NPI registry status
Active
2026 NPPES data Colon & Rectal Surgery Physician NPI 1053424853 MD
Verify on CMS → Peter Falk, MD
Colon & Rectal Surgery Physician in Green Bay, Wisconsin.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 1,642 in Colon & Rectal Surgery 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
148
Medicare Part D claims · 78 beneficiaries · Colon & Rectal Surgery Physician avg: 210
Generic prescribing
82%
generic claims · 18% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
94.6/100
▲ 11 pts above national avg 83.5 · Exceptional
Source: CMS Medicare Part D Prescriber Public Use File, 2024
What the federal data shows
Peter Falk, MD reported a CMS MIPS final score of 94.6/100 - above the 83.5 national average - and filed 148 Medicare Part D claims in 2024.
- 94.6/100
- MIPS score · +11 vs avg
- 148
- Part D claims, 2024
- 82%
- 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.
Federal trust snapshot
What official records show about Peter Falk, MD
Federal records show an active NPI with both Medicare prescribing volume and a measured CMS quality score — objective registry data, not patient reviews.
- Verified
NPI registry status
Active listing in the CMS National Provider Identifier Registry (NPI 1053424853), first enumerated 08/16/2006.
Source: CMS NPPES
- Reported
Medicare Part D participation
Filed 148 Medicare Part D prescription claims in the 2023 CMS public use file — indicates active Medicare prescribing participation.
Source: CMS Part D Prescriber PUF
- Reported
CMS quality reporting (MIPS)
Reported a CMS MIPS final score of 94.6/100 in the Quality Payment Program — a federal quality measure, not a patient review.
Source: CMS Quality Payment Program
- Reported
Board certification signal
Heuristic suggests board-certified status based on ABMS-eligible specialty taxonomy plus active CMS participation signals — not a direct ABMS verification.
- Reported
Hospital affiliations
1 CMS Care Compare hospital affiliation on record — practice footprint from the Doctors and Clinicians file.
Source: CMS Care Compare
- Not in federal data
Individual sanction lookup
PlainDoctor does not publish per-provider disciplinary determinations. Confirm current license and any individual actions through the state medical board or FSMB verification service.
Source: State medical board / FSMB
This trust snapshot summarizes only what appears in federal CMS/NPPES public records. It is not a composite score, star rating, patient review, or clinical recommendation. PlainDoctor never fabricates reviews or AggregateRating schema.
CMS NPPES provider registry desk
NPI 1053424853 · Colon & Rectal Surgery Physician
NPI-10 · ENUM-LEGACY · TAX-NARROW · MIPS-ELITE · RX-LIGHT · BOOK-THIN · PHOTO-FINISH
- NPI-10 1053424853
- ENUM-LEGACY 2006
- TAX-NARROW 1,642
- MIPS-ELITE 94.6/100
- RX-LIGHT 148
- BOOK-THIN 17 in Wisconsin
- PHOTO-FINISH Frank Carter · ±0.1
MIPS final-score neighbourhood
Same-specialty nationwide peers by CMS final score, not geographic proximity
- Frank Carter · l…
Frank Carter
94.5 MIPS pts
- Wayne Devos · near
Wayne Devos
94.5 MIPS pts
- Falk · this prov…
Falk · this provider
94.6 MIPS pts
- Glendon Hyde · h…
Glendon Hyde
94.7 MIPS pts
What this shows Nearest measured MIPS peers for this NUCC specialty (2023 performance year).
Peter Falk, MD's MIPS score vs every measured U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure. Clinicians whose score CMS assigned without scoring any category are excluded.
95 ≥ 73rd percentile 73% of 454,083 measured providers are in lower value bands
Each bar is a band; taller bars hold more measured 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.
The percentile is a conservative whole-score-point band: it counts only measured clinicians in lower score bands. A CMS MIPS metric is not a recommendation or a clinical-quality rating by PlainDoctor. See methodology § corpus placement.
Source CMS Merit-based Incentive Payment System (MIPS) · 2023
Where Peter Falk, MD sits
This provider among colon & rectal surgery physician peers
Across the 511 colon & rectal surgery physician providers who report both Medicare Part D prescribing and a MIPS quality score, Peter Falk, MD writes more Part D claims than 49% of them and scores higher on MIPS quality than 78% - placing this provider in the lower-volume, high-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Each dot is one colon & rectal surgery physician peer from a representative sample of 60; the gold marker is Peter Falk, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Peter Falk, MD 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 Peter Falk, MD?
High performer (top quartile)Primary specialty
Colon & Rectal Surgery Physician
Medicare Part D claims
148 30% vs specialty avg
MIPS final score
94.6/100 11.1 pts vs avg
Specialty distribution in Wisconsin
How Colon & Rectal Surgery Physician compares to other specialties among Wisconsin providers
Medicare quality performance, MIPS
Peter Falk, MD's 2023 MIPS final score plotted against the Colon & Rectal Surgery Physician national average
- MIPS Final Score
- 94.6/100
- vs 83.5 national avg · 2023 performance year
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).
Practice Address
Provider Details
| NPI | 1053424853 |
|---|---|
| Specialty | Colon & Rectal Surgery Physician |
| Credentials | MD |
| Gender | Male |
| NPI Issued | 08/16/2006 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
94.6154
Final Score
Measured-score avg: 83.5
85.1795
Quality
100
Promoting Interoperability
Reporting: Alternative Payment Model
Hospital and facility affiliations
Facilities where Peter Falk, MD 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.
St Vincent Hospital-Hospital Sisters-Third Order OF St Francis
Green Bay, WI
Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).
Brand vs generic prescribing mix · Typical
Peter Falk, MD - brand share 18.0%
Colon & Rectal Surgery Physician average
18% brand-name claims vs 82% generic, on 148 2024 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 2024.
148
Total Claims
$4K
Total Drug Cost
78
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 184.5
- Total Day Supply
- 2,625
- Brand vs Generic
- 18% brand / 82% generic
- Brand Drug Cost
- $787
- Generic Drug Cost
- $3K
- Opioid Claims
- 24 (16.2% rate)
- Antibiotic Claims
- 31
Patient Demographics
- Average Patient Age
- 71.8 years
- Avg HCC Risk Score
- 1.20
- Gender Split
- 55% female / 45% male
- Age Distribution
- <65: 12, 65-74: 40, 75-84: N/A, 85+: N/A
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2024. Based on Medicare Part D data only.
| Drug | Claims |
|---|---|
| Peg 3350-Electrolyte Sodium Chloride/Nahco3/Kcl/Peg | 49 |
| Ciprofloxacin Hcl | 12 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Colon & Rectal Surgery Physician Overview
How Peter Falk, MD fits within the Colon & Rectal Surgery Physician landscape nationally.
1,642
Colon & Rectal Surgery Physician Providers in US
50
States with Colon & Rectal Surgery Physician
210
Avg Claims per Provider
Peter Falk, MD's 148 claims are below the specialty average of 210.
Nationwide Colon & Rectal Surgery Physician peers with similar MIPS or enrollment year
Two federal-record peer sets for Falk, both outside Wisconsin so the neighborhoods are not geographic containment.
Similar MIPS final score
Nearest same-specialty clinicians by CMS MIPS final score (94.6 here).
Same NPPES enumeration year (2006)
Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.
Nearby Colon & Rectal Surgery Physician Providers in Wisconsin
Other clinicians with the same primary specialty enrolled in Wisconsin, drawn from the same CMS NPPES roster as Falk.
One of 17 Colon & Rectal Surgery Physician providers enrolled in Wisconsin, 5 are shown here.
Dr. Constante Avecilla
MD
Neillsville, WI
Dr. Jed Calata
M.D.
Milwaukee, WI
Dr. Eugene Foley
M.D.
Cross Plains, WI
Dr. Amy Hanna-Salami
M.D.
Milwaukee, WI
Dr. Theresa Hayssen
MD
Brookfield, WI
Compare Colon & Rectal Surgery Physician nationally: see state-by-state distribution →
Frequently Asked Questions
What is Peter Falk, MD's specialty? ▼
Peter Falk, MD specializes in Colon & Rectal Surgery Physician and practices in Green Bay, Wisconsin. Credentials: MD.
How much does Peter Falk, MD prescribe under Medicare Part D? ▼
In 2024, Peter Falk, MD wrote 148 Medicare Part D claims totaling $4K in drug costs for 78 beneficiaries.
What is Peter Falk, MD's Medicare quality score? ▼
Peter Falk, MD has a CMS MIPS Final Score of 94.6/100 (Quality: 85.2). The average MIPS Final Score across the 454,083 clinicians with at least one published category score is 83.5; clinicians whose score CMS assigned without scoring any category are excluded from that average. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Peter Falk, MD located? ▼
Peter Falk, MD is located at 670 CORMIER ROAD, Green Bay, WI, 54304. Phone: (920) 494-9685.
What is Peter Falk, MD's NPI number? ▼
Peter Falk, MD's National Provider Identifier (NPI) is 1053424853, issued on 08/16/2006.
Does Peter Falk, MD prescribe more brand-name or generic drugs? ▼
Peter Falk, MD's prescribing is 18% brand-name and 82% generic drugs by claim count, with $787 in brand drug costs.
Does Peter Falk, MD prescribe opioids? ▼
Yes, Peter Falk, MD had 24 opioid claims in 2024 with an opioid prescribing rate of 16.2%.
How many Colon & Rectal Surgery Physician providers are there in the US? ▼
There are 1,642 Colon & Rectal Surgery Physician providers across 50 states in the US. The average Colon & Rectal Surgery Physician provider writes 210 Medicare Part D claims per year.
What drugs does Peter Falk, MD prescribe most often? ▼
Based on 2024 Medicare Part D data, Peter Falk, MD's most frequently prescribed drugs include Peg 3350-Electrolyte, Ciprofloxacin Hcl. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Peter Falk, MD accept Medicare? ▼
Peter Falk, MD appears in CMS Medicare data with 148 Part D claims and 78 Medicare beneficiaries in 2024. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Peter Falk, MD's credentials? ▼
Peter Falk, MD's NPI is 1053424853 with credentials MD. 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 (2024). 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 August 2026 (NPPES) / 2024 (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
Every figure on PlainDoctor is rendered directly from the federal CMS NPPES registry, Medicare Part D, MIPS, and Open Payments records, no number is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of August 2026.