Pai-Yue Lu, M.D.
Pediatric Rheumatology Physician in Lexington, Kentucky. This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 390 in Pediatric Rheumatology 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.
Source: CMS Medicare Part D Prescriber Public Use File, 2023
What the federal data shows
Pai-Yue Lu, M.D. reported a CMS MIPS final score of 100/100 - above the 83.1 national average - and filed 28 Medicare Part D claims in 2023.
- 100/100
- MIPS score · +17 vs avg
- 28
- Part D claims, 2023
- 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.
Pai-Yue Lu, 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
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 Pai-Yue Lu, M.D. sits
This provider among pediatric rheumatology physician peers
Across the 16 pediatric rheumatology physician providers who report both Medicare Part D prescribing and a MIPS quality score, Pai-Yue Lu, M.D. writes more Part D claims than 38% of them and scores higher on MIPS quality than 94% - placing this provider in the lower-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 pediatric rheumatology physician peer from a representative sample of 15; the gold marker is Pai-Yue Lu, M.D.. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
Pai-Yue Lu, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 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 Pai-Yue Lu, M.D.?
High performer (top quartile)Primary specialty
Medicare Part D claims
MIPS final score
Specialty distribution in Kentucky
How Pediatric Rheumatology Physician compares to other specialties among Kentucky providers
Largest specialties in Kentucky (% of in-state providers)
Pediatric Rheumatology Physician ranks #399 among Kentucky's specialties (0% of in-state providers)
Each bar is a specialty's share of the Kentucky provider total, by primary NUCC taxonomy. The highlighted bar is Pediatric Rheumatology Physician; the long tail of smaller specialties is omitted for legibility.
Medicare quality performance, MIPS
Pai-Yue Lu, M.D.'s 2023 MIPS final score plotted against the Pediatric Rheumatology Physician national average
- MIPS Final Score
- 100/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Pediatric Rheumatology Physician) - 100/100 vs national avg 83.1
Quality benchmarks
- National MIPS avg 2023 reporting year
- Specialty volume Pediatric Rheumatology Physician US NPIs
100/100 MIPS final score - 16.9 pts above the 83.1 national average
Quality, Cost, Promoting Interoperability, and Improvement Activities composite score for the 2023 performance year. Specialty: Pediatric Rheumatology Physician.
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).
Pai-Yue Lu, M.D. appears in the CMS NPPES registry as a Pediatric Rheumatology Physician provider holding M.D. credentials at 740 S LIMESTONE ST, Lexington, KY, 40536, with a listed phone of (859) 257-5548. NPI 1972707784 was issued on 06/14/2007. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what Lu 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 28 prescription claims written by this provider, covering N/A Medicare beneficiaries and totaling roughly $812 in drug spend. 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 100/100 for the 2023 performance year, compared with the national average of 83.1.
Pediatric Rheumatology Physician is a narrow specialty nationwide, with 390 enrolled providers across 43 states and an average of 200 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 | 1972707784 |
|---|---|
| Specialty | Pediatric Rheumatology Physician |
| Credentials | M.D. |
| Gender | Female |
| NPI Issued | 06/14/2007 |
Verify this provider's license
PlainDoctor pulls this profile from the CMS NPPES public registry. Confirm Pai-Yue Lu, M.D.'s current license status, disciplinary history, and board certifications with the Kentucky Board of Medical Licensure in Kentucky before relying on this page for a clinical or care decision.
How we sourced this profile
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
Reporting: Group practice
Hospital and facility affiliations
Facilities where Pai-Yue Lu, 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.
Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2023.
Prescribing Breakdown
- 30-Day Fills
- 28
- Total Day Supply
- 801
- Brand Drug Cost
- $0
- Generic Drug Cost
- $812
Patient Demographics
- Average Patient Age
- 23.0 years
- Avg HCC Risk Score
- 3.23
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
| Drug | Claims |
|---|---|
| Prednisone | 17 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Pediatric Rheumatology Physician Overview
How Pai-Yue Lu, M.D. fits within the Pediatric Rheumatology Physician landscape nationally.
Pai-Yue Lu, M.D.'s 28 claims are below the specialty average of 200.
Nearby Pediatric Rheumatology Physician Providers in Kentucky
Other clinicians with the same primary specialty enrolled in Kentucky, drawn from the same CMS NPPES roster as Lu.
Compare Pediatric Rheumatology 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 Kentucky medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Pediatric Rheumatology 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 Pai-Yue Lu, M.D.'s specialty? ▼
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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.
- 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