2026 NPPES data General Practice Registered Nurse NPI 1194395376
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PAYTON O'TOOLE

General Practice Registered Nurse in BILLINGS, Montana. 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
86
Medicare Part D claims · 52 beneficiaries · General Practice Registered Nurse avg: 1K
MIPS score
94.3056/100
▲ 11 pts above national avg 83.1 · [object Object]
Industry payments
$771.43
5 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: PAYTON O'TOOLE is a General Practice Registered Nurse ([object Object]) practicing in BILLINGS, Montana with a Medicare Part D prescribing footprint of 86 claims across 52 beneficiaries . Their CMS MIPS Final Score of 94.3056/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $771.43 across 5 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: PAYTON O'TOOLE reported a CMS MIPS final score of 94.3056 out of 100, above the 83.1 national average, and filed 86 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

PAYTON O'TOOLE at a glance

High performer (top quartile)

NPI registry status

Active

Issued 06/29/2021

NPI 1194395376

Primary specialty

General Practice Registered Nurse

Mid-sized

5,478 US NPIs in this specialty

Medicare Part D claims

86 93% vs specialty avg

2023 prescription claims

Specialty avg: 1,187

MIPS final score

94.3056/100 11.205600000000004% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Montana

How General Practice Registered Nurse compares to other specialties among Montana providers

Montana providers

General Practice Registered Nurse share within Montana

1. General Practice Registered Nurse42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
General Practice Registered Nurse share within Montana

Medicare quality performance — MIPS

PAYTON O'TOOLE's 2023 MIPS final score plotted against the General Practice Registered Nurse national average

High performer (top quartile)
MIPS Final Score
94.3056/100
vs 83.1 national avg · 2023 performance year

MIPS final score (General Practice Registered Nurse) — 94.3056/100 vs national avg 83.1

0%100%National avg83%94.3%
MIPS final score (General Practice Registered Nurse) — 94.3056/100 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).

PAYTON O'TOOLE is a General Practice Registered Nurse provider practicing in BILLINGS, Montana, according to the CMS National Plan and Provider Enumeration System (NPPES). NPI: 1194395376. 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.

PAYTON O'TOOLE appears in the CMS NPPES registry as a General Practice Registered Nurse provider at 801 N 29TH ST, BILLINGS, MT, 59101, with a listed phone of (406) 238-2500. NPI 1194395376 was issued on 06/29/2021. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what O'TOOLE 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 86 prescription claims written by this provider, covering 52 Medicare beneficiaries and totaling roughly $1K in drug spend, with an opioid prescribing rate of 31.4%. 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 94.3056/100 for the 2023 performance year (Quality 85.5889), compared with the national average of 83.1.

General Practice Registered Nurse is a mid-sized specialty nationwide, with 5,478 enrolled providers across 55 states and an average of 1,187 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

801 N 29TH ST
BILLINGS, MT 59101

Provider Details

NPI 1194395376
Specialty General Practice Registered Nurse
Gender Female
NPI Issued 06/29/2021

CMS Quality Score (MIPS)

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

94.3056
Final Score
Avg: 83.1
85.5889
Quality
100
Promoting Interoperability

Reporting: Alternative Payment Model

Hospital and facility affiliations

Facilities where PAYTON O'TOOLE 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.

BILLINGS CLINIC
★★★★☆ 4/5
BILLINGS, MT
Acute Care Hospitals
CMS CCN: 270004

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 PAYTON O'TOOLE. Source: openpaymentsdata.cms.gov.

Total received

$771

Largest payer

Medtronic, 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.

Medicare Part D Prescribing Data

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

86
Total Claims
$1K
Total Drug Cost
52
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
94
Total Day Supply
1,423
Generic Drug Cost
$1K
Opioid Claims
27 (31.4% rate)

Patient Demographics

Average Patient Age
71.4 years
Avg HCC Risk Score
1.10
Gender Split
52% female / 48% male

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Oxycodone Hcl
16
Cyclobenzaprine Hcl
12

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

General Practice Registered Nurse Overview

How PAYTON O'TOOLE fits within the General Practice Registered Nurse landscape nationally.

5,478
General Practice Registered Nurse Providers in US
55
States with General Practice Registered Nurse
1,187
Avg Claims per Provider

PAYTON O'TOOLE's 86 claims are below the specialty average of 1,187.

Nearby General Practice Registered Nurse Providers in Montana

Other clinicians with the same primary specialty enrolled in Montana, drawn from the same CMS NPPES roster as O'TOOLE.

Compare General Practice Registered Nurse nationally: see state-by-state distribution →

Frequently Asked Questions

What is PAYTON O'TOOLE's specialty?
PAYTON O'TOOLE specializes in General Practice Registered Nurse and practices in BILLINGS, Montana.
How much does PAYTON O'TOOLE prescribe under Medicare Part D?
In 2023, PAYTON O'TOOLE wrote 86 Medicare Part D claims totaling $1K in drug costs for 52 beneficiaries.
What is PAYTON O'TOOLE's Medicare quality score?
PAYTON O'TOOLE has a CMS MIPS Final Score of 94.3056/100 (Quality: 85.5889). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is PAYTON O'TOOLE located?
PAYTON O'TOOLE is located at 801 N 29TH ST, BILLINGS, MT, 59101. Phone: (406) 238-2500.
What is PAYTON O'TOOLE's NPI number?
PAYTON O'TOOLE's National Provider Identifier (NPI) is 1194395376, issued on 06/29/2021.
Does PAYTON O'TOOLE prescribe opioids?
Yes, PAYTON O'TOOLE had 27 opioid claims in 2023 with an opioid prescribing rate of 31.4%.
How many General Practice Registered Nurse providers are there in the US?
There are 5,478 General Practice Registered Nurse providers across 55 states in the US. The average General Practice Registered Nurse provider writes 1,187 Medicare Part D claims per year.
What drugs does PAYTON O'TOOLE prescribe most often?
Based on 2023 Medicare Part D data, PAYTON O'TOOLE's most frequently prescribed drugs include Oxycodone Hcl, Cyclobenzaprine Hcl. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does PAYTON O'TOOLE accept Medicare?
PAYTON O'TOOLE appears in CMS Medicare data with 86 Part D claims and 52 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify PAYTON O'TOOLE's credentials?
PAYTON O'TOOLE's NPI is 1194395376. 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