2026 NPPES data Internal Medicine Physician NPI 1255361218 M.D.
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Paul Durbin, M.D.

Internal Medicine Physician in Racine, Wisconsin. This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 172,858 in Internal Medicine 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
16K
Medicare Part D claims · 913 beneficiaries · Internal Medicine Physician avg: 3K
Generic prescribing
83%
generic claims · 16% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
82.4/100
▼ 1 pts below national avg 83.1 · Above neutral
Industry payments
$44.33
2 payments · CMS Open Payments (Sunshine Act)
Compiled from official public sources by the PlainDoctor editorial team.

What the federal data shows

Paul Durbin, M.D. reported a CMS MIPS final score of 82.4/100 - below the 83.1 national average - and filed 15,591 Medicare Part D claims in 2023.

82.4/100
MIPS score · -1 vs avg
16K
Part D claims, 2023
83%
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.

Paul Durbin, 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

82 39th percentile higher than 39% 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%). Below this entry. 80–90: 129,887 scored providers (27%). This entry sits in this band. 90+: 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

Where Paul Durbin, M.D. sits

This provider among internal medicine physician peers

Across the 36,260 internal medicine physician providers who report both Medicare Part D prescribing and a MIPS quality score, Paul Durbin, M.D. writes more Part D claims than 97% of them and scores higher on MIPS quality than 39% - 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

Lower volume · High qualityHigh volume · High qualityLower volume · Lower qualityHigh volume · Lower quality02550751000255075100Part D claim volume, percentile in specialtyMIPS quality, percentilePart D claim volume, percentile in specialty: 97 · MIPS quality, percentile: 88Part D claim volume, percentile in specialty: 43 · MIPS quality, percentile: 67Part D claim volume, percentile in specialty: 55 · MIPS quality, percentile: 18Part D claim volume, percentile in specialty: 82 · MIPS quality, percentile: 47Part D claim volume, percentile in specialty: 30 · MIPS quality, percentile: 42Part D claim volume, percentile in specialty: 77 · MIPS quality, percentile: 43Part D claim volume, percentile in specialty: 3 · MIPS quality, percentile: 85Part D claim volume, percentile in specialty: 42 · MIPS quality, percentile: 38Part D claim volume, percentile in specialty: 95 · MIPS quality, percentile: 53Part D claim volume, percentile in specialty: 65 · MIPS quality, percentile: 93Part D claim volume, percentile in specialty: 20 · MIPS quality, percentile: 97Part D claim volume, percentile in specialty: 37 · MIPS quality, percentile: 60Part D claim volume, percentile in specialty: 27 · MIPS quality, percentile: 25Part D claim volume, percentile in specialty: 28 · MIPS quality, percentile: 13Part D claim volume, percentile in specialty: 93 · MIPS quality, percentile: 0Part D claim volume, percentile in specialty: 92 · MIPS quality, percentile: 18Part D claim volume, percentile in specialty: 70 · MIPS quality, percentile: 92Part D claim volume, percentile in specialty: 15 · MIPS quality, percentile: 12Part D claim volume, percentile in specialty: 90 · MIPS quality, percentile: 18Part D claim volume, percentile in specialty: 0 · MIPS quality, percentile: 27Part D claim volume, percentile in specialty: 47 · MIPS quality, percentile: 30Part D claim volume, percentile in specialty: 67 · MIPS quality, percentile: 77Part D claim volume, percentile in specialty: 53 · MIPS quality, percentile: 97Part D claim volume, percentile in specialty: 73 · MIPS quality, percentile: 3Part D claim volume, percentile in specialty: 7 · MIPS quality, percentile: 52Part D claim volume, percentile in specialty: 23 · MIPS quality, percentile: 55Part D claim volume, percentile in specialty: 48 · MIPS quality, percentile: 10Part D claim volume, percentile in specialty: 52 · MIPS quality, percentile: 17Part D claim volume, percentile in specialty: 22 · MIPS quality, percentile: 33Part D claim volume, percentile in specialty: 78 · MIPS quality, percentile: 77Part D claim volume, percentile in specialty: 98 · MIPS quality, percentile: 2Part D claim volume, percentile in specialty: 85 · MIPS quality, percentile: 50Part D claim volume, percentile in specialty: 83 · MIPS quality, percentile: 73Part D claim volume, percentile in specialty: 35 · MIPS quality, percentile: 83Part D claim volume, percentile in specialty: 72 · MIPS quality, percentile: 32Part D claim volume, percentile in specialty: 12 · MIPS quality, percentile: 15Part D claim volume, percentile in specialty: 88 · MIPS quality, percentile: 40Part D claim volume, percentile in specialty: 25 · MIPS quality, percentile: 35Part D claim volume, percentile in specialty: 5 · MIPS quality, percentile: 62Part D claim volume, percentile in specialty: 57 · MIPS quality, percentile: 70Part D claim volume, percentile in specialty: 80 · MIPS quality, percentile: 5Part D claim volume, percentile in specialty: 62 · MIPS quality, percentile: 18Part D claim volume, percentile in specialty: 75 · MIPS quality, percentile: 58Part D claim volume, percentile in specialty: 87 · MIPS quality, percentile: 28Part D claim volume, percentile in specialty: 38 · MIPS quality, percentile: 88Part D claim volume, percentile in specialty: 8 · MIPS quality, percentile: 75Part D claim volume, percentile in specialty: 33 · MIPS quality, percentile: 87Part D claim volume, percentile in specialty: 63 · MIPS quality, percentile: 8Part D claim volume, percentile in specialty: 18 · MIPS quality, percentile: 72Part D claim volume, percentile in specialty: 68 · MIPS quality, percentile: 68Part D claim volume, percentile in specialty: 40 · MIPS quality, percentile: 45Part D claim volume, percentile in specialty: 50 · MIPS quality, percentile: 7Part D claim volume, percentile in specialty: 2 · MIPS quality, percentile: 63Part D claim volume, percentile in specialty: 60 · MIPS quality, percentile: 95Part D claim volume, percentile in specialty: 45 · MIPS quality, percentile: 37Part D claim volume, percentile in specialty: 10 · MIPS quality, percentile: 57Part D claim volume, percentile in specialty: 13 · MIPS quality, percentile: 82Part D claim volume, percentile in specialty: 32 · MIPS quality, percentile: 63Part D claim volume, percentile in specialty: 58 · MIPS quality, percentile: 97Part D claim volume, percentile in specialty: 17 · MIPS quality, percentile: 80Paul Durbin, M.D.-Part D claim volume, percentile in specialty: 97 · MIPS quality, percentile: 39
Part D claim volume vs MIPS quality, by specialty percentile

Each dot is one internal medicine physician peer from a representative sample of 60; the gold marker is Paul Durbin, M.D.. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.

Board certification likely (heuristic, not verified)

Paul Durbin, 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 Paul Durbin, M.D.?

Near national average

NPI registry status

Active

Issued 07/04/2006

NPI 1255361218

Primary specialty

Internal Medicine Physician

High-volume

172,858 US NPIs in this specialty

Medicare Part D claims

15,591 vs specialty avg

2023 prescription claims

Specialty avg: 2,716

MIPS final score

82.4/100 0.7 pts vs avg

Above neutral band

vs 83.1 national avg

Specialty distribution in Wisconsin

How Internal Medicine Physician compares to other specialties among Wisconsin providers

Wisconsin providers

Largest specialties in Wisconsin (% of in-state providers)

Physical Therapist - 5.6%Physical Therapist5.6%Pharmacist - 4.8%Pharmacist4.8%Registered Nurse - 4.5%Registered Nurse4.5%Professional Counselor - 3.3%Professional Counselor3.3%Student in an Organized Health Care Education/Training Program - 3.3%Student in an Organized Health Care Education/Training Program3.3%Family Medicine Physician - 3.2%Family Medicine Physician3.2%Internal Medicine Physician - 2.5%Internal Medicine Physician2.5%
Largest specialties in Wisconsin (% of in-state providers)

Medicare quality performance, MIPS

Paul Durbin, M.D.'s 2023 MIPS final score plotted against the Internal Medicine Physician national average

Near national average
MIPS Final Score
82.4/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Internal Medicine Physician) - 82.4/100 vs national avg 83.1

0%100%National avg83%82.4%
MIPS final score (Internal Medicine Physician) - 82.4/100 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).

Paul Durbin, M.D. appears in the CMS NPPES registry as a Internal Medicine Physician provider holding M.D. credentials at 3807 SPRING ST, Racine, WI, 53405, with a listed phone of (262) 687-8300. NPI 1255361218 was issued on 07/04/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what Durbin 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 15,591 prescription claims written by this provider, covering 913 Medicare beneficiaries and totaling roughly $1.7 million in drug spend, split 16% brand-name and 83% generic by claim count, with an opioid prescribing rate of 2.8%. 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 82.4/100 for the 2023 performance year (Quality 77.9, Cost 74.4), compared with the national average of 83.1.

Internal Medicine Physician is a high-volume specialty nationwide, with 172,858 enrolled providers across 56 states and an average of 2,716 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

3807 SPRING ST
Racine, WI 53405

Provider Details

NPI 1255361218
Specialty Internal Medicine Physician
Credentials M.D.
Gender Male
NPI Issued 07/04/2006

CMS Quality Score (MIPS)

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

82.3961
Final Score
Avg: 83.1
77.8816
Quality
74.3833
Cost
81
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where Paul Durbin, 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.

Ascension Medical Group-Southeast Wisconsin Inc
Brookfield, WI

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

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 Paul Durbin, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$44

Largest payer

Exact Sciences Corporation

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

Paul Durbin, M.D. - brand share 16.0%
Internal Medicine Physician average

16% brand-name claims vs 83% generic, on 15,591 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.

15,591
Total Claims
$1.7M
Total Drug Cost
913
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
35,891
Total Day Supply
1,040,295
Brand vs Generic
16% brand / 83% generic
Brand Drug Cost
$1.4M
Generic Drug Cost
$269K
Opioid Claims
443 (2.8% rate)
Antibiotic Claims
353

Patient Demographics

Average Patient Age
75.0 years
Avg HCC Risk Score
1.11
Gender Split
53% female / 47% male
Age Distribution
<65: 57, 65-74: 411, 75-84: 300, 85+: 145

Top Prescribed Drugs (Medicare Part D)

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

What Paul Durbin, M.D. 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
Losartan Potassium
923
Atorvastatin Calcium
868
Amlodipine Besylate
831
Levothyroxine Sodium
613
Rosuvastatin Calcium
447
Lisinopril
371
Omeprazole
349
Pantoprazole Sodium
333
Metoprolol Succinate
328
Pravastatin Sodium
303

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

Internal Medicine Physician Overview

How Paul Durbin, M.D. fits within the Internal Medicine Physician landscape nationally.

172,858
Internal Medicine Physician Providers in US
56
States with Internal Medicine Physician
2,716
Avg Claims per Provider

Paul Durbin, M.D.'s 15,591 claims are above the specialty average of 2,716.

Nearby Internal Medicine Physician Providers in Wisconsin

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

Compare Internal Medicine 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 Wisconsin medical board, federal registration is not a license check. Credential verification guide
  • Weigh a second option: compare this provider with a nearby Internal Medicine 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.

Frequently Asked Questions

What is Paul Durbin, M.D.'s specialty?
Paul Durbin, M.D. specializes in Internal Medicine Physician and practices in Racine, Wisconsin. Credentials: M.D..
How much does Paul Durbin, M.D. prescribe under Medicare Part D?
In 2023, Paul Durbin, M.D. wrote 15,591 Medicare Part D claims totaling $1.7M in drug costs for 913 beneficiaries.
What is Paul Durbin, M.D.'s Medicare quality score?
Paul Durbin, M.D. has a CMS MIPS Final Score of 82.4/100 (Quality: 77.9, Cost: 74.4). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Paul Durbin, M.D. located?
Paul Durbin, M.D. is located at 3807 SPRING ST, Racine, WI, 53405. Phone: (262) 687-8300.
What is Paul Durbin, M.D.'s NPI number?
Paul Durbin, M.D.'s National Provider Identifier (NPI) is 1255361218, issued on 07/04/2006.
Does Paul Durbin, M.D. prescribe more brand-name or generic drugs?
Paul Durbin, M.D.'s prescribing is 16% brand-name and 83% generic drugs by claim count, with $1.4M in brand drug costs.
Does Paul Durbin, M.D. prescribe opioids?
Yes, Paul Durbin, M.D. had 443 opioid claims in 2023 with an opioid prescribing rate of 2.8%.
How many Internal Medicine Physician providers are there in the US?
There are 172,858 Internal Medicine Physician providers across 56 states in the US. The average Internal Medicine Physician provider writes 2,716 Medicare Part D claims per year.
What drugs does Paul Durbin, M.D. prescribe most often?
Based on 2023 Medicare Part D data, Paul Durbin, M.D.'s most frequently prescribed drugs include Losartan Potassium, Atorvastatin Calcium, Amlodipine Besylate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Paul Durbin, M.D. accept Medicare?
Paul Durbin, M.D. appears in CMS Medicare data with 15,591 Part D claims and 913 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Paul Durbin, M.D.'s credentials?
Paul Durbin, M.D.'s NPI is 1255361218 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

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.