2026 NPPES data Psychiatry Physician NPI 1093889206 M.D
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PAUL FALLON, M.D

Psychiatry Physician in PORTSMOUTH, New Hampshire. 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
5K
Medicare Part D claims · 257 beneficiaries · Psychiatry Physician avg: 1K
Generic prescribing
95%
generic claims · 5% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
75/100
▼ 8 pts below national avg 83.1 · [object Object]
Industry payments
$234.66
18 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

PAUL FALLON, M.D reported a CMS MIPS final score of 75/100 — below the 83.1 national average — and filed 4,750 Medicare Part D claims in 2023.

75/100
MIPS score · -8 vs avg
5K
Part D claims, 2023
95%
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 FALLON, 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

75 15th percentile higher than 15% 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)

PAUL FALLON, 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 FALLON, M.D?

Below national average

NPI registry status

Active

Issued 11/20/2006

NPI 1093889206

Primary specialty

Psychiatry Physician

High-volume

53,104 US NPIs in this specialty

Medicare Part D claims

4,750 358% vs specialty avg

2023 prescription claims

Specialty avg: 1,038

MIPS final score

75/100 8.099999999999994% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in New Hampshire

How Psychiatry Physician compares to other specialties among New Hampshire providers

New Hampshire providers

Psychiatry Physician share within New Hampshire

1. Psychiatry Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Psychiatry Physician share within New Hampshire

Medicare quality performance — MIPS

PAUL FALLON, M.D's 2023 MIPS final score plotted against the Psychiatry Physician national average

Below national average
MIPS Final Score
75/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Psychiatry Physician) — 75/100 vs national avg 83.1

0%100%National avg83%75%
MIPS final score (Psychiatry Physician) — 75/100 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 FALLON, M.D appears in the CMS NPPES registry as a Psychiatry Physician provider holding M.D credentials at 1145 SAGAMORE AVE, PORTSMOUTH, NH, 03801, with a listed phone of (603) 431-6703. NPI 1093889206 was issued on 11/20/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what FALLON 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 4,750 prescription claims written by this provider, covering 257 Medicare beneficiaries and totaling roughly $493K in drug spend, split 5% brand-name and 95% 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 75/100 for the 2023 performance year, compared with the national average of 83.1.

Psychiatry Physician is a high-volume specialty nationwide, with 53,104 enrolled providers across 56 states and an average of 1,038 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

1145 SAGAMORE AVE
PORTSMOUTH, NH 03801

Provider Details

NPI 1093889206
Specialty Psychiatry Physician
Credentials M.D
Gender Male
NPI Issued 11/20/2006

CMS Quality Score (MIPS)

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

75
Final Score
Avg: 83.1

Reporting: Group practice

Hospital and facility affiliations

Facilities where PAUL FALLON, 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.

SEACOAST MENTAL HEALTH CENTER INC
PORTSMOUTH, NH

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 FALLON, M.D. Source: openpaymentsdata.cms.gov.

Total received

$235

Largest payer

Lundbeck LLC

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 · Generic-heavy

PAUL FALLON, M.D — brand share 5.0%
Specialty average (est.)

5% brand-name claims vs 95% generic, on 4,750 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.

4,750
Total Claims
$493K
Total Drug Cost
257
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
6,057
Total Day Supply
177,413
Brand vs Generic
5% brand / 95% generic
Brand Drug Cost
$349K
Generic Drug Cost
$143K

Patient Demographics

Average Patient Age
57.1 years
Avg HCC Risk Score
1.03
Gender Split
61% female / 39% male
Age Distribution
<65: 165, 65-74: 73, 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.

What PAUL FALLON, 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
Clonazepam
354
Buspirone Hcl
309
Lorazepam
295
Sertraline Hcl
270
Fluoxetine Hcl
249
Quetiapine Fumarate
226
Trazodone Hcl
195
Mirtazapine
191
Duloxetine Hcl
157
Alprazolam
151

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

Psychiatry Physician Overview

How PAUL FALLON, M.D fits within the Psychiatry Physician landscape nationally.

53,104
Psychiatry Physician Providers in US
56
States with Psychiatry Physician
1,038
Avg Claims per Provider

PAUL FALLON, M.D's 4,750 claims are above the specialty average of 1,038.

Nearby Psychiatry Physician Providers in New Hampshire

Other clinicians with the same primary specialty enrolled in New Hampshire, drawn from the same CMS NPPES roster as FALLON.

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

Frequently Asked Questions

What is PAUL FALLON, M.D's specialty?
PAUL FALLON, M.D specializes in Psychiatry Physician and practices in PORTSMOUTH, New Hampshire. Credentials: M.D.
How much does PAUL FALLON, M.D prescribe under Medicare Part D?
In 2023, PAUL FALLON, M.D wrote 4,750 Medicare Part D claims totaling $493K in drug costs for 257 beneficiaries.
What is PAUL FALLON, M.D's Medicare quality score?
PAUL FALLON, M.D has a CMS MIPS Final Score of 75/100. The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is PAUL FALLON, M.D located?
PAUL FALLON, M.D is located at 1145 SAGAMORE AVE, PORTSMOUTH, NH, 03801. Phone: (603) 431-6703.
What is PAUL FALLON, M.D's NPI number?
PAUL FALLON, M.D's National Provider Identifier (NPI) is 1093889206, issued on 11/20/2006.
Does PAUL FALLON, M.D prescribe more brand-name or generic drugs?
PAUL FALLON, M.D's prescribing is 5% brand-name and 95% generic drugs by claim count, with $349K in brand drug costs.
How many Psychiatry Physician providers are there in the US?
There are 53,104 Psychiatry Physician providers across 56 states in the US. The average Psychiatry Physician provider writes 1,038 Medicare Part D claims per year.
What drugs does PAUL FALLON, M.D prescribe most often?
Based on 2023 Medicare Part D data, PAUL FALLON, M.D's most frequently prescribed drugs include Clonazepam, Buspirone Hcl, Lorazepam. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does PAUL FALLON, M.D accept Medicare?
PAUL FALLON, M.D appears in CMS Medicare data with 4,750 Part D claims and 257 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify PAUL FALLON, M.D's credentials?
PAUL FALLON, M.D's NPI is 1093889206 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