2026 NPPES data Emergency Medicine Physician NPI 1861415028 MD
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Rachel Waldron, MD

Emergency Medicine Physician in Flushing, New York. This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers — including 64,398 in Emergency Medicine 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
1K
Medicare Part D claims · 509 beneficiaries · Emergency Medicine Physician avg: 352
Generic prescribing
95%
generic claims · 4% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
75/100
▼ 8 pts below national avg 83.1 · Above neutral
Compiled from official public sources by the PlainDoctor editorial team.

What the federal data shows

Rachel Waldron, MD reported a CMS MIPS final score of 75/100 — below the 83.1 national average — and filed 1,176 Medicare Part D claims in 2023.

75/100
MIPS score · -8 vs avg
1K
Part D claims, 2023
95%
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.

Rachel Waldron, MD's MIPS score vs every scored U.S. clinician

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

75 15th percentile higher than 15% 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%). This entry sits in this band. 80–90: 129,887 scored providers (27%). Above this entry. 90–100: 189,403 scored providers (40%). Above this entry. 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

Where Rachel Waldron, MD sits

This provider among emergency medicine physician peers

Across the 14,967 emergency medicine physician providers who report both Medicare Part D prescribing and a MIPS quality score, Rachel Waldron, MD writes more Part D claims than 97% of them and scores higher on MIPS quality than 9% — 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

Lower volume · High qualityHigh volume · High qualityLower volume · Lower qualityHigh volume · Lower quality02550751000255075100Part D claim volume — percentile in specialtyMIPS quality — percentilePart D claim volume — percentile in specialty: 73 · MIPS quality — percentile: 13Part D claim volume — percentile in specialty: 60 · MIPS quality — percentile: 63Part D claim volume — percentile in specialty: 88 · MIPS quality — percentile: 37Part D claim volume — percentile in specialty: 65 · MIPS quality — percentile: 67Part D claim volume — percentile in specialty: 95 · MIPS quality — percentile: 15Part D claim volume — percentile in specialty: 62 · MIPS quality — percentile: 18Part D claim volume — percentile in specialty: 32 · MIPS quality — percentile: 70Part D claim volume — percentile in specialty: 58 · MIPS quality — percentile: 62Part D claim volume — percentile in specialty: 67 · MIPS quality — percentile: 3Part D claim volume — percentile in specialty: 40 · MIPS quality — percentile: 97Part D claim volume — percentile in specialty: 12 · MIPS quality — percentile: 92Part D claim volume — percentile in specialty: 52 · MIPS quality — percentile: 52Part D claim volume — percentile in specialty: 80 · MIPS quality — percentile: 58Part D claim volume — percentile in specialty: 92 · MIPS quality — percentile: 38Part D claim volume — percentile in specialty: 5 · MIPS quality — percentile: 87Part D claim volume — percentile in specialty: 7 · MIPS quality — percentile: 2Part D claim volume — percentile in specialty: 90 · MIPS quality — percentile: 30Part D claim volume — percentile in specialty: 30 · MIPS quality — percentile: 32Part D claim volume — percentile in specialty: 0 · MIPS quality — percentile: 20Part D claim volume — percentile in specialty: 13 · MIPS quality — percentile: 52Part D claim volume — percentile in specialty: 17 · MIPS quality — percentile: 73Part D claim volume — percentile in specialty: 17 · MIPS quality — percentile: 33Part D claim volume — percentile in specialty: 10 · MIPS quality — percentile: 93Part D claim volume — percentile in specialty: 42 · MIPS quality — percentile: 35Part D claim volume — percentile in specialty: 85 · MIPS quality — percentile: 22Part D claim volume — percentile in specialty: 93 · MIPS quality — percentile: 28Part D claim volume — percentile in specialty: 22 · MIPS quality — percentile: 48Part D claim volume — percentile in specialty: 45 · MIPS quality — percentile: 43Part D claim volume — percentile in specialty: 68 · MIPS quality — percentile: 75Part D claim volume — percentile in specialty: 23 · MIPS quality — percentile: 42Part D claim volume — percentile in specialty: 78 · MIPS quality — percentile: 75Part D claim volume — percentile in specialty: 48 · MIPS quality — percentile: 5Part D claim volume — percentile in specialty: 87 · MIPS quality — percentile: 17Part D claim volume — percentile in specialty: 25 · MIPS quality — percentile: 82Part D claim volume — percentile in specialty: 0 · MIPS quality — percentile: 23Part D claim volume — percentile in specialty: 47 · MIPS quality — percentile: 83Part D claim volume — percentile in specialty: 53 · MIPS quality — percentile: 75Part D claim volume — percentile in specialty: 98 · MIPS quality — percentile: 95Part D claim volume — percentile in specialty: 82 · MIPS quality — percentile: 98Part D claim volume — percentile in specialty: 35 · MIPS quality — percentile: 83Part D claim volume — percentile in specialty: 55 · MIPS quality — percentile: 65Part D claim volume — percentile in specialty: 20 · MIPS quality — percentile: 12Part D claim volume — percentile in specialty: 28 · MIPS quality — percentile: 88Part D claim volume — percentile in specialty: 37 · MIPS quality — percentile: 98Part D claim volume — percentile in specialty: 15 · MIPS quality — percentile: 50Part D claim volume — percentile in specialty: 38 · MIPS quality — percentile: 5Part D claim volume — percentile in specialty: 3 · MIPS quality — percentile: 23Part D claim volume — percentile in specialty: 73 · MIPS quality — percentile: 45Part D claim volume — percentile in specialty: 62 · MIPS quality — percentile: 0Part D claim volume — percentile in specialty: 27 · MIPS quality — percentile: 55Part D claim volume — percentile in specialty: 68 · MIPS quality — percentile: 45Part D claim volume — percentile in specialty: 83 · MIPS quality — percentile: 5Part D claim volume — percentile in specialty: 77 · MIPS quality — percentile: 70Part D claim volume — percentile in specialty: 8 · MIPS quality — percentile: 55Part D claim volume — percentile in specialty: 57 · MIPS quality — percentile: 68Part D claim volume — percentile in specialty: 50 · MIPS quality — percentile: 27Part D claim volume — percentile in specialty: 72 · MIPS quality — percentile: 75Part D claim volume — percentile in specialty: 33 · MIPS quality — percentile: 60Part D claim volume — percentile in specialty: 97 · MIPS quality — percentile: 38Part D claim volume — percentile in specialty: 43 · MIPS quality — percentile: 88Rachel Waldron, MD — Part D claim volume — percentile in specialty: 97 · MIPS quality — percentile: 9
Part D claim volume vs MIPS quality, by specialty percentile

Each dot is one emergency medicine physician peer from a representative sample of 60; the gold marker is Rachel Waldron, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.

Board certification likely (heuristic — not verified)

Rachel Waldron, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting — 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 Rachel Waldron, MD?

Below national average

NPI registry status

Active

Issued 07/26/2006

NPI 1861415028

Primary specialty

Emergency Medicine Physician

High-volume

64,398 US NPIs in this specialty

Medicare Part D claims

1,176 234% vs specialty avg

2023 prescription claims

Specialty avg: 352

MIPS final score

75/100 8.1 pts vs avg

Above neutral band

vs 83.1 national avg

Specialty distribution in New York

How Emergency Medicine Physician compares to other specialties among New York providers

New York providers

Largest specialties in New York (% of in-state providers)

Student in an Organized Health Care Education/Training Program — 7.8%Student in an Organized Health Care Education/Training Program7.8%Registered Nurse — 5.2%Registered Nurse5.2%Clinical Social Worker — 4.9%Clinical Social Worker4.9%Social Worker — 4.5%Social Worker4.5%Speech-Language Pathologist — 4.5%Speech-Language Pathologist4.5%Licensed Practical Nurse — 4.3%Licensed Practical Nurse4.3%Emergency Medicine Physician — 0.8%Emergency Medicine Physician0.8%
Largest specialties in New York (% of in-state providers)

Medicare quality performance — MIPS

Rachel Waldron, MD's 2023 MIPS final score plotted against the Emergency Medicine Physician national average

Below national average
MIPS Final Score
75/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Emergency Medicine Physician) — 75/100 vs national avg 83.1

0%100%National avg83%75%
MIPS final score (Emergency Medicine Physician) — 75/100 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).

Rachel Waldron, MD appears in the CMS NPPES registry as a Emergency Medicine Physician provider holding MD credentials at 56-45 MAIN STREET, Flushing, NY, 11355, with a listed phone of (718) 670-1231. NPI 1861415028 was issued on 07/26/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what Waldron 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 1,176 prescription claims written by this provider, covering 509 Medicare beneficiaries and totaling roughly $20K in drug spend, split 4% brand-name and 95% generic by claim count, with an opioid prescribing rate of 15.7%. 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 75/100 for the 2023 performance year, compared with the national average of 83.1.

Emergency Medicine Physician is a high-volume specialty nationwide, with 64,398 enrolled providers across 56 states and an average of 352 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

56-45 MAIN STREET
Flushing, NY 11355

Provider Details

NPI 1861415028
Specialty Emergency Medicine Physician
Credentials MD
Gender Female
NPI Issued 07/26/2006

CMS Quality Score (MIPS)

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

75
Final Score
Avg: 83.1

Reporting: Group practice

License & disciplinary context — New York NYSBPMC 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 ~100K New York medical licensees in 2023 — they are NOT specific to Rachel Waldron, MD. To verify Rachel Waldron, MD's current license status, search the NYSBPMC public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

312
Total board actions, New York 2023
Across 302 cases
3.12
Actions per 1,000 licensees
New York statewide rate
probation
Most common action type
89 cases

NYSBPMC 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 New York disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Generic-heavy

Rachel Waldron, MD — brand share 4.0%
Emergency Medicine Physician average

4% brand-name claims vs 95% generic, on 1,176 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.

1,176
Total Claims
$20K
Total Drug Cost
509
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
1,185
Total Day Supply
11,237
Brand vs Generic
4% brand / 95% generic
Brand Drug Cost
$13K
Generic Drug Cost
$8K
Opioid Claims
185 (15.7% rate)
Antibiotic Claims
165

Patient Demographics

Average Patient Age
69.4 years
Avg HCC Risk Score
2.11
Gender Split
64% female / 36% male
Age Distribution
<65: 140, 65-74: 176, 75-84: 142, 85+: 51

Top Prescribed Drugs (Medicare Part D)

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

What Rachel Waldron, 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
Ondansetron Odt
Ondansetron
174
Hydrocodone-Acetaminophen
Hydrocodone/Acetaminophen
110
Prednisone
76
Meloxicam
66
Promethazine Hcl
66
Cyclobenzaprine Hcl
62
Naproxen
59
Oxycodone-Acetaminophen
Oxycodone Hcl/Acetaminophen
45
Cephalexin
43
Tramadol Hcl
29

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

Emergency Medicine Physician Overview

How Rachel Waldron, MD fits within the Emergency Medicine Physician landscape nationally.

64,398
Emergency Medicine Physician Providers in US
56
States with Emergency Medicine Physician
352
Avg Claims per Provider

Rachel Waldron, MD's 1,176 claims are above the specialty average of 352.

Nearby Emergency Medicine Physician Providers in New York

Other clinicians with the same primary specialty enrolled in New York, drawn from the same CMS NPPES roster as Waldron.

Compare Emergency Medicine 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 New York medical board — federal registration is not a license check. Credential verification guide
  • Weigh a second option: compare this provider with a nearby Emergency Medicine 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.

Frequently Asked Questions

What is Rachel Waldron, MD's specialty?
Rachel Waldron, MD specializes in Emergency Medicine Physician and practices in Flushing, New York. Credentials: MD.
How much does Rachel Waldron, MD prescribe under Medicare Part D?
In 2023, Rachel Waldron, MD wrote 1,176 Medicare Part D claims totaling $20K in drug costs for 509 beneficiaries.
What is Rachel Waldron, MD's Medicare quality score?
Rachel Waldron, MD has a CMS MIPS Final Score of 75/100. The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Rachel Waldron, MD located?
Rachel Waldron, MD is located at 56-45 MAIN STREET, Flushing, NY, 11355. Phone: (718) 670-1231.
What is Rachel Waldron, MD's NPI number?
Rachel Waldron, MD's National Provider Identifier (NPI) is 1861415028, issued on 07/26/2006.
Does Rachel Waldron, MD prescribe more brand-name or generic drugs?
Rachel Waldron, MD's prescribing is 4% brand-name and 95% generic drugs by claim count, with $13K in brand drug costs.
Does Rachel Waldron, MD prescribe opioids?
Yes, Rachel Waldron, MD had 185 opioid claims in 2023 with an opioid prescribing rate of 15.7%.
How many Emergency Medicine Physician providers are there in the US?
There are 64,398 Emergency Medicine Physician providers across 56 states in the US. The average Emergency Medicine Physician provider writes 352 Medicare Part D claims per year.
What drugs does Rachel Waldron, MD prescribe most often?
Based on 2023 Medicare Part D data, Rachel Waldron, MD's most frequently prescribed drugs include Ondansetron Odt, Hydrocodone-Acetaminophen, Prednisone. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Rachel Waldron, MD accept Medicare?
Rachel Waldron, MD appears in CMS Medicare data with 1,176 Part D claims and 509 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Rachel Waldron, MD's credentials?
Rachel Waldron, MD's NPI is 1861415028 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

Compiled from official public sources by the PlainDoctor editorial team.