2026 NPPES data Otolaryngology Physician NPI 1225001357 M.D.
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MATTHEW GRAFENBERG, M.D.

Otolaryngology Physician in PINEHURST, North Carolina. 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
600
Medicare Part D claims · 229 beneficiaries · Otolaryngology Physician avg: 509
Generic prescribing
95%
generic claims · 5% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
87.9598/100
▲ 5 pts above national avg 83.1 · [object Object]
Industry payments
$821.51
20 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

MATTHEW GRAFENBERG, M.D. reported a CMS MIPS final score of 87.9598/100 — above the 83.1 national average — and filed 600 Medicare Part D claims in 2023.

87.9598/100
MIPS score · +5 vs avg
600
Part D claims, 2023
95%
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.

MATTHEW GRAFENBERG, M.D.'s MIPS score vs every scored U.S. clinician

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

88 Top 46% higher than 54% 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

Board certification likely (heuristic — not verified)

MATTHEW GRAFENBERG, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 2 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 GRAFENBERG, M.D.?

High performer (top quartile)

NPI registry status

Active

Issued 02/09/2006

NPI 1225001357

Primary specialty

Otolaryngology Physician

Mid-sized

10,895 US NPIs in this specialty

Medicare Part D claims

600 18% vs specialty avg

2023 prescription claims

Specialty avg: 509

MIPS final score

87.9598/100 4.859800000000007% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in North Carolina

How Otolaryngology Physician compares to other specialties among North Carolina providers

North Carolina providers

Otolaryngology Physician share within North Carolina

1. Otolaryngology Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Otolaryngology Physician share within North Carolina

Medicare quality performance — MIPS

MATTHEW GRAFENBERG, M.D.'s 2023 MIPS final score plotted against the Otolaryngology Physician national average

High performer (top quartile)
MIPS Final Score
87.9598/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Otolaryngology Physician) — 87.9598/100 vs national avg 83.1

0%100%National avg83%88%
MIPS final score (Otolaryngology Physician) — 87.9598/100 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).

MATTHEW GRAFENBERG, M.D. appears in the CMS NPPES registry as a Otolaryngology Physician provider holding M.D. credentials at 5 FIRSTVILLAGE DRIVE, PINEHURST, NC, 28374, with a listed phone of (910) 295-6831. NPI 1225001357 was issued on 02/09/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what GRAFENBERG 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 600 prescription claims written by this provider, covering 229 Medicare beneficiaries and totaling roughly $56K in drug spend, split 5% brand-name and 95% generic by claim count, with an opioid prescribing rate of 5.5%. 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 87.9598/100 for the 2023 performance year (Quality 76.5778, Cost 83.2883), compared with the national average of 83.1.

Otolaryngology Physician is a mid-sized specialty nationwide, with 10,895 enrolled providers across 54 states and an average of 509 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

5 FIRSTVILLAGE DRIVE
PINEHURST, NC 28374

Provider Details

NPI 1225001357
Specialty Otolaryngology Physician
Credentials M.D.
Gender Male
NPI Issued 02/09/2006

CMS Quality Score (MIPS)

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

87.9598
Final Score
Avg: 83.1
76.5778
Quality
83.2883
Cost
100
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where MATTHEW GRAFENBERG, M.D. 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.

MCPC-9 LLC
PINEHURST, NC
PINEHURST SURGICAL CLINIC PA
PINEHURST, NC

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 GRAFENBERG, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$822

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.

Brand vs generic prescribing mix · Generic-heavy

MATTHEW GRAFENBERG, M.D. — brand share 5.0%
Specialty average (est.)

5% brand-name claims vs 95% generic, on 600 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.

600
Total Claims
$56K
Total Drug Cost
229
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
773
Total Day Supply
17,617
Brand vs Generic
5% brand / 95% generic
Brand Drug Cost
$41K
Generic Drug Cost
$15K
Opioid Claims
33 (5.5% rate)
Antibiotic Claims
97

Patient Demographics

Average Patient Age
71.7 years
Avg HCC Risk Score
1.38
Gender Split
59% female / 41% male
Age Distribution
<65: 34, 65-74: 113, 75-84: 62, 85+: 20

Top Prescribed Drugs (Medicare Part D)

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

What MATTHEW GRAFENBERG, M.D. 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
Azelastine Hcl
86
Ipratropium Bromide
77
Omeprazole
57
Fluticasone Propionate
51
Doxycycline Hyclate
31
Prednisone
30
Cephalexin
28
Tramadol Hcl
21
Ciprofloxacin-Dexamethasone
Ciprofloxacin Hcl/Dexameth
16
Methylprednisolone
13

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

Otolaryngology Physician Overview

How MATTHEW GRAFENBERG, M.D. fits within the Otolaryngology Physician landscape nationally.

10,895
Otolaryngology Physician Providers in US
54
States with Otolaryngology Physician
509
Avg Claims per Provider

MATTHEW GRAFENBERG, M.D.'s 600 claims are above the specialty average of 509.

Nearby Otolaryngology Physician Providers in North Carolina

Other clinicians with the same primary specialty enrolled in North Carolina, drawn from the same CMS NPPES roster as GRAFENBERG.

Compare Otolaryngology Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is MATTHEW GRAFENBERG, M.D.'s specialty?
MATTHEW GRAFENBERG, M.D. specializes in Otolaryngology Physician and practices in PINEHURST, North Carolina. Credentials: M.D..
How much does MATTHEW GRAFENBERG, M.D. prescribe under Medicare Part D?
In 2023, MATTHEW GRAFENBERG, M.D. wrote 600 Medicare Part D claims totaling $56K in drug costs for 229 beneficiaries.
What is MATTHEW GRAFENBERG, M.D.'s Medicare quality score?
MATTHEW GRAFENBERG, M.D. has a CMS MIPS Final Score of 87.9598/100 (Quality: 76.5778, Cost: 83.2883). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is MATTHEW GRAFENBERG, M.D. located?
MATTHEW GRAFENBERG, M.D. is located at 5 FIRSTVILLAGE DRIVE, PINEHURST, NC, 28374. Phone: (910) 295-6831.
What is MATTHEW GRAFENBERG, M.D.'s NPI number?
MATTHEW GRAFENBERG, M.D.'s National Provider Identifier (NPI) is 1225001357, issued on 02/09/2006.
Does MATTHEW GRAFENBERG, M.D. prescribe more brand-name or generic drugs?
MATTHEW GRAFENBERG, M.D.'s prescribing is 5% brand-name and 95% generic drugs by claim count, with $41K in brand drug costs.
Does MATTHEW GRAFENBERG, M.D. prescribe opioids?
Yes, MATTHEW GRAFENBERG, M.D. had 33 opioid claims in 2023 with an opioid prescribing rate of 5.5%.
How many Otolaryngology Physician providers are there in the US?
There are 10,895 Otolaryngology Physician providers across 54 states in the US. The average Otolaryngology Physician provider writes 509 Medicare Part D claims per year.
What drugs does MATTHEW GRAFENBERG, M.D. prescribe most often?
Based on 2023 Medicare Part D data, MATTHEW GRAFENBERG, M.D.'s most frequently prescribed drugs include Azelastine Hcl, Ipratropium Bromide, Omeprazole. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does MATTHEW GRAFENBERG, M.D. accept Medicare?
MATTHEW GRAFENBERG, M.D. appears in CMS Medicare data with 600 Part D claims and 229 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify MATTHEW GRAFENBERG, M.D.'s credentials?
MATTHEW GRAFENBERG, M.D.'s NPI is 1225001357 with credentials M.D.. 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