NPI registry status
Active
2026 NPPES data Pulmonary Disease Physician NPI 1730184789 MD
Verify on CMS → Michele Ballou, MD
Pulmonary Disease Physician in Low Moor, Virginia.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 9,271 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
7K
Medicare Part D claims · 394 beneficiaries · Pulmonary Disease Physician avg: 1K
Generic prescribing
79%
generic claims · 20% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
100/100
▲ 17 pts above national avg 83.1 · Exceptional
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
Michele Ballou, MD reported a CMS MIPS final score of 100/100 - above the 83.1 national average - and filed 6,839 Medicare Part D claims in 2023.
- 100/100
- MIPS score · +17 vs avg
- 7K
- Part D claims, 2023
- 79%
- 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.
Michele Ballou, MD's MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
100 Top 7% higher than 93% 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 Michele Ballou, 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, Michele Ballou, MD writes more Part D claims than 97% of them and scores higher on MIPS quality than 93% - placing this provider in the high-volume, high-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 Michele Ballou, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Michele Ballou, 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 Michele Ballou, MD?
High performer (top quartile)Primary specialty
Pulmonary Disease Physician
Medicare Part D claims
6,839 369% vs specialty avg
MIPS final score
100/100 16.9 pts vs avg
Specialty distribution in Virginia
How Pulmonary Disease Physician compares to other specialties among Virginia providers
Medicare quality performance, MIPS
Michele Ballou, MD's 2023 MIPS final score plotted against the Pulmonary Disease Physician national average
- MIPS Final Score
- 100/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Pulmonary Disease Physician) - 100/100 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).
Michele Ballou, MD appears in the CMS NPPES registry as a Pulmonary Disease Physician provider holding MD credentials at 200 ARH LANE, Low Moor, VA, 24457, with a listed phone of (540) 862-6710. NPI 1730184789 was issued on 06/16/2005.
Medicare Part D records for calendar year 2023 show 6,839 prescription claims written by this provider, covering 394 Medicare beneficiaries and totaling roughly $987K in drug spend, split 20% brand-name and 79% generic by claim count, with an opioid prescribing rate of 2.3%. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 100/100 for the 2023 performance year, compared with the national average of 83.1.
Pulmonary Disease Physician is a mid-sized specialty nationwide, with 9,271 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 | 1730184789 |
|---|---|
| Specialty | Pulmonary Disease Physician |
| Credentials | MD |
| Gender | Female |
| NPI Issued | 06/16/2005 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
100
Final Score
Avg: 83.1
100
Promoting Interoperability
Reporting: Group practice
Brand vs generic prescribing mix · Typical
Michele Ballou, MD - brand share 20.0%
Pulmonary Disease Physician average
20% brand-name claims vs 79% generic, on 6,839 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.
6,839
Total Claims
$987K
Total Drug Cost
394
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 13,768
- Total Day Supply
- 402,846
- Brand vs Generic
- 20% brand / 79% generic
- Brand Drug Cost
- $881K
- Generic Drug Cost
- $105K
- Opioid Claims
- 154 (2.3% rate)
- Antibiotic Claims
- 172
Patient Demographics
- Average Patient Age
- 74.5 years
- Avg HCC Risk Score
- 1.67
- Gender Split
- 68% female / 32% male
- Age Distribution
- <65: 58, 65-74: 108, 75-84: 169, 85+: 59
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Michele Ballou, MD prescribes most
Top Medicare Part D drugs by claim count, 2023
- Levothyroxine Sodium
Levothyroxine Sodium
263 claims
- Montelukast Sodium
Montelukast Sodium
249 claims
- Albuterol Sulfate …
Albuterol Sulfate Hfa
248 claims
- Trelegy Ellipta
Trelegy Ellipta
248 claims
- Atorvastatin Calcium
Atorvastatin Calcium
233 claims
- Amlodipine Besylate
Amlodipine Besylate
213 claims
- Omeprazole
Omeprazole
206 claims
- Furosemide
Furosemide
191 claims
| Drug | Claims |
|---|---|
| Levothyroxine Sodium | 263 |
| Montelukast Sodium | 249 |
| Albuterol Sulfate Hfa Albuterol Sulfate | 248 |
| Trelegy Ellipta Fluticasone/Umeclidin/Vilanter | 248 |
| Atorvastatin Calcium | 233 |
| Amlodipine Besylate | 213 |
| Omeprazole | 206 |
| Furosemide | 191 |
| Prednisone | 182 |
| Losartan Potassium | 164 |
* 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 Michele Ballou, MD fits within the Pulmonary Disease Physician landscape nationally.
9,271
Pulmonary Disease Physician Providers in US
53
States with Pulmonary Disease Physician
1,457
Avg Claims per Provider
Michele Ballou, MD's 6,839 claims are above the specialty average of 1,457.
Nearby Pulmonary Disease Physician Providers in Virginia
Other clinicians with the same primary specialty enrolled in Virginia, drawn from the same CMS NPPES roster as Ballou.
Dr. Nathalie Abi Hatem
M.D.
Salem, VA
Dr. Youssef Abouleish
MD
Suffolk, VA
Dr. Jawed Abubaker
MD
Petersburg, VA
Dr. Richard Ackart
MD
Williamsburg, VA
Dr. Choi Mei Adams
FNP
Charlottesville, VA
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 Virginia 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.
Healthcare Guides
Learn more about finding, verifying, and understanding healthcare providers.
How to Find a Doctor
Step-by-step guide to choosing a provider
Verify Credentials
Check NPI, board certification & license status
Medical Specialties Explained
Who treats what and how specialties differ
Understanding Medicare Claims Data
What prescribing data reveals about a provider
In-Network vs Out-of-Network
How insurance networks affect your costs
Telehealth Guide
Virtual care options and coverage in 2026
Explore Virginia
Frequently Asked Questions
What is Michele Ballou, MD's specialty? ▼
Michele Ballou, MD specializes in Pulmonary Disease Physician and practices in Low Moor, Virginia. Credentials: MD.
How much does Michele Ballou, MD prescribe under Medicare Part D? ▼
In 2023, Michele Ballou, MD wrote 6,839 Medicare Part D claims totaling $987K in drug costs for 394 beneficiaries.
What is Michele Ballou, MD's Medicare quality score? ▼
Michele Ballou, MD has a CMS MIPS Final Score of 100/100. The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Michele Ballou, MD located? ▼
Michele Ballou, MD is located at 200 ARH LANE, Low Moor, VA, 24457. Phone: (540) 862-6710.
What is Michele Ballou, MD's NPI number? ▼
Michele Ballou, MD's National Provider Identifier (NPI) is 1730184789, issued on 06/16/2005.
Does Michele Ballou, MD prescribe more brand-name or generic drugs? ▼
Michele Ballou, MD's prescribing is 20% brand-name and 79% generic drugs by claim count, with $881K in brand drug costs.
Does Michele Ballou, MD prescribe opioids? ▼
Yes, Michele Ballou, MD had 154 opioid claims in 2023 with an opioid prescribing rate of 2.3%.
How many Pulmonary Disease Physician providers are there in the US? ▼
There are 9,271 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 Michele Ballou, MD prescribe most often? ▼
Based on 2023 Medicare Part D data, Michele Ballou, MD's most frequently prescribed drugs include Levothyroxine Sodium, Montelukast Sodium, Albuterol Sulfate Hfa. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Michele Ballou, MD accept Medicare? ▼
Michele Ballou, MD appears in CMS Medicare data with 6,839 Part D claims and 394 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Michele Ballou, MD's credentials? ▼
Michele Ballou, MD's NPI is 1730184789 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.