2026 NPPES data Adult Medicine Physician NPI 1063804193
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PAUL LE

Adult Medicine Physician in PHILADELPHIA, Pennsylvania. 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
8K
Medicare Part D claims · 618 beneficiaries · Adult Medicine Physician avg: 3K
Generic prescribing
90%
generic claims · 10% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
95.6426/100
▲ 13 pts above national avg 83.1 · [object Object]
What the federal data reveals: PAUL LE is a Adult Medicine Physician ([object Object]) practicing in PHILADELPHIA, Pennsylvania with a Medicare Part D prescribing footprint of 8K claims across 618 beneficiaries — 10% brand-name prescribing . Their CMS MIPS Final Score of 95.6426/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities .

What stands out: PAUL LE reported a CMS MIPS final score of 95.6426 out of 100, above the 83.1 national average, and filed 8,223 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

Board certification likely (heuristic — not verified)

PAUL LE 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).

PAUL LE at a glance

High performer (top quartile)

NPI registry status

Active

Issued 02/26/2015

NPI 1063804193

Primary specialty

Adult Medicine Physician

Niche

2,481 US NPIs in this specialty

Medicare Part D claims

8,223 193% vs specialty avg

2023 prescription claims

Specialty avg: 2,807

MIPS final score

95.6426/100 12.542600000000007% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Pennsylvania

How Adult Medicine Physician compares to other specialties among Pennsylvania providers

Pennsylvania providers

Adult Medicine Physician share within Pennsylvania

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

Medicare quality performance — MIPS

PAUL LE's 2023 MIPS final score plotted against the Adult Medicine Physician national average

High performer (top quartile)
MIPS Final Score
95.6426/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Adult Medicine Physician) — 95.6426/100 vs national avg 83.1

0%100%National avg83%95.6%
MIPS final score (Adult Medicine Physician) — 95.6426/100 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 LE is a Adult Medicine Physician provider practicing in PHILADELPHIA, Pennsylvania, according to the CMS National Plan and Provider Enumeration System (NPPES). NPI: 1063804193. 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 LE appears in the CMS NPPES registry as a Adult Medicine Physician provider at 3900 WOODLAND AVE, PHILADELPHIA, PA, 19104, with a listed phone of (215) 823-5800. NPI 1063804193 was issued on 02/26/2015. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what LE 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 8,223 prescription claims written by this provider, covering 618 Medicare beneficiaries and totaling roughly $775K in drug spend, split 10% brand-name and 90% generic by claim count, with an opioid prescribing rate of 1.7%. 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 95.6426/100 for the 2023 performance year (Quality 80.5735), compared with the national average of 83.1.

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

3900 WOODLAND AVE
PHILADELPHIA, PA 19104

Provider Details

NPI 1063804193
Specialty Adult Medicine Physician
Gender Male
NPI Issued 02/26/2015

CMS Quality Score (MIPS)

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

95.6426
Final Score
Avg: 83.1
80.5735
Quality
100
Promoting Interoperability

Reporting: Alternative Payment Model

License & disciplinary context — Pennsylvania PA-BOM 2023 annual report

Aggregate state board data only — NOT a determination of any individual provider's status. The figures below describe statewide disciplinary activity across all ~45K Pennsylvania medical licensees in 2023 — they are NOT specific to PAUL LE. To verify PAUL LE's current license status, search the PA-BOM public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

133
Total board actions, Pennsylvania 2023
Across 129 cases
2.96
Actions per 1,000 licensees
Pennsylvania statewide rate
probation
Most common action type
48 cases

PA-BOM publishes annual disciplinary statistics as part of public-record reporting under each state's Administrative Procedure Act. See the full breakdown by action type and year on the Pennsylvania disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Typical

PAUL LE — brand share 10.0%
Specialty average (est.)

10% brand-name claims vs 90% generic, on 8,223 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.

8,223
Total Claims
$775K
Total Drug Cost
618
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
20,454
Total Day Supply
598,083
Brand vs Generic
10% brand / 90% generic
Brand Drug Cost
$608K
Generic Drug Cost
$164K
Opioid Claims
142 (1.7% rate)
Antibiotic Claims
281

Patient Demographics

Average Patient Age
75.2 years
Avg HCC Risk Score
1.15
Gender Split
56% female / 44% male
Age Distribution
<65: 18, 65-74: 304, 75-84: 201, 85+: 95

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Atorvastatin Calcium
590
Rosuvastatin Calcium
493
Losartan Potassium
351
Amlodipine Besylate
344
Levothyroxine Sodium
290
Metoprolol Succinate
251
Lisinopril
210
Metformin Hcl
187
Atenolol
169
Omeprazole
168

* 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 LE 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 LE's 8,223 claims are above the specialty average of 2,807.

Nearby Adult Medicine Physician Providers in Pennsylvania

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

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

Frequently Asked Questions

What is PAUL LE's specialty?
PAUL LE specializes in Adult Medicine Physician and practices in PHILADELPHIA, Pennsylvania.
How much does PAUL LE prescribe under Medicare Part D?
In 2023, PAUL LE wrote 8,223 Medicare Part D claims totaling $775K in drug costs for 618 beneficiaries.
What is PAUL LE's Medicare quality score?
PAUL LE has a CMS MIPS Final Score of 95.6426/100 (Quality: 80.5735). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is PAUL LE located?
PAUL LE is located at 3900 WOODLAND AVE, PHILADELPHIA, PA, 19104. Phone: (215) 823-5800.
What is PAUL LE's NPI number?
PAUL LE's National Provider Identifier (NPI) is 1063804193, issued on 02/26/2015.
Does PAUL LE prescribe more brand-name or generic drugs?
PAUL LE's prescribing is 10% brand-name and 90% generic drugs by claim count, with $608K in brand drug costs.
Does PAUL LE prescribe opioids?
Yes, PAUL LE had 142 opioid claims in 2023 with an opioid prescribing rate of 1.7%.
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 LE prescribe most often?
Based on 2023 Medicare Part D data, PAUL LE's most frequently prescribed drugs include Atorvastatin Calcium, Rosuvastatin Calcium, Losartan Potassium. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does PAUL LE accept Medicare?
PAUL LE appears in CMS Medicare data with 8,223 Part D claims and 618 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify PAUL LE's credentials?
PAUL LE's NPI is 1063804193. 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