MICHAEL PALMS, FNP-BC appears in the CMS NPPES registry as a General Practice Registered Nurse provider holding FNP-BC credentials at 199 W SHIELDS AVE, FRESNO, CA, 93705, with a listed phone of (559) 225-4706. NPI 1336739739 was issued on 01/20/2021. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what PALMS 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 2,027 prescription claims written by this provider, covering 263 Medicare beneficiaries and totaling roughly $259K in drug spend, split 14% brand-name and 86% generic by claim count, with an opioid prescribing rate of 12.9%. 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 31.51/100 for the 2023 performance year (Quality 0, Cost 88.3665), compared with the national average of 83.1.

General Practice Registered Nurse is a mid-sized specialty nationwide, with 5,478 enrolled providers across 55 states and an average of 1,187 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.