NPI registry status
Active
2026 NPPES data Adult Medicine Physician NPI 1063804193
Verify on CMS → Paul Le
Adult Medicine Physician in Philadelphia, Pennsylvania.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 2,481 in Adult 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
8K
Medicare Part D claims · 618 beneficiaries · Adult Medicine Physician avg: 3K
Generic prescribing
89%
generic claims · 10% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
95.6/100
▲ 13 pts above national avg 83.1 · Exceptional
Source: CMS Medicare Part D Prescriber Public Use File, 2023
Compiled from official public sources by the PlainDoctor editorial team.
What the federal data shows
Paul Le reported a CMS MIPS final score of 95.6/100 - above the 83.1 national average - and filed 8,223 Medicare Part D claims in 2023.
- 95.6/100
- MIPS score · +13 vs avg
- 8K
- Part D claims, 2023
- 89%
- 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 Le's MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
96 Top 21% higher than 79% of 477,587 scored providers
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 Le sits
This provider among adult medicine physician peers
Across the 216 adult medicine physician providers who report both Medicare Part D prescribing and a MIPS quality score, Paul Le writes more Part D claims than 86% of them and scores higher on MIPS quality than 81% - placing this provider in the high-volume, high-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
Each dot is one adult medicine physician peer from a representative sample of 60; the gold marker is Paul Le. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
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).
What does the federal data show about Paul Le?
High performer (top quartile)Primary specialty
Adult Medicine Physician
Medicare Part D claims
8,223 193% vs specialty avg
MIPS final score
95.6/100 12.5 pts vs avg
Specialty distribution in Pennsylvania
How Adult Medicine Physician compares to other specialties among Pennsylvania providers
Medicare quality performance, MIPS
Paul Le's 2023 MIPS final score plotted against the Adult Medicine Physician national average
- MIPS Final Score
- 95.6/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Adult Medicine Physician) - 95.6/100 vs national avg 83.1
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).
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.
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 89% generic by claim count, with an opioid prescribing rate of 1.7%. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 95.6/100 for the 2023 performance year (Quality 80.6), 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
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%
Adult Medicine Physician average
10% brand-name claims vs 89% 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 / 89% 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.
What Paul Le prescribes most
Top Medicare Part D drugs by claim count, 2023
- Atorvastatin Calcium
Atorvastatin Calcium
590 claims
- Rosuvastatin Calcium
Rosuvastatin Calcium
493 claims
- Losartan Potassium
Losartan Potassium
351 claims
- Amlodipine Besylate
Amlodipine Besylate
344 claims
- Levothyroxine Sodium
Levothyroxine Sodium
290 claims
- Metoprolol Succinate
Metoprolol Succinate
251 claims
- Lisinopril 210
Lisinopril
210 claims
- Metformin Hcl 187
Metformin Hcl
187 claims
| 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.
Dr. Iyalla Adoki
MD
Coraopolis, PA
Dr. Jawad Ahsan
DO
Philadelphia, PA
Dr. Lisa Albert
CRNP
Lower Gwynedd, PA
Dr. Syed Atif
MD
Myerstown, PA
Dr. Ramon Baker
M.D.
Kunkletown, PA
Compare Adult 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 Pennsylvania medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Adult 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.
Healthcare Guides
Learn more about finding, verifying, and understanding healthcare providers.
How to Find a Doctor
Step-by-step guide to choosing a provider
Verify Credentials
Check NPI, board certification & license status
Medical Specialties Explained
Who treats what and how specialties differ
Understanding Medicare Claims Data
What prescribing data reveals about a provider
In-Network vs Out-of-Network
How insurance networks affect your costs
Telehealth Guide
Virtual care options and coverage in 2026
Explore Pennsylvania
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 95.6/100 (Quality: 80.6). 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 89% 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
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 (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.