NPI registry status
Active
2026 NPPES data Orthopaedic Surgery Physician NPI 1407803687 M.D.
Verify on CMS → Philip Balikian, M.D.
Orthopaedic Surgery Physician in Poway, California.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 25,781 in Orthopaedic 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
250
Medicare Part D claims · 79 beneficiaries · Orthopaedic Surgery Physician avg: 324
MIPS score
80.2/100
▼ 3 pts below national avg 83.1 · Above neutral
Industry payments
$191.75
7 payments · CMS Open Payments (Sunshine Act)
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
Philip Balikian, M.D. reported a CMS MIPS final score of 80.2/100 - below the 83.1 national average - and filed 250 Medicare Part D claims in 2023.
- 80.2/100
- MIPS score · -3 vs avg
- 250
- Part D claims, 2023
- 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.
Philip Balikian, M.D.'s MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
80 33rd percentile higher than 33% 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 Philip Balikian, M.D. sits
This provider among orthopaedic surgery physician peers
Across the 8,194 orthopaedic surgery physician providers who report both Medicare Part D prescribing and a MIPS quality score, Philip Balikian, M.D. writes more Part D claims than 50% of them and scores higher on MIPS quality than 48% - placing this provider in the high-volume, lower-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 orthopaedic surgery physician peer from a representative sample of 60; the gold marker is Philip Balikian, M.D.. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Philip Balikian, 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).
What does the federal data show about Philip Balikian, M.D.?
Near national averagePrimary specialty
Orthopaedic Surgery Physician
Medicare Part D claims
250 23% vs specialty avg
MIPS final score
80.2/100 2.9 pts vs avg
Specialty distribution in California
How Orthopaedic Surgery Physician compares to other specialties among California providers
Medicare quality performance, MIPS
Philip Balikian, M.D.'s 2023 MIPS final score plotted against the Orthopaedic Surgery Physician national average
- MIPS Final Score
- 80.2/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Orthopaedic Surgery Physician) - 80.2/100 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).
Philip Balikian, M.D. appears in the CMS NPPES registry as a Orthopaedic Surgery Physician provider holding M.D. credentials at 15611 POMERADO RD, Poway, CA, 92064, with a listed phone of (858) 613-8900. NPI 1407803687 was issued on 05/31/2006.
Medicare Part D records for calendar year 2023 show 250 prescription claims written by this provider, covering 79 Medicare beneficiaries and totaling roughly $4K in drug spend, with an opioid prescribing rate of 23.2%. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 80.2/100 for the 2023 performance year (Quality 69), compared with the national average of 83.1.
Orthopaedic Surgery Physician is a mid-sized specialty nationwide, with 25,781 enrolled providers across 56 states and an average of 324 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 | 1407803687 |
|---|---|
| Specialty | Orthopaedic Surgery Physician |
| Credentials | M.D. |
| Gender | Male |
| NPI Issued | 05/31/2006 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
80.1593
Final Score
Avg: 83.1
69.0148
Quality
76
Promoting Interoperability
Reporting: Alternative Payment Model
Hospital and facility affiliations
Facilities where Philip Balikian, 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.
Arch Health Partners Inc
Poway, CA
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 Philip Balikian, M.D.. Source: openpaymentsdata.cms.gov.
Total received
$192
Largest payer
DePuy Synthes Sales 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 - California MBC 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 ~150K California medical licensees in 2023 - they are NOT specific to Philip Balikian, M.D.. To verify Philip Balikian, M.D.'s current license status, search the MBC public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.
576
Total board actions, California 2023
Across 556 cases
3.84
Actions per 1,000 licensees
California statewide rate
probation
Most common action type
186 cases
MBC 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 California 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.
250
Total Claims
$4K
Total Drug Cost
79
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 276
- Total Day Supply
- 5,030
- Brand Drug Cost
- $0
- Generic Drug Cost
- $4K
- Opioid Claims
- 58 (23.2% rate)
- Antibiotic Claims
- 68
Patient Demographics
- Average Patient Age
- 73.7 years
- Avg HCC Risk Score
- 0.84
- 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.
What Philip Balikian, M.D. prescribes most
Top Medicare Part D drugs by claim count, 2023
- Celecoxib
Celecoxib
54 claims
- Oxycodone-Acetamin…
Oxycodone-Acetaminophen
46 claims
- Ibuprofen
Ibuprofen
36 claims
- Cephalexin
Cephalexin
35 claims
- Amoxicillin 18
Amoxicillin
18 claims
- Diclofenac Sodium 12
Diclofenac Sodium
12 claims
| Drug | Claims |
|---|---|
| Celecoxib | 54 |
| Oxycodone-Acetaminophen Oxycodone Hcl/Acetaminophen | 46 |
| Ibuprofen | 36 |
| Cephalexin | 35 |
| Amoxicillin | 18 |
| Diclofenac Sodium | 12 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Orthopaedic Surgery Physician Overview
How Philip Balikian, M.D. fits within the Orthopaedic Surgery Physician landscape nationally.
25,781
Orthopaedic Surgery Physician Providers in US
56
States with Orthopaedic Surgery Physician
324
Avg Claims per Provider
Philip Balikian, M.D.'s 250 claims are below the specialty average of 324.
Nearby Orthopaedic Surgery Physician Providers in California
Other clinicians with the same primary specialty enrolled in California, drawn from the same CMS NPPES roster as Balikian.
Dr. Karim Abdollahi
M.D.
Laguna Beach, CA
Dr. Douglas Abeles
MD
Castro Valley, CA
Dr. Anthony Abene
MD
San Jose, CA
Dr. Nicholas Abidi
MD
Capitola, CA
Dr. Joshua Acebo
MD
Palo Alto, CA
Compare Orthopaedic Surgery 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 California medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Orthopaedic Surgery 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.
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Frequently Asked Questions
What is Philip Balikian, M.D.'s specialty? ▼
Philip Balikian, M.D. specializes in Orthopaedic Surgery Physician and practices in Poway, California. Credentials: M.D..
How much does Philip Balikian, M.D. prescribe under Medicare Part D? ▼
In 2023, Philip Balikian, M.D. wrote 250 Medicare Part D claims totaling $4K in drug costs for 79 beneficiaries.
What is Philip Balikian, M.D.'s Medicare quality score? ▼
Philip Balikian, M.D. has a CMS MIPS Final Score of 80.2/100 (Quality: 69). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Philip Balikian, M.D. located? ▼
Philip Balikian, M.D. is located at 15611 POMERADO RD, Poway, CA, 92064. Phone: (858) 613-8900.
What is Philip Balikian, M.D.'s NPI number? ▼
Philip Balikian, M.D.'s National Provider Identifier (NPI) is 1407803687, issued on 05/31/2006.
Does Philip Balikian, M.D. prescribe opioids? ▼
Yes, Philip Balikian, M.D. had 58 opioid claims in 2023 with an opioid prescribing rate of 23.2%.
How many Orthopaedic Surgery Physician providers are there in the US? ▼
There are 25,781 Orthopaedic Surgery Physician providers across 56 states in the US. The average Orthopaedic Surgery Physician provider writes 324 Medicare Part D claims per year.
What drugs does Philip Balikian, M.D. prescribe most often? ▼
Based on 2023 Medicare Part D data, Philip Balikian, M.D.'s most frequently prescribed drugs include Celecoxib, Oxycodone-Acetaminophen, Ibuprofen. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Philip Balikian, M.D. accept Medicare? ▼
Philip Balikian, M.D. appears in CMS Medicare data with 250 Part D claims and 79 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Philip Balikian, M.D.'s credentials? ▼
Philip Balikian, M.D.'s NPI is 1407803687 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
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.