2026 NPPES data Ophthalmic Plastic and Reconstructive Surgery Physician NPI 1003131657 M.D.
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PAUL PHELPS, M.D.

Ophthalmic Plastic and Reconstructive Surgery Physician in CHICAGO, Illinois. 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
45
Medicare Part D claims · 27 beneficiaries · Ophthalmic Plastic and Reconstructive Surgery Physician avg: 624
MIPS score
84.5729/100
▲ 1 pts above national avg 83.1 · [object Object]
Industry payments
$9.7K
19 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: PAUL PHELPS, M.D. is a Ophthalmic Plastic and Reconstructive Surgery Physician ([object Object]) practicing in CHICAGO, Illinois with a Medicare Part D prescribing footprint of 45 claims across 27 beneficiaries . Their CMS MIPS Final Score of 84.5729/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $9.7K across 19 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: PAUL PHELPS, M.D. reported a CMS MIPS final score of 84.5729 out of 100, above the 83.1 national average, and filed 45 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 PHELPS, 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).

PAUL PHELPS, M.D. at a glance

Near national average

NPI registry status

Active

Issued 04/06/2010

NPI 1003131657

Primary specialty

Ophthalmic Plastic and Reconstructive Surgery Physician

Rare

291 US NPIs in this specialty

Medicare Part D claims

45 93% vs specialty avg

2023 prescription claims

Specialty avg: 624

MIPS final score

84.5729/100 1.4729000000000099% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in Illinois

How Ophthalmic Plastic and Reconstructive Surgery Physician compares to other specialties among Illinois providers

Illinois providers

Ophthalmic Plastic and Reconstructive Surgery Physician share within Illinois

1. Ophthalmic Plastic and Reconstructive Surgery Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Ophthalmic Plastic and Reconstructive Surgery Physician share within Illinois

Medicare quality performance — MIPS

PAUL PHELPS, M.D.'s 2023 MIPS final score plotted against the Ophthalmic Plastic and Reconstructive Surgery Physician national average

Near national average
MIPS Final Score
84.5729/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Ophthalmic Plastic and Reconstructive Surgery Physician) — 84.5729/100 vs national avg 83.1

0%100%National avg83%84.6%
MIPS final score (Ophthalmic Plastic and Reconstructive Surgery Physician) — 84.5729/100 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 PHELPS, M.D. is a Ophthalmic Plastic and Reconstructive Surgery Physician provider practicing in CHICAGO, Illinois, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: M.D.. NPI: 1003131657. 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 PHELPS, M.D. appears in the CMS NPPES registry as a Ophthalmic Plastic and Reconstructive Surgery Physician provider holding M.D. credentials at 2001 N HALSTED ST STE 200, CHICAGO, IL, 60614, with a listed phone of (312) 888-5754. NPI 1003131657 was issued on 04/06/2010. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what PHELPS 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 45 prescription claims written by this provider, covering 27 Medicare beneficiaries and totaling roughly $174K in drug spend. 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 84.5729/100 for the 2023 performance year (Quality 60.2504, Cost 67.0015), compared with the national average of 83.1.

Ophthalmic Plastic and Reconstructive Surgery Physician is a narrow specialty nationwide, with 291 enrolled providers across 46 states and an average of 624 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

2001 N HALSTED ST STE 200
CHICAGO, IL 60614

Provider Details

NPI 1003131657
Specialty Ophthalmic Plastic and Reconstructive Surgery Physician
Credentials M.D.
Gender Male
NPI Issued 04/06/2010

CMS Quality Score (MIPS)

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

84.5729
Final Score
Avg: 83.1
60.2504
Quality
67.0015
Cost
100
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where PAUL PHELPS, 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.

COOK COUNTY
CHICAGO, IL

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

Total received

$9.7K

Largest payer

Amgen 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.

License & disciplinary context — Illinois IDFPR 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 ~42K Illinois medical licensees in 2023 — they are NOT specific to PAUL PHELPS, M.D.. To verify PAUL PHELPS, M.D.'s current license status, search the IDFPR public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

106
Total board actions, Illinois 2023
Across 103 cases
2.52
Actions per 1,000 licensees
Illinois statewide rate
probation
Most common action type
38 cases

IDFPR 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 Illinois disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

45
Total Claims
$174K
Total Drug Cost
27
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
45
Total Day Supply
488
Generic Drug Cost
$561

Patient Demographics

Average Patient Age
72.4 years
Avg HCC Risk Score
0.63

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Erythromycin
Erythromycin Base
17

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

Ophthalmic Plastic and Reconstructive Surgery Physician Overview

How PAUL PHELPS, M.D. fits within the Ophthalmic Plastic and Reconstructive Surgery Physician landscape nationally.

291
Ophthalmic Plastic and Reconstructive Surgery Physician Providers in US
46
States with Ophthalmic Plastic and Reconstructive Surgery Physician
624
Avg Claims per Provider

PAUL PHELPS, M.D.'s 45 claims are below the specialty average of 624.

Nearby Ophthalmic Plastic and Reconstructive Surgery Physician Providers in Illinois

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

Compare Ophthalmic Plastic and Reconstructive Surgery Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is PAUL PHELPS, M.D.'s specialty?
PAUL PHELPS, M.D. specializes in Ophthalmic Plastic and Reconstructive Surgery Physician and practices in CHICAGO, Illinois. Credentials: M.D..
How much does PAUL PHELPS, M.D. prescribe under Medicare Part D?
In 2023, PAUL PHELPS, M.D. wrote 45 Medicare Part D claims totaling $174K in drug costs for 27 beneficiaries.
What is PAUL PHELPS, M.D.'s Medicare quality score?
PAUL PHELPS, M.D. has a CMS MIPS Final Score of 84.5729/100 (Quality: 60.2504, Cost: 67.0015). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is PAUL PHELPS, M.D. located?
PAUL PHELPS, M.D. is located at 2001 N HALSTED ST STE 200, CHICAGO, IL, 60614. Phone: (312) 888-5754.
What is PAUL PHELPS, M.D.'s NPI number?
PAUL PHELPS, M.D.'s National Provider Identifier (NPI) is 1003131657, issued on 04/06/2010.
How many Ophthalmic Plastic and Reconstructive Surgery Physician providers are there in the US?
There are 291 Ophthalmic Plastic and Reconstructive Surgery Physician providers across 46 states in the US. The average Ophthalmic Plastic and Reconstructive Surgery Physician provider writes 624 Medicare Part D claims per year.
What drugs does PAUL PHELPS, M.D. prescribe most often?
Based on 2023 Medicare Part D data, PAUL PHELPS, M.D.'s most frequently prescribed drugs include Erythromycin. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does PAUL PHELPS, M.D. accept Medicare?
PAUL PHELPS, M.D. appears in CMS Medicare data with 45 Part D claims and 27 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify PAUL PHELPS, M.D.'s credentials?
PAUL PHELPS, M.D.'s NPI is 1003131657 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