NPI registry status
Active
2026 NPPES data Endocrinology, Diabetes & Metabolism Physician NPI 1083654404 M.D.
Verify on CMS → Nirmal Banskota, M.D.
Endocrinology, Diabetes & Metabolism Physician in Arcadia, California.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 7,852 in Endocrinology, Diabetes & Metabolism 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
6K
Medicare Part D claims · 480 beneficiaries · Endocrinology, Diabetes & Metabolism Physician avg: 3K
Generic prescribing
58%
generic claims · 38% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
12/100
▼ 71 pts below national avg 83.1 · Penalty band
Industry payments
$38.92
2 payments · CMS Open Payments (Sunshine Act)
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
Nirmal Banskota, M.D. reported a CMS MIPS final score of 12/100 - below the 83.1 national average - and filed 6,006 Medicare Part D claims in 2023.
- 12/100
- MIPS score · -71 vs avg
- 6K
- Part D claims, 2023
- 58%
- 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.
Nirmal Banskota, 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
12 2nd percentile higher than 2% 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 Nirmal Banskota, M.D. sits
This provider among endocrinology, diabetes & metabolism physician peers
Across the 2,521 endocrinology, diabetes & metabolism physician providers who report both Medicare Part D prescribing and a MIPS quality score, Nirmal Banskota, M.D. writes more Part D claims than 86% of them and scores higher on MIPS quality than 1% - placing this provider in the high-volume, lower-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 endocrinology, diabetes & metabolism physician peer from a representative sample of 60; the gold marker is Nirmal Banskota, M.D.. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Nirmal Banskota, M.D. 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 Nirmal Banskota, M.D.?
Below national averagePrimary specialty
Endocrinology, Diabetes & Metabolism Physician
Medicare Part D claims
6,006 128% vs specialty avg
MIPS final score
12/100 71.1 pts vs avg
Specialty distribution in California
How Endocrinology, Diabetes & Metabolism Physician compares to other specialties among California providers
Medicare quality performance, MIPS
Nirmal Banskota, M.D.'s 2023 MIPS final score plotted against the Endocrinology, Diabetes & Metabolism Physician national average
- MIPS Final Score
- 12/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Endocrinology, Diabetes & Metabolism Physician) - 12/100 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).
Nirmal Banskota, M.D. appears in the CMS NPPES registry as a Endocrinology, Diabetes & Metabolism Physician provider holding M.D. credentials at 1015 N 1ST AVE B, Arcadia, CA, 91006, with a listed phone of (626) 446-0559. NPI 1083654404 was issued on 06/07/2006.
Medicare Part D records for calendar year 2023 show 6,006 prescription claims written by this provider, covering 480 Medicare beneficiaries and totaling roughly $2.2 million in drug spend, split 38% brand-name and 58% generic by claim count, with an opioid prescribing rate of 0.8%. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 12/100 for the 2023 performance year (Quality 0, Cost 40.1), compared with the national average of 83.1.
Endocrinology, Diabetes & Metabolism Physician is a mid-sized specialty nationwide, with 7,852 enrolled providers across 54 states and an average of 2,639 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 | 1083654404 |
|---|---|
| Specialty | Endocrinology, Diabetes & Metabolism Physician |
| Credentials | M.D. |
| Gender | Male |
| NPI Issued | 06/07/2006 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
12.0158
Final Score
Avg: 83.1
0
Quality
40.0528
Cost
Reporting: Individual
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 Nirmal Banskota, M.D.. Source: openpaymentsdata.cms.gov.
Total received
$39
Largest payer
Abbott Laboratories
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.
License & disciplinary context - California MBC 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 ~150K California medical licensees in 2023 - they are NOT specific to Nirmal Banskota, M.D.. To verify Nirmal Banskota, M.D.'s current license status, search the MBC public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.
576
Total board actions, California 2023
Across 556 cases
3.84
Actions per 1,000 licensees
California statewide rate
probation
Most common action type
186 cases
MBC 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 California disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.
Brand vs generic prescribing mix · Above average
Nirmal Banskota, M.D. - brand share 38.0%
Endocrinology, Diabetes & Metabolism Physician average
38% brand-name claims vs 58% generic, on 6,006 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.
6,006
Total Claims
$2.2M
Total Drug Cost
480
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 11,675
- Total Day Supply
- 341,967
- Brand vs Generic
- 38% brand / 58% generic
- Brand Drug Cost
- $2.1M
- Generic Drug Cost
- $98K
- Opioid Claims
- 46 (0.8% rate)
- Antibiotic Claims
- 76
Patient Demographics
- Average Patient Age
- 75.9 years
- Avg HCC Risk Score
- 1.32
- Gender Split
- 55% female / 45% male
- Age Distribution
- <65: 17, 65-74: 199, 75-84: 186, 85+: 78
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Nirmal Banskota, M.D. prescribes most
Top Medicare Part D drugs by claim count, 2023
- Levothyroxine Sodium
Levothyroxine Sodium
408 claims
- Metformin Hcl
Metformin Hcl
243 claims
- Jardiance
Jardiance
222 claims
- Ozempic
Ozempic
197 claims
- Gabapentin
Gabapentin
181 claims
- Atorvastatin Calcium 161
Atorvastatin Calcium
161 claims
- Synjardy Xr 157
Synjardy Xr
157 claims
- Synthroid 153
Synthroid
153 claims
| Drug | Claims |
|---|---|
| Levothyroxine Sodium | 408 |
| Metformin Hcl | 243 |
| Jardiance Empagliflozin | 222 |
| Ozempic Semaglutide | 197 |
| Gabapentin | 181 |
| Atorvastatin Calcium | 161 |
| Synjardy Xr Empagliflozin/Metformin Hcl | 157 |
| Synthroid Levothyroxine Sodium | 153 |
| Trulicity Dulaglutide | 148 |
| Alprazolam | 128 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
More Endocrinology, Diabetes & Metabolism Physician in CA →
All providers in California →
Compare specialties →
Endocrinology, Diabetes & Metabolism Physician Overview
How Nirmal Banskota, M.D. fits within the Endocrinology, Diabetes & Metabolism Physician landscape nationally.
7,852
Endocrinology, Diabetes & Metabolism Physician Providers in US
54
States with Endocrinology, Diabetes & Metabolism Physician
2,639
Avg Claims per Provider
Nirmal Banskota, M.D.'s 6,006 claims are above the specialty average of 2,639.
Nearby Endocrinology, Diabetes & Metabolism Physician Providers in California
Other clinicians with the same primary specialty enrolled in California, drawn from the same CMS NPPES roster as Banskota.
Dr. Anita Abraham
M.D.
Stockton, CA
Dr. Sallie Adams
M.D.
Roseville, CA
Ananta Addala
Palo Alto, CA
Dr. Helen Adelberg
M.D.
Encino, CA
Dr. David Aftergood
MD
Beverly Hills, CA
Compare Endocrinology, Diabetes & Metabolism 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 California medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Endocrinology, Diabetes & Metabolism 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.
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Frequently Asked Questions
What is Nirmal Banskota, M.D.'s specialty? ▼
Nirmal Banskota, M.D. specializes in Endocrinology, Diabetes & Metabolism Physician and practices in Arcadia, California. Credentials: M.D..
How much does Nirmal Banskota, M.D. prescribe under Medicare Part D? ▼
In 2023, Nirmal Banskota, M.D. wrote 6,006 Medicare Part D claims totaling $2.2M in drug costs for 480 beneficiaries.
What is Nirmal Banskota, M.D.'s Medicare quality score? ▼
Nirmal Banskota, M.D. has a CMS MIPS Final Score of 12/100 (Quality: 0, Cost: 40.1). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Nirmal Banskota, M.D. located? ▼
Nirmal Banskota, M.D. is located at 1015 N 1ST AVE B, Arcadia, CA, 91006. Phone: (626) 446-0559.
What is Nirmal Banskota, M.D.'s NPI number? ▼
Nirmal Banskota, M.D.'s National Provider Identifier (NPI) is 1083654404, issued on 06/07/2006.
Does Nirmal Banskota, M.D. prescribe more brand-name or generic drugs? ▼
Nirmal Banskota, M.D.'s prescribing is 38% brand-name and 58% generic drugs by claim count, with $2.1M in brand drug costs.
Does Nirmal Banskota, M.D. prescribe opioids? ▼
Yes, Nirmal Banskota, M.D. had 46 opioid claims in 2023 with an opioid prescribing rate of 0.8%.
How many Endocrinology, Diabetes & Metabolism Physician providers are there in the US? ▼
There are 7,852 Endocrinology, Diabetes & Metabolism Physician providers across 54 states in the US. The average Endocrinology, Diabetes & Metabolism Physician provider writes 2,639 Medicare Part D claims per year.
What drugs does Nirmal Banskota, M.D. prescribe most often? ▼
Based on 2023 Medicare Part D data, Nirmal Banskota, M.D.'s most frequently prescribed drugs include Levothyroxine Sodium, Metformin Hcl, Jardiance. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Nirmal Banskota, M.D. accept Medicare? ▼
Nirmal Banskota, M.D. appears in CMS Medicare data with 6,006 Part D claims and 480 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Nirmal Banskota, M.D.'s credentials? ▼
Nirmal Banskota, M.D.'s NPI is 1083654404 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
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.