2026 NPPES data Adult Medicine Physician NPI 1861706038 MBBS
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PANKAJ AGRAWAL, MBBS

Adult Medicine Physician in MARSHALLTOWN, Iowa. 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
125
Medicare Part D claims · 61 beneficiaries · Adult Medicine Physician avg: 3K
Generic prescribing
81%
generic claims · 19% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
85.9941/100
▲ 3 pts above national avg 83.1 · [object Object]
What the federal data reveals: PANKAJ AGRAWAL, MBBS is a Adult Medicine Physician ([object Object]) practicing in MARSHALLTOWN, Iowa with a Medicare Part D prescribing footprint of 125 claims across 61 beneficiaries — 19% brand-name prescribing . Their CMS MIPS Final Score of 85.9941/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities .

What stands out: PANKAJ AGRAWAL, MBBS reported a CMS MIPS final score of 85.9941 out of 100, above the 83.1 national average, and filed 125 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

Board certification likely (heuristic — not verified)

PANKAJ AGRAWAL, MBBS practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 2 hospital affiliations — signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).

PANKAJ AGRAWAL, MBBS at a glance

High performer (top quartile)

NPI registry status

Active

Issued 07/30/2010

NPI 1861706038

Primary specialty

Adult Medicine Physician

Niche

2,481 US NPIs in this specialty

Medicare Part D claims

125 96% vs specialty avg

2023 prescription claims

Specialty avg: 2,807

MIPS final score

85.9941/100 2.8941000000000088% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in Iowa

How Adult Medicine Physician compares to other specialties among Iowa providers

Iowa providers

Adult Medicine Physician share within Iowa

1. Adult Medicine Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Adult Medicine Physician share within Iowa

Medicare quality performance — MIPS

PANKAJ AGRAWAL, MBBS's 2023 MIPS final score plotted against the Adult Medicine Physician national average

High performer (top quartile)
MIPS Final Score
85.9941/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Adult Medicine Physician) — 85.9941/100 vs national avg 83.1

0%100%National avg83%86%
MIPS final score (Adult Medicine Physician) — 85.9941/100 vs national avg 83.1

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).

PANKAJ AGRAWAL, MBBS is a Adult Medicine Physician provider practicing in MARSHALLTOWN, Iowa, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: MBBS. NPI: 1861706038. 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.

PANKAJ AGRAWAL, MBBS appears in the CMS NPPES registry as a Adult Medicine Physician provider holding MBBS credentials at 3 S 4TH AVE, MARSHALLTOWN, IA, 50158, with a listed phone of (641) 754-5151. NPI 1861706038 was issued on 07/30/2010. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what AGRAWAL 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 125 prescription claims written by this provider, covering 61 Medicare beneficiaries and totaling roughly $13K in drug spend, split 19% brand-name and 81% generic by claim count. 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 85.9941/100 for the 2023 performance year (Quality 67.989, Cost 80.6352), compared with the national average of 83.1.

Adult Medicine Physician is a narrow specialty nationwide, with 2,481 enrolled providers across 52 states and an average of 2,807 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

3 S 4TH AVE
MARSHALLTOWN, IA 50158

Provider Details

NPI 1861706038
Specialty Adult Medicine Physician
Credentials MBBS
Gender Male
NPI Issued 07/30/2010

CMS Quality Score (MIPS)

Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.

85.9941
Final Score
Avg: 83.1
67.989
Quality
80.6352
Cost

Reporting: Group practice

Hospital and facility affiliations

Facilities where PANKAJ AGRAWAL, MBBS 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.

APOGEE MEDICAL GROUP GEORGIA
VALDOSTA, GA
SOUTH GEORGIA MEDICAL CENTER INC
VALDOSTA, GA

Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).

Brand vs generic prescribing mix · Typical

PANKAJ AGRAWAL, MBBS — brand share 19.0%
Specialty average (est.)

19% brand-name claims vs 81% generic, on 125 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.

125
Total Claims
$13K
Total Drug Cost
61
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
133
Total Day Supply
2,760
Brand vs Generic
19% brand / 81% generic
Brand Drug Cost
$11K
Generic Drug Cost
$2K
Antibiotic Claims
25

Patient Demographics

Average Patient Age
70.3 years
Avg HCC Risk Score
2.71
Gender Split
56% female / 44% male

Adult Medicine Physician Overview

How PANKAJ AGRAWAL, MBBS fits within the Adult Medicine Physician landscape nationally.

2,481
Adult Medicine Physician Providers in US
52
States with Adult Medicine Physician
2,807
Avg Claims per Provider

PANKAJ AGRAWAL, MBBS's 125 claims are below the specialty average of 2,807.

Nearby Adult Medicine Physician Providers in Iowa

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

Compare Adult Medicine Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is PANKAJ AGRAWAL, MBBS's specialty?
PANKAJ AGRAWAL, MBBS specializes in Adult Medicine Physician and practices in MARSHALLTOWN, Iowa. Credentials: MBBS.
How much does PANKAJ AGRAWAL, MBBS prescribe under Medicare Part D?
In 2023, PANKAJ AGRAWAL, MBBS wrote 125 Medicare Part D claims totaling $13K in drug costs for 61 beneficiaries.
What is PANKAJ AGRAWAL, MBBS's Medicare quality score?
PANKAJ AGRAWAL, MBBS has a CMS MIPS Final Score of 85.9941/100 (Quality: 67.989, Cost: 80.6352). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is PANKAJ AGRAWAL, MBBS located?
PANKAJ AGRAWAL, MBBS is located at 3 S 4TH AVE, MARSHALLTOWN, IA, 50158. Phone: (641) 754-5151.
What is PANKAJ AGRAWAL, MBBS's NPI number?
PANKAJ AGRAWAL, MBBS's National Provider Identifier (NPI) is 1861706038, issued on 07/30/2010.
Does PANKAJ AGRAWAL, MBBS prescribe more brand-name or generic drugs?
PANKAJ AGRAWAL, MBBS's prescribing is 19% brand-name and 81% generic drugs by claim count, with $11K in brand drug costs.
How many Adult Medicine Physician providers are there in the US?
There are 2,481 Adult Medicine Physician providers across 52 states in the US. The average Adult Medicine Physician provider writes 2,807 Medicare Part D claims per year.
Does PANKAJ AGRAWAL, MBBS accept Medicare?
PANKAJ AGRAWAL, MBBS appears in CMS Medicare data with 125 Part D claims and 61 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify PANKAJ AGRAWAL, MBBS's credentials?
PANKAJ AGRAWAL, MBBS's NPI is 1861706038 with credentials MBBS. 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.
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