2026 NPPES data Adult Medicine Physician NPI 1780613455 MD
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PAUL ESPINOZA, MD

Adult Medicine Physician in LEXINGTON, South 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
27
Medicare Part D claims · 14 beneficiaries · Adult Medicine Physician avg: 3K
Generic prescribing
48%
generic claims · 52% brand-name · higher generic rates reduce patient out-of-pocket costs
Industry payments
$991.68
19 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: PAUL ESPINOZA, MD is a Adult Medicine Physician ([object Object]) practicing in LEXINGTON, South Carolina with a Medicare Part D prescribing footprint of 27 claims across 14 beneficiaries — 52% brand-name prescribing . Industry payments of $991.68 across 19 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: PAUL ESPINOZA, MD filed 27 Medicare Part D claims in 2023 across LEXINGTON, South Carolina. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

Board certification likely (heuristic — not verified)

PAUL ESPINOZA, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + 1 hospital affiliation — signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).

PAUL ESPINOZA, MD at a glance

Quality data not reported

NPI registry status

Active

Issued 07/03/2006

NPI 1780613455

Primary specialty

Adult Medicine Physician

Niche

2,481 US NPIs in this specialty

Medicare Part D claims

27 99% vs specialty avg

2023 prescription claims

Specialty avg: 2,807

Specialty distribution in South Carolina

How Adult Medicine Physician compares to other specialties among South Carolina providers

South Carolina providers

Adult Medicine Physician share within South Carolina

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

Specialty board-certification context

Estimated specialty board-certified rate — Adult Medicine Physician (ABMS / AOA reference)

Quality data not reported
Est. board-certified rate
78%
Adult Medicine Physician ABMS/AOA estimate

Est. board-certified rate (Adult Medicine Physician) — ABMS / AOA estimate

0%100%78%
Est. board-certified rate (Adult Medicine Physician) — ABMS / AOA estimate

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 ESPINOZA, MD is a Adult Medicine Physician provider practicing in LEXINGTON, South Carolina, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: MD. NPI: 1780613455. 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.

PAUL ESPINOZA, MD appears in the CMS NPPES registry as a Adult Medicine Physician provider holding MD credentials at 117 PARK PLACE CT, LEXINGTON, SC, 29072, with a listed phone of (038) 626-9075. NPI 1780613455 was issued on 07/03/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what ESPINOZA 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 27 prescription claims written by this provider, covering 14 Medicare beneficiaries and totaling roughly $9K in drug spend, split 52% brand-name and 48% 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.

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

117 PARK PLACE CT
LEXINGTON, SC 29072

Provider Details

NPI 1780613455
Specialty Adult Medicine Physician
Credentials MD
Gender Male
NPI Issued 07/03/2006

Hospital and facility affiliations

Facilities where PAUL ESPINOZA, MD 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.

ESPINOZA VEIN INSTITUTE LLC
LEXINGTON, SC

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 ESPINOZA, MD. Source: openpaymentsdata.cms.gov.

Total received

$992

Largest payer

Tactile Systems Technology 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 · Brand-heavy

PAUL ESPINOZA, MD — brand share 52.0%
Specialty average (est.)

52% brand-name claims vs 48% generic, on 27 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.

27
Total Claims
$9K
Total Drug Cost
14
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
29
Total Day Supply
711
Brand vs Generic
52% brand / 48% generic
Brand Drug Cost
$8K
Generic Drug Cost
$946

Patient Demographics

Average Patient Age
77.1 years
Avg HCC Risk Score
1.35
Age Distribution
<65: 0, 65-74: N/A, 75-84: N/A, 85+: N/A

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Eliquis
Apixaban
11

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

Adult Medicine Physician Overview

How PAUL ESPINOZA, MD 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

PAUL ESPINOZA, MD's 27 claims are below the specialty average of 2,807.

Nearby Adult Medicine Physician Providers in South Carolina

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

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

Frequently Asked Questions

What is PAUL ESPINOZA, MD's specialty?
PAUL ESPINOZA, MD specializes in Adult Medicine Physician and practices in LEXINGTON, South Carolina. Credentials: MD.
How much does PAUL ESPINOZA, MD prescribe under Medicare Part D?
In 2023, PAUL ESPINOZA, MD wrote 27 Medicare Part D claims totaling $9K in drug costs for 14 beneficiaries.
Where is PAUL ESPINOZA, MD located?
PAUL ESPINOZA, MD is located at 117 PARK PLACE CT, LEXINGTON, SC, 29072. Phone: (038) 626-9075.
What is PAUL ESPINOZA, MD's NPI number?
PAUL ESPINOZA, MD's National Provider Identifier (NPI) is 1780613455, issued on 07/03/2006.
Does PAUL ESPINOZA, MD prescribe more brand-name or generic drugs?
PAUL ESPINOZA, MD's prescribing is 52% brand-name and 48% generic drugs by claim count, with $8K 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.
What drugs does PAUL ESPINOZA, MD prescribe most often?
Based on 2023 Medicare Part D data, PAUL ESPINOZA, MD's most frequently prescribed drugs include Eliquis. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does PAUL ESPINOZA, MD accept Medicare?
PAUL ESPINOZA, MD appears in CMS Medicare data with 27 Part D claims and 14 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify PAUL ESPINOZA, MD's credentials?
PAUL ESPINOZA, MD's NPI is 1780613455 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.
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