2026 NPPES data Pediatrics Physician NPI 1881822492 MD
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PONEH HEINE, MD

Pediatrics Physician in LAWRENCEVILLE, Georgia. 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
416
Medicare Part D claims · 82 beneficiaries · Pediatrics Physician avg: 762
Generic prescribing
67%
generic claims · 33% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
98.3/100
▲ 15 pts above national avg 83.1 · [object Object]
Industry payments
$1.9K
72 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

PONEH HEINE, MD reported a CMS MIPS final score of 98.3/100 — above the 83.1 national average — and filed 416 Medicare Part D claims in 2023.

98.3/100
MIPS score · +15 vs avg
416
Part D claims, 2023
67%
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.

PONEH HEINE, MD's MIPS score vs every scored U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023 — the federal quality measure

98 Top 11% higher than 89% of 477,587 scored providers

0–10: 8,684 scored providers (2%). Below this entry. 10–20: 3,008 scored providers (1%). Below this entry. 20–30: 3,069 scored providers (1%). Below this entry. 30–40: 2,746 scored providers (1%). Below this entry. 40–50: 2,928 scored providers (1%). Below this entry. 50–60: 5,882 scored providers (1%). Below this entry. 60–70: 13,906 scored providers (3%). Below this entry. 70–80: 118,074 scored providers (25%). Below this entry. 80–90: 129,887 scored providers (27%). Below this entry. 90–100: 189,403 scored providers (40%). This entry sits in this band. This provider 0 100 every MIPS-scored clinician, bucketed by value

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

Board certification likely (heuristic — not verified)

PONEH HEINE, 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 PONEH HEINE, MD?

High performer (top quartile)

NPI registry status

Active

Issued 06/23/2009

NPI 1881822492

Primary specialty

Pediatrics Physician

High-volume

80,574 US NPIs in this specialty

Medicare Part D claims

416 45% vs specialty avg

2023 prescription claims

Specialty avg: 762

MIPS final score

98.3/100 15.200000000000003% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Georgia

How Pediatrics Physician compares to other specialties among Georgia providers

Georgia providers

Pediatrics Physician share within Georgia

1. Pediatrics Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Pediatrics Physician share within Georgia

Medicare quality performance — MIPS

PONEH HEINE, MD's 2023 MIPS final score plotted against the Pediatrics Physician national average

High performer (top quartile)
MIPS Final Score
98.3/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Pediatrics Physician) — 98.3/100 vs national avg 83.1

0%100%National avg83%98.3%
MIPS final score (Pediatrics Physician) — 98.3/100 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).

PONEH HEINE, MD appears in the CMS NPPES registry as a Pediatrics Physician provider holding MD credentials at 565 OLD NORCROSS RD, LAWRENCEVILLE, GA, 30046, with a listed phone of (770) 995-5131. NPI 1881822492 was issued on 06/23/2009. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what HEINE 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 416 prescription claims written by this provider, covering 82 Medicare beneficiaries and totaling roughly $59K in drug spend, split 33% brand-name and 67% generic by claim count. 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 98.3/100 for the 2023 performance year, compared with the national average of 83.1.

Pediatrics Physician is a high-volume specialty nationwide, with 80,574 enrolled providers across 56 states and an average of 762 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

565 OLD NORCROSS RD
LAWRENCEVILLE, GA 30046

Provider Details

NPI 1881822492
Specialty Pediatrics Physician
Credentials MD
Gender Female
NPI Issued 06/23/2009

CMS Quality Score (MIPS)

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

98.3
Final Score
Avg: 83.1
98
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where PONEH HEINE, 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.

ALLERGY ASSOCIATES, PA
MACON, GA

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 PONEH HEINE, MD. Source: openpaymentsdata.cms.gov.

Total received

$1.9K

Largest payer

GENZYME CORPORATION

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.

Brand vs generic prescribing mix · Above average

PONEH HEINE, MD — brand share 33.0%
Specialty average (est.)

33% brand-name claims vs 67% generic, on 416 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.

416
Total Claims
$59K
Total Drug Cost
82
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
533
Total Day Supply
14,616
Brand vs Generic
33% brand / 67% generic
Brand Drug Cost
$51K
Generic Drug Cost
$8K
Antibiotic Claims
15

Patient Demographics

Average Patient Age
68.9 years
Avg HCC Risk Score
0.94
Gender Split
70% female / 30% male

Top Prescribed Drugs (Medicare Part D)

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

What PONEH HEINE, MD prescribes most

Top Medicare Part D drugs by claim count, 2023

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2023
Drug Claims
Montelukast Sodium
118
Fluticasone Propionate
44
Albuterol Sulfate Hfa
Albuterol Sulfate
32
Arnuity Ellipta
Fluticasone Furoate
21
Ipratropium Bromide
18
Trelegy Ellipta
Fluticasone/Umeclidin/Vilanter
18
Epinephrine
17
Breo Ellipta
Fluticasone/Vilanterol
16
Advair Hfa
Fluticasone Propion/Salmeterol
14
Flovent Hfa
Fluticasone Propionate
14

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

Pediatrics Physician Overview

How PONEH HEINE, MD fits within the Pediatrics Physician landscape nationally.

80,574
Pediatrics Physician Providers in US
56
States with Pediatrics Physician
762
Avg Claims per Provider

PONEH HEINE, MD's 416 claims are below the specialty average of 762.

Nearby Pediatrics Physician Providers in Georgia

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

Compare Pediatrics Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is PONEH HEINE, MD's specialty?
PONEH HEINE, MD specializes in Pediatrics Physician and practices in LAWRENCEVILLE, Georgia. Credentials: MD.
How much does PONEH HEINE, MD prescribe under Medicare Part D?
In 2023, PONEH HEINE, MD wrote 416 Medicare Part D claims totaling $59K in drug costs for 82 beneficiaries.
What is PONEH HEINE, MD's Medicare quality score?
PONEH HEINE, MD has a CMS MIPS Final Score of 98.3/100. The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is PONEH HEINE, MD located?
PONEH HEINE, MD is located at 565 OLD NORCROSS RD, LAWRENCEVILLE, GA, 30046. Phone: (770) 995-5131.
What is PONEH HEINE, MD's NPI number?
PONEH HEINE, MD's National Provider Identifier (NPI) is 1881822492, issued on 06/23/2009.
Does PONEH HEINE, MD prescribe more brand-name or generic drugs?
PONEH HEINE, MD's prescribing is 33% brand-name and 67% generic drugs by claim count, with $51K in brand drug costs.
How many Pediatrics Physician providers are there in the US?
There are 80,574 Pediatrics Physician providers across 56 states in the US. The average Pediatrics Physician provider writes 762 Medicare Part D claims per year.
What drugs does PONEH HEINE, MD prescribe most often?
Based on 2023 Medicare Part D data, PONEH HEINE, MD's most frequently prescribed drugs include Montelukast Sodium, Fluticasone Propionate, Albuterol Sulfate Hfa. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does PONEH HEINE, MD accept Medicare?
PONEH HEINE, MD appears in CMS Medicare data with 416 Part D claims and 82 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify PONEH HEINE, MD's credentials?
PONEH HEINE, MD's NPI is 1881822492 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

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