NPI registry status
Active
2026 NPPES data Otolaryngology Physician NPI 1306880992 MD
Verify on CMS → Pankaj Gupta, MD
Otolaryngology Physician in Durham, North Carolina.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 11,060 in Otolaryngology 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
682
Medicare Part D claims · 244 beneficiaries · Otolaryngology Physician avg: 536
Generic prescribing
90%
generic claims · 10% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
77/100
▼ 6 pts below national avg 83.5 · Above neutral
Industry payments
$402.07
14 payments · CMS Open Payments (Sunshine Act)
Source: CMS Medicare Part D Prescriber Public Use File, 2024
What the federal data shows
Pankaj Gupta, MD reported a CMS MIPS final score of 77/100 - below the 83.5 national average - and filed 682 Medicare Part D claims in 2024.
- 77/100
- MIPS score · -6 vs avg
- 682
- Part D claims, 2024
- 90%
- 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.
Federal trust snapshot
What official records show about Pankaj Gupta, MD
Federal records show an active NPI with both Medicare prescribing volume and a measured CMS quality score — objective registry data, not patient reviews.
- Verified
NPI registry status
Active listing in the CMS National Provider Identifier Registry (NPI 1306880992), first enumerated 06/15/2006.
Source: CMS NPPES
- Reported
Medicare Part D participation
Filed 682 Medicare Part D prescription claims in the 2023 CMS public use file — indicates active Medicare prescribing participation.
Source: CMS Part D Prescriber PUF
- Reported
CMS quality reporting (MIPS)
Reported a CMS MIPS final score of 77/100 in the Quality Payment Program — a federal quality measure, not a patient review.
Source: CMS Quality Payment Program
- Reported
Board certification signal
Heuristic suggests board-certified status based on ABMS-eligible specialty taxonomy plus active CMS participation signals — not a direct ABMS verification.
- Reported
Industry payment transparency
$402.07 in reported industry payments (14 transfers) in 2024 under the federal Sunshine Act — disclosed transfers of value, not a quality rating.
Source: CMS Open Payments
- Not in federal data
Individual sanction lookup
PlainDoctor does not publish per-provider disciplinary determinations. Confirm current license and any individual actions through the state medical board or FSMB verification service.
Source: State medical board / FSMB
This trust snapshot summarizes only what appears in federal CMS/NPPES public records. It is not a composite score, star rating, patient review, or clinical recommendation. PlainDoctor never fabricates reviews or AggregateRating schema.
CMS NPPES provider registry desk
NPI 1306880992 · Otolaryngology Physician
NPI-10 · ENUM-LEGACY · TAX-MID · MIPS-BELOW · RX-LIGHT · BOOK-THIN · PHOTO-FINISH
- NPI-10 1306880992
- ENUM-LEGACY 2006
- TAX-MID 11K Otolaryngology Physician
- MIPS-BELOW 77/100
- RX-LIGHT 682
- BOOK-THIN 371 in North Carolina
- PHOTO-FINISH James Massey, M.D. · ±0.0
MIPS final-score neighbourhood
Same-specialty nationwide peers by CMS final score, not geographic proximity
- Gupta · this pro…
Gupta · this provider
77 MIPS pts
- Carl Guarino, MD…
Carl Guarino, MD
77 MIPS pts
- Barbara Burggraa…
Barbara Burggraaff, MD
77 MIPS pts
- Jeffrey Braaten,…
Jeffrey Braaten, D.O.
77 MIPS pts
- James Massey, M.…
James Massey, M.D.
77 MIPS pts
What this shows Nearest measured MIPS peers for this NUCC specialty (2023 performance year).
Pankaj Gupta, MD's MIPS score vs every measured U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure. Clinicians whose score CMS assigned without scoring any category are excluded.
77 ≥ 20th percentile 20% of 454,083 measured providers are in lower value bands
Each bar is a band; taller bars hold more measured 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.
The percentile is a conservative whole-score-point band: it counts only measured clinicians in lower score bands. A CMS MIPS metric is not a recommendation or a clinical-quality rating by PlainDoctor. See methodology § corpus placement.
Source CMS Merit-based Incentive Payment System (MIPS) · 2023
Where Pankaj Gupta, MD sits
This provider among otolaryngology physician peers
Across the 3,290 otolaryngology physician providers who report both Medicare Part D prescribing and a MIPS quality score, Pankaj Gupta, MD writes more Part D claims than 69% of them and scores higher on MIPS quality than 26% - placing this provider in the high-volume, lower-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Each dot is one otolaryngology physician peer from a representative sample of 60; the gold marker is Pankaj Gupta, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 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 averagePrimary specialty
Otolaryngology Physician
Medicare Part D claims
682 27% vs specialty avg
MIPS final score
77/100 6.5 pts vs avg
Specialty distribution in North Carolina
How Otolaryngology Physician compares to other specialties among North Carolina providers
Medicare quality performance, MIPS
Pankaj Gupta, MD's 2023 MIPS final score plotted against the Otolaryngology Physician national average
- MIPS Final Score
- 77/100
- vs 83.5 national avg · 2023 performance year
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).
Practice Address
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
Measured-score avg: 83.5
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 10.0%
Otolaryngology Physician average
10% brand-name claims vs 90% generic, on 682 2024 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 2024.
682
Total Claims
$40K
Total Drug Cost
244
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 787.9
- Total Day Supply
- 13,817
- Brand vs Generic
- 10% brand / 90% generic
- Brand Drug Cost
- $26K
- Generic Drug Cost
- $15K
- Opioid Claims
- 57 (8.4% rate)
- Antibiotic Claims
- 120
Patient Demographics
- Average Patient Age
- 73.2 years
- Avg HCC Risk Score
- 1.24
- Gender Split
- 57% female / 43% male
- Age Distribution
- <65: 24, 65-74: 113, 75-84: 79, 85+: 28
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2024. Based on Medicare Part D data only.
What Pankaj Gupta, MD prescribes most
Top Medicare Part D drugs by claim count, 2024
- Prednisone
Prednisone
62 claims
- Hydrocodone-Acetam…
Hydrocodone-Acetaminophen
53 claims
- Ipratropium Bromide
Ipratropium Bromide
47 claims
- Doxycycline Hyclate
Doxycycline Hyclate
39 claims
- Fluocinolone Aceto…
Fluocinolone Acetonide Oil
29 claims
- Ciprofloxacin-Dexa…
Ciprofloxacin-Dexamethasone
28 claims
- Fluticasone Propio…
Fluticasone Propionate
26 claims
- Lorazepam
Lorazepam
25 claims
| Drug | Claims |
|---|---|
| Prednisone | 62 |
| Hydrocodone-Acetaminophen Hydrocodone/Acetaminophen | 53 |
| Ipratropium Bromide | 47 |
| Doxycycline Hyclate | 39 |
| Fluocinolone Acetonide Oil | 29 |
| Ciprofloxacin-Dexamethasone Ciprofloxacin Hcl/Dexameth | 28 |
| Fluticasone Propionate | 26 |
| Lorazepam | 25 |
| Levofloxacin | 22 |
| Cefdinir | 21 |
* 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.
11,060
Otolaryngology Physician Providers in US
54
States with Otolaryngology Physician
536
Avg Claims per Provider
Pankaj Gupta, MD's 682 claims are above the specialty average of 536.
Nationwide Otolaryngology Physician peers with similar MIPS or enrollment year
Two federal-record peer sets for Gupta, both outside North Carolina so the neighborhoods are not geographic containment.
Similar MIPS final score
Nearest same-specialty clinicians by CMS MIPS final score (77 here).
Same NPPES enumeration year (2006)
Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.
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.
One of 371 Otolaryngology Physician providers enrolled in North Carolina, 5 are shown here.
Dr. Feras Ackall
M.D.
Durham, NC
Dr. Marcus Albernaz
MD
Greenville, NC
Dr. Bailin Alexander
MD
Charlotte, NC
Dr. Richard Alexander
MD, PHD, MBA
Oxford, NC
Dr. Daniel Alicea
MD
Chapel Hill, NC
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 2024, Pankaj Gupta, MD wrote 682 Medicare Part D claims totaling $40K in drug costs for 244 beneficiaries.
What is Pankaj Gupta, MD's Medicare quality score? ▼
Pankaj Gupta, MD has a CMS MIPS Final Score of 77/100 (Quality: 60.4). The average MIPS Final Score across the 454,083 clinicians with at least one published category score is 83.5; clinicians whose score CMS assigned without scoring any category are excluded from that average. 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 10% brand-name and 90% generic drugs by claim count, with $26K in brand drug costs.
Does Pankaj Gupta, MD prescribe opioids? ▼
Yes, Pankaj Gupta, MD had 57 opioid claims in 2024 with an opioid prescribing rate of 8.4%.
How many Otolaryngology Physician providers are there in the US? ▼
There are 11,060 Otolaryngology Physician providers across 54 states in the US. The average Otolaryngology Physician provider writes 536 Medicare Part D claims per year.
What drugs does Pankaj Gupta, MD prescribe most often? ▼
Based on 2024 Medicare Part D data, Pankaj Gupta, MD's most frequently prescribed drugs include Prednisone, Hydrocodone-Acetaminophen, Ipratropium Bromide. 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 682 Part D claims and 244 Medicare beneficiaries in 2024. 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
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 (2024). 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 August 2026 (NPPES) / 2024 (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
Every figure on PlainDoctor is rendered directly from the federal CMS NPPES registry, Medicare Part D, MIPS, and Open Payments records, no number is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of August 2026.