91.2532
Final Score
Avg: 83.1
74.9203
Quality
91.6794
Promoting Interoperability

Reporting: Alternative Payment Model

Hospital and facility affiliations

Facilities where Matthew Ballenberger, MD 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.

According to CMS billing records, Matthew Ballenberger, MD is affiliated with 4 Medicare-billing facilities, 2 of which carry a CMS Hospital overall star rating.

Rhode Island Hospital
★★★★☆ 4/5
Providence, RI
Acute Care Hospitals
CMS CCN: 410007
The Miriam Hospital
★★★★☆ 4/5
Providence, RI
Acute Care Hospitals
CMS CCN: 410012
Brown Medicine
Riverside, RI
Lifespan Physician Group Inc
North Providence, RI

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 Matthew Ballenberger, MD. Source: openpaymentsdata.cms.gov.

Total received

$339

Largest payer

Inspire Medical Systems, 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.

Internal Medicine Physician Overview

How Matthew Ballenberger, MD fits within the Internal Medicine Physician landscape nationally.

172,858
Internal Medicine Physician Providers in US
56
States with Internal Medicine Physician
2,716
Avg Claims per Provider

Nearby Internal Medicine Physician Providers in Rhode Island

Other clinicians with the same primary specialty enrolled in Rhode Island, drawn from the same CMS NPPES roster as Ballenberger.

Compare Internal 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 Rhode Island medical board, federal registration is not a license check. Credential verification guide
  • Weigh a second option: compare this provider with a nearby Internal 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 Matthew Ballenberger, MD's specialty?
Matthew Ballenberger, MD specializes in Internal Medicine Physician and practices in Riverside, Rhode Island. Credentials: MD.
What is Matthew Ballenberger, MD's Medicare quality score?
Matthew Ballenberger, MD has a CMS MIPS Final Score of 91.3/100 (Quality: 74.9). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Matthew Ballenberger, MD located?
Matthew Ballenberger, MD is located at 375 WAMPANOAG TRL, Riverside, RI, 02915. Phone: (401) 649-4070.
What is Matthew Ballenberger, MD's NPI number?
Matthew Ballenberger, MD's National Provider Identifier (NPI) is 1497296685, issued on 03/20/2017.
How many Internal Medicine Physician providers are there in the US?
There are 172,858 Internal Medicine Physician providers across 56 states in the US. The average Internal Medicine Physician provider writes 2,716 Medicare Part D claims per year.
Does Matthew Ballenberger, MD accept Medicare?
Matthew Ballenberger, MD appears in CMS Medicare data. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Matthew Ballenberger, MD's credentials?
Matthew Ballenberger, MD's NPI is 1497296685 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.
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.