2026 NPPES data Otolaryngology Physician NPI 1306880992 MD
Verify on CMS →

PANKAJ GUPTA, MD

Otolaryngology Physician in DURHAM, North Carolina. 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
343
Medicare Part D claims · 150 beneficiaries · Otolaryngology Physician avg: 509
Generic prescribing
88%
generic claims · 12% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
77.0164/100
▼ 6 pts below national avg 83.1 · [object Object]
Industry payments
$402.07
14 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

PANKAJ GUPTA, MD reported a CMS MIPS final score of 77.0164/100 — below the 83.1 national average — and filed 343 Medicare Part D claims in 2023.

77.0164/100
MIPS score · -6 vs avg
343
Part D claims, 2023
88%
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.

PANKAJ GUPTA, MD's MIPS score vs every scored U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023 — the federal quality measure

77 24th percentile higher than 24% of 477,587 scored providers

0–10: 8,684 scored providers (2%). Below this entry. 10–20: 3,008 scored providers (1%). Below this entry. 20–30: 3,069 scored providers (1%). Below this entry. 30–40: 2,746 scored providers (1%). Below this entry. 40–50: 2,928 scored providers (1%). Below this entry. 50–60: 5,882 scored providers (1%). Below this entry. 60–70: 13,906 scored providers (3%). Below this entry. 70–80: 118,074 scored providers (25%). This entry sits in this band. 80–90: 129,887 scored providers (27%). Above this entry. 90–100: 189,403 scored providers (40%). Above this entry. This provider 0 100 every MIPS-scored clinician, bucketed by value

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

Board certification likely (heuristic — not verified)

PANKAJ GUPTA, 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 PANKAJ GUPTA, MD?

Below national average

NPI registry status

Active

Issued 06/15/2006

NPI 1306880992

Primary specialty

Otolaryngology Physician

Mid-sized

10,895 US NPIs in this specialty

Medicare Part D claims

343 33% vs specialty avg

2023 prescription claims

Specialty avg: 509

MIPS final score

77.0164/100 6.08359999999999% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in North Carolina

How Otolaryngology Physician compares to other specialties among North Carolina providers

North Carolina providers

Otolaryngology Physician share within North Carolina

1. Otolaryngology Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Otolaryngology Physician share within North Carolina

Medicare quality performance — MIPS

PANKAJ GUPTA, MD's 2023 MIPS final score plotted against the Otolaryngology Physician national average

Below national average
MIPS Final Score
77.0164/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Otolaryngology Physician) — 77.0164/100 vs national avg 83.1

0%100%National avg83%77%
MIPS final score (Otolaryngology Physician) — 77.0164/100 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 GUPTA, MD appears in the CMS NPPES registry as a Otolaryngology Physician provider holding MD credentials at 4102 N ROXBORO ST, DURHAM, NC, 27704, with a listed phone of (919) 595-2000. NPI 1306880992 was issued on 06/15/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what GUPTA 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 343 prescription claims written by this provider, covering 150 Medicare beneficiaries and totaling roughly $30K in drug spend, split 12% brand-name and 88% 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. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 77.0164/100 for the 2023 performance year (Quality 60.3935), compared with the national average of 83.1.

Otolaryngology Physician is a mid-sized specialty nationwide, with 10,895 enrolled providers across 54 states and an average of 509 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

4102 N ROXBORO ST
DURHAM, NC 27704

Provider Details

NPI 1306880992
Specialty Otolaryngology Physician
Credentials MD
Gender Male
NPI Issued 06/15/2006

CMS Quality Score (MIPS)

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

77.0164
Final Score
Avg: 83.1
60.3935
Quality
96
Promoting Interoperability

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 PANKAJ GUPTA, MD. Source: openpaymentsdata.cms.gov.

Total received

$402

Largest payer

Regeneron Healthcare Solutions, Inc.

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.

Brand vs generic prescribing mix · Typical

PANKAJ GUPTA, MD — brand share 12.0%
Specialty average (est.)

12% brand-name claims vs 88% generic, on 343 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.

343
Total Claims
$30K
Total Drug Cost
150
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
403
Total Day Supply
7,492
Brand vs Generic
12% brand / 88% generic
Brand Drug Cost
$21K
Generic Drug Cost
$9K
Opioid Claims
24 (7.0% rate)
Antibiotic Claims
50

Patient Demographics

Average Patient Age
74.5 years
Avg HCC Risk Score
0.95
Gender Split
63% female / 37% male

Top Prescribed Drugs (Medicare Part D)

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

What PANKAJ GUPTA, MD prescribes most

Top Medicare Part D drugs by claim count, 2023

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2023
Drug Claims
Fluticasone Propionate
23
Hydrocodone-Acetaminophen
Hydrocodone/Acetaminophen
23
Cefdinir
19
Prednisone
17
Ciprofloxacin-Dexamethasone
Ciprofloxacin Hcl/Dexameth
16
Ofloxacin
15
Azelastine Hcl
14
Methylprednisolone
14
Ipratropium Bromide
13
Lorazepam
13

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

Otolaryngology Physician Overview

How PANKAJ GUPTA, MD fits within the Otolaryngology Physician landscape nationally.

10,895
Otolaryngology Physician Providers in US
54
States with Otolaryngology Physician
509
Avg Claims per Provider

PANKAJ GUPTA, MD's 343 claims are below the specialty average of 509.

Nearby Otolaryngology Physician Providers in North Carolina

Other clinicians with the same primary specialty enrolled in North Carolina, drawn from the same CMS NPPES roster as GUPTA.

Compare Otolaryngology Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is PANKAJ GUPTA, MD's specialty?
PANKAJ GUPTA, MD specializes in Otolaryngology Physician and practices in DURHAM, North Carolina. Credentials: MD.
How much does PANKAJ GUPTA, MD prescribe under Medicare Part D?
In 2023, PANKAJ GUPTA, MD wrote 343 Medicare Part D claims totaling $30K in drug costs for 150 beneficiaries.
What is PANKAJ GUPTA, MD's Medicare quality score?
PANKAJ GUPTA, MD has a CMS MIPS Final Score of 77.0164/100 (Quality: 60.3935). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is PANKAJ GUPTA, MD located?
PANKAJ GUPTA, MD is located at 4102 N ROXBORO ST, DURHAM, NC, 27704. Phone: (919) 595-2000.
What is PANKAJ GUPTA, MD's NPI number?
PANKAJ GUPTA, MD's National Provider Identifier (NPI) is 1306880992, issued on 06/15/2006.
Does PANKAJ GUPTA, MD prescribe more brand-name or generic drugs?
PANKAJ GUPTA, MD's prescribing is 12% brand-name and 88% generic drugs by claim count, with $21K in brand drug costs.
Does PANKAJ GUPTA, MD prescribe opioids?
Yes, PANKAJ GUPTA, MD had 24 opioid claims in 2023 with an opioid prescribing rate of 7.0%.
How many Otolaryngology Physician providers are there in the US?
There are 10,895 Otolaryngology Physician providers across 54 states in the US. The average Otolaryngology Physician provider writes 509 Medicare Part D claims per year.
What drugs does PANKAJ GUPTA, MD prescribe most often?
Based on 2023 Medicare Part D data, PANKAJ GUPTA, MD's most frequently prescribed drugs include Fluticasone Propionate, Hydrocodone-Acetaminophen, Cefdinir. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does PANKAJ GUPTA, MD accept Medicare?
PANKAJ GUPTA, MD appears in CMS Medicare data with 343 Part D claims and 150 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify PANKAJ GUPTA, MD's credentials?
PANKAJ GUPTA, MD's NPI is 1306880992 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.
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