2026 NPPES data Family Medicine Physician NPI 1003970021 M.D.
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MICHAEL BALFE, M.D.

Family Medicine Physician in OLYMPIA, Washington. 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
5K
Medicare Part D claims · 1K beneficiaries · Family Medicine Physician avg: 3K
Generic prescribing
91%
generic claims · 9% brand-name · higher generic rates reduce patient out-of-pocket costs

What the federal data shows

MICHAEL BALFE, M.D. filed 5,440 Medicare Part D claims in 2023 as a Family Medicine Physician in OLYMPIA, Washington, prescribing 91% generic.

5K
Part D claims, 2023
91%
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.

MICHAEL BALFE, M.D.'s Medicare Part D volume vs every U.S. prescriber

Total Medicare Part D claims, 2023 — across all CMS prescribers nationally

5,440 Top 6% higher than 94% of 1,370,886 prescribers

0–200: 670,926 prescribers (49%). Below this entry. 200–400: 182,923 prescribers (13%). Below this entry. 400–600: 90,619 prescribers (7%). Below this entry. 600–800: 56,224 prescribers (4%). Below this entry. 800–1,000: 40,919 prescribers (3%). Below this entry. 1,000–1,200: 31,827 prescribers (2%). Below this entry. 1,200–1,400: 26,224 prescribers (2%). Below this entry. 1,400–1,600: 21,710 prescribers (2%). Below this entry. 1,600–1,800: 19,072 prescribers (1%). Below this entry. 1,800–2,000: 16,451 prescribers (1%). Below this entry. 2,000–2,200: 213,991 prescribers (16%). This entry sits in this band. This provider 0 2K+ every Part D prescriber (claims/yr), bucketed by value

Each bar is a band; taller bars hold more prescribers. 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 Medicare Part D Prescriber Public Use File · 2023

Board certification likely (heuristic — not verified)

MICHAEL BALFE, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + 1 hospital affiliation — 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 MICHAEL BALFE, M.D.?

Quality data not reported

NPI registry status

Active

Issued 12/21/2006

NPI 1003970021

Primary specialty

Family Medicine Physician

High-volume

147,640 US NPIs in this specialty

Medicare Part D claims

5,440 59% vs specialty avg

2023 prescription claims

Specialty avg: 3,418

Specialty distribution in Washington

How Family Medicine Physician compares to other specialties among Washington providers

Washington providers

Family Medicine Physician share within Washington

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

Specialty board-certification context

Estimated specialty board-certified rate — Family Medicine Physician (ABMS / AOA reference)

Quality data not reported
Est. board-certified rate
78%
Family Medicine Physician ABMS/AOA estimate

Est. board-certified rate (Family Medicine Physician) — ABMS / AOA estimate

0%100%78%
Est. board-certified rate (Family Medicine Physician) — ABMS / AOA estimate

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).

MICHAEL BALFE, M.D. appears in the CMS NPPES registry as a Family Medicine Physician provider holding M.D. credentials at 700 LILLY RD NE, OLYMPIA, WA, 98506, with a listed phone of (360) 923-7000. NPI 1003970021 was issued on 12/21/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BALFE 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 5,440 prescription claims written by this provider, covering 1,164 Medicare beneficiaries and totaling roughly $236K in drug spend, split 9% brand-name and 91% generic by claim count, with an opioid prescribing rate of 8.7%. 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.

Family Medicine Physician is a high-volume specialty nationwide, with 147,640 enrolled providers across 56 states and an average of 3,418 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

700 LILLY RD NE
OLYMPIA, WA 98506

Provider Details

NPI 1003970021
Specialty Family Medicine Physician
Credentials M.D.
Gender Male
NPI Issued 12/21/2006

Hospital and facility affiliations

Facilities where MICHAEL BALFE, 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.

KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
OLYMPIA, WA

Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).

License & disciplinary context — Washington WMC 2023 annual report

Aggregate state board data only — NOT a determination of any individual provider's status. The figures below describe statewide disciplinary activity across all ~34K Washington medical licensees in 2023 — they are NOT specific to MICHAEL BALFE, M.D.. To verify MICHAEL BALFE, M.D.'s current license status, search the WMC public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

88
Total board actions, Washington 2023
Across 85 cases
2.59
Actions per 1,000 licensees
Washington statewide rate
probation
Most common action type
31 cases

WMC publishes annual disciplinary statistics as part of public-record reporting under each state's Administrative Procedure Act. See the full breakdown by action type and year on the Washington disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Generic-heavy

MICHAEL BALFE, M.D. — brand share 9.0%
Specialty average (est.)

9% brand-name claims vs 91% generic, on 5,440 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.

5,440
Total Claims
$236K
Total Drug Cost
1,164
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
12,738
Total Day Supply
371,215
Brand vs Generic
9% brand / 91% generic
Brand Drug Cost
$123K
Generic Drug Cost
$113K
Opioid Claims
471 (8.7% rate)
Antibiotic Claims
43

Patient Demographics

Average Patient Age
73.1 years
Avg HCC Risk Score
1.19
Gender Split
55% female / 45% male
Age Distribution
<65: 107, 65-74: 540, 75-84: 400, 85+: 117

Top Prescribed Drugs (Medicare Part D)

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

What MICHAEL BALFE, 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
Rosuvastatin Calcium
272
Atorvastatin Calcium
266
Hydrocodone-Acetaminophen
Hydrocodone/Acetaminophen
212
Levothyroxine Sodium
202
Amlodipine Besylate
185
Losartan Potassium
168
Lisinopril
167
Omeprazole
139
Hydrochlorothiazide
128
Albuterol Sulfate Hfa
Albuterol Sulfate
127

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

Family Medicine Physician Overview

How MICHAEL BALFE, M.D. fits within the Family Medicine Physician landscape nationally.

147,640
Family Medicine Physician Providers in US
56
States with Family Medicine Physician
3,418
Avg Claims per Provider

MICHAEL BALFE, M.D.'s 5,440 claims are above the specialty average of 3,418.

Nearby Family Medicine Physician Providers in Washington

Other clinicians with the same primary specialty enrolled in Washington, drawn from the same CMS NPPES roster as BALFE.

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

Frequently Asked Questions

What is MICHAEL BALFE, M.D.'s specialty?
MICHAEL BALFE, M.D. specializes in Family Medicine Physician and practices in OLYMPIA, Washington. Credentials: M.D..
How much does MICHAEL BALFE, M.D. prescribe under Medicare Part D?
In 2023, MICHAEL BALFE, M.D. wrote 5,440 Medicare Part D claims totaling $236K in drug costs for 1,164 beneficiaries.
Where is MICHAEL BALFE, M.D. located?
MICHAEL BALFE, M.D. is located at 700 LILLY RD NE, OLYMPIA, WA, 98506. Phone: (360) 923-7000.
What is MICHAEL BALFE, M.D.'s NPI number?
MICHAEL BALFE, M.D.'s National Provider Identifier (NPI) is 1003970021, issued on 12/21/2006.
Does MICHAEL BALFE, M.D. prescribe more brand-name or generic drugs?
MICHAEL BALFE, M.D.'s prescribing is 9% brand-name and 91% generic drugs by claim count, with $123K in brand drug costs.
Does MICHAEL BALFE, M.D. prescribe opioids?
Yes, MICHAEL BALFE, M.D. had 471 opioid claims in 2023 with an opioid prescribing rate of 8.7%.
How many Family Medicine Physician providers are there in the US?
There are 147,640 Family Medicine Physician providers across 56 states in the US. The average Family Medicine Physician provider writes 3,418 Medicare Part D claims per year.
What drugs does MICHAEL BALFE, M.D. prescribe most often?
Based on 2023 Medicare Part D data, MICHAEL BALFE, M.D.'s most frequently prescribed drugs include Rosuvastatin Calcium, Atorvastatin Calcium, Hydrocodone-Acetaminophen. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does MICHAEL BALFE, M.D. accept Medicare?
MICHAEL BALFE, M.D. appears in CMS Medicare data with 5,440 Part D claims and 1,164 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify MICHAEL BALFE, M.D.'s credentials?
MICHAEL BALFE, M.D.'s NPI is 1003970021 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.
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