2026 NPPES data Specialist NPI 1942454061 MD
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NAZIR BALOUCH, MD

Specialist in RENTON, 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
387
Medicare Part D claims · 139 beneficiaries · Specialist avg: 1K
Generic prescribing
86%
generic claims · 14% brand-name · higher generic rates reduce patient out-of-pocket costs
What the federal data reveals: NAZIR BALOUCH, MD is a Specialist ([object Object]) practicing in RENTON, Washington with a Medicare Part D prescribing footprint of 387 claims across 139 beneficiaries — 14% brand-name prescribing .

What stands out: NAZIR BALOUCH, MD filed 387 Medicare Part D claims in 2023 across RENTON, Washington. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

NAZIR BALOUCH, MD at a glance

Quality data not reported

NPI registry status

Active

Issued 11/17/2008

NPI 1942454061

Primary specialty

Specialist

High-volume

69,658 US NPIs in this specialty

Medicare Part D claims

387 74% vs specialty avg

2023 prescription claims

Specialty avg: 1,474

Specialty distribution in Washington

How Specialist compares to other specialties among Washington providers

Washington providers

Specialist share within Washington

1. Specialist42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Specialist share within Washington

Specialty board-certification context

Estimated specialty board-certified rate — Specialist (ABMS / AOA reference)

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

Est. board-certified rate (Specialist) — ABMS / AOA estimate

0%100%78%
Est. board-certified rate (Specialist) — 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).

NAZIR BALOUCH, MD is a Specialist provider practicing in RENTON, Washington, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: MD. NPI: 1942454061. This profile includes practice location, specialty classification, and organizational affiliations from the CMS provider registry. Provider information is self-reported to CMS and updated monthly.

NAZIR BALOUCH, MD appears in the CMS NPPES registry as a Specialist provider holding MD credentials at 400 S 43RD ST, RENTON, WA, 98055, with a listed phone of (425) 228-3440. NPI 1942454061 was issued on 11/17/2008. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BALOUCH 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 387 prescription claims written by this provider, covering 139 Medicare beneficiaries and totaling roughly $29K in drug spend, split 14% brand-name and 86% generic by claim count, with an opioid prescribing rate of 7.0%. 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.

Specialist is a high-volume specialty nationwide, with 69,658 enrolled providers across 55 states and an average of 1,474 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

400 S 43RD ST
RENTON, WA 98055

Provider Details

NPI 1942454061
Specialty Specialist
Credentials MD
Gender Male
NPI Issued 11/17/2008

Hospital and facility affiliations

Facilities where NAZIR BALOUCH, 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.

VALLEY MEDICAL GROUP-RENTON
RENTON, 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 NAZIR BALOUCH, MD. To verify NAZIR BALOUCH, MD'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 · Typical

NAZIR BALOUCH, MD — brand share 14.0%
Specialty average (est.)

14% brand-name claims vs 86% generic, on 387 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.

387
Total Claims
$29K
Total Drug Cost
139
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
435
Total Day Supply
9,820
Brand vs Generic
14% brand / 86% generic
Brand Drug Cost
$21K
Generic Drug Cost
$7K
Opioid Claims
27 (7.0% rate)
Antibiotic Claims
48

Patient Demographics

Average Patient Age
73.5 years
Avg HCC Risk Score
2.71
Gender Split
49% female / 51% male
Age Distribution
<65: 27, 65-74: 42, 75-84: 46, 85+: 24

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Atorvastatin Calcium
26
Metoprolol Succinate
22
Amoxicillin-Clavulanate Potass
Amoxicillin/Potassium Clav
16
Levofloxacin
15
Clopidogrel
Clopidogrel Bisulfate
14
Prednisone
14
Oxycodone Hcl
13
Pantoprazole Sodium
13
Furosemide
11

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

Specialist Overview

How NAZIR BALOUCH, MD fits within the Specialist landscape nationally.

69,658
Specialist Providers in US
55
States with Specialist
1,474
Avg Claims per Provider

NAZIR BALOUCH, MD's 387 claims are below the specialty average of 1,474.

Nearby Specialist Providers in Washington

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

Compare Specialist nationally: see state-by-state distribution →

Frequently Asked Questions

What is NAZIR BALOUCH, MD's specialty?
NAZIR BALOUCH, MD specializes in Specialist and practices in RENTON, Washington. Credentials: MD.
How much does NAZIR BALOUCH, MD prescribe under Medicare Part D?
In 2023, NAZIR BALOUCH, MD wrote 387 Medicare Part D claims totaling $29K in drug costs for 139 beneficiaries.
Where is NAZIR BALOUCH, MD located?
NAZIR BALOUCH, MD is located at 400 S 43RD ST, RENTON, WA, 98055. Phone: (425) 228-3440.
What is NAZIR BALOUCH, MD's NPI number?
NAZIR BALOUCH, MD's National Provider Identifier (NPI) is 1942454061, issued on 11/17/2008.
Does NAZIR BALOUCH, MD prescribe more brand-name or generic drugs?
NAZIR BALOUCH, MD's prescribing is 14% brand-name and 86% generic drugs by claim count, with $21K in brand drug costs.
Does NAZIR BALOUCH, MD prescribe opioids?
Yes, NAZIR BALOUCH, MD had 27 opioid claims in 2023 with an opioid prescribing rate of 7.0%.
How many Specialist providers are there in the US?
There are 69,658 Specialist providers across 55 states in the US. The average Specialist provider writes 1,474 Medicare Part D claims per year.
What drugs does NAZIR BALOUCH, MD prescribe most often?
Based on 2023 Medicare Part D data, NAZIR BALOUCH, MD's most frequently prescribed drugs include Atorvastatin Calcium, Metoprolol Succinate, Amoxicillin-Clavulanate Potass. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does NAZIR BALOUCH, MD accept Medicare?
NAZIR BALOUCH, MD appears in CMS Medicare data with 387 Part D claims and 139 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify NAZIR BALOUCH, MD's credentials?
NAZIR BALOUCH, MD's NPI is 1942454061 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

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