2026 NPPES data Interventional Cardiology Physician NPI 1598766370 M.D.
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RAJ BALJEPALLY, M.D.

Interventional Cardiology Physician in KNOXVILLE, Tennessee. 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
2K
Medicare Part D claims · 279 beneficiaries · Interventional Cardiology Physician avg: 3K
Generic prescribing
78%
generic claims · 22% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
95.6914/100
▲ 13 pts above national avg 83.1 · [object Object]
Industry payments
$1.6K
69 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: RAJ BALJEPALLY, M.D. is a Interventional Cardiology Physician ([object Object]) practicing in KNOXVILLE, Tennessee with a Medicare Part D prescribing footprint of 2K claims across 279 beneficiaries — 22% brand-name prescribing . Their CMS MIPS Final Score of 95.6914/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $1.6K across 69 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: RAJ BALJEPALLY, M.D. reported a CMS MIPS final score of 95.6914 out of 100, above the 83.1 national average, and filed 1,730 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

Board certification likely (heuristic — not verified)

RAJ BALJEPALLY, 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).

RAJ BALJEPALLY, M.D. at a glance

High performer (top quartile)

NPI registry status

Active

Issued 08/03/2005

NPI 1598766370

Primary specialty

Interventional Cardiology Physician

Niche

3,382 US NPIs in this specialty

Medicare Part D claims

1,730 42% vs specialty avg

2023 prescription claims

Specialty avg: 2,984

MIPS final score

95.6914/100 12.591400000000007% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Tennessee

How Interventional Cardiology Physician compares to other specialties among Tennessee providers

Tennessee providers

Interventional Cardiology Physician share within Tennessee

1. Interventional Cardiology Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Interventional Cardiology Physician share within Tennessee

Medicare quality performance — MIPS

RAJ BALJEPALLY, M.D.'s 2023 MIPS final score plotted against the Interventional Cardiology Physician national average

High performer (top quartile)
MIPS Final Score
95.6914/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Interventional Cardiology Physician) — 95.6914/100 vs national avg 83.1

0%100%National avg83%95.7%
MIPS final score (Interventional Cardiology Physician) — 95.6914/100 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).

RAJ BALJEPALLY, M.D. is a Interventional Cardiology Physician provider practicing in KNOXVILLE, Tennessee, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: M.D.. NPI: 1598766370. 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.

RAJ BALJEPALLY, M.D. appears in the CMS NPPES registry as a Interventional Cardiology Physician provider holding M.D. credentials at 1940 ALCOA HWY, KNOXVILLE, TN, 37920, with a listed phone of (865) 544-2800. NPI 1598766370 was issued on 08/03/2005. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BALJEPALLY 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 1,730 prescription claims written by this provider, covering 279 Medicare beneficiaries and totaling roughly $436K in drug spend, split 22% brand-name and 78% 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 95.6914/100 for the 2023 performance year (Quality 85.2885), compared with the national average of 83.1.

Interventional Cardiology Physician is a narrow specialty nationwide, with 3,382 enrolled providers across 53 states and an average of 2,984 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

1940 ALCOA HWY
KNOXVILLE, TN 37920

Provider Details

NPI 1598766370
Specialty Interventional Cardiology Physician
Credentials M.D.
Gender Male
NPI Issued 08/03/2005

CMS Quality Score (MIPS)

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

95.6914
Final Score
Avg: 83.1
85.2885
Quality
100
Promoting Interoperability

Reporting: Alternative Payment Model

Hospital and facility affiliations

Facilities where RAJ BALJEPALLY, 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.

UNIVERSITY HEALTH SYSTEM, INC.
SEVIERVILLE, TN

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 RAJ BALJEPALLY, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$1.6K

Largest payer

Boston Scientific 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 · Typical

RAJ BALJEPALLY, M.D. — brand share 22.0%
Specialty average (est.)

22% brand-name claims vs 78% generic, on 1,730 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.

1,730
Total Claims
$436K
Total Drug Cost
279
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
4,405
Total Day Supply
131,593
Brand vs Generic
22% brand / 78% generic
Brand Drug Cost
$396K
Generic Drug Cost
$40K

Patient Demographics

Average Patient Age
75.7 years
Avg HCC Risk Score
1.74
Gender Split
37% female / 63% male
Age Distribution
<65: 24, 65-74: 86, 75-84: 129, 85+: 40

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Eliquis
Apixaban
221
Atorvastatin Calcium
144
Metoprolol Tartrate
134
Amlodipine Besylate
91
Metoprolol Succinate
91
Carvedilol
80
Clopidogrel
Clopidogrel Bisulfate
77
Losartan Potassium
75
Rosuvastatin Calcium
65
Isosorbide Mononitrate Er
Isosorbide Mononitrate
59

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

Interventional Cardiology Physician Overview

How RAJ BALJEPALLY, M.D. fits within the Interventional Cardiology Physician landscape nationally.

3,382
Interventional Cardiology Physician Providers in US
53
States with Interventional Cardiology Physician
2,984
Avg Claims per Provider

RAJ BALJEPALLY, M.D.'s 1,730 claims are below the specialty average of 2,984.

Nearby Interventional Cardiology Physician Providers in Tennessee

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

Compare Interventional Cardiology Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is RAJ BALJEPALLY, M.D.'s specialty?
RAJ BALJEPALLY, M.D. specializes in Interventional Cardiology Physician and practices in KNOXVILLE, Tennessee. Credentials: M.D..
How much does RAJ BALJEPALLY, M.D. prescribe under Medicare Part D?
In 2023, RAJ BALJEPALLY, M.D. wrote 1,730 Medicare Part D claims totaling $436K in drug costs for 279 beneficiaries.
What is RAJ BALJEPALLY, M.D.'s Medicare quality score?
RAJ BALJEPALLY, M.D. has a CMS MIPS Final Score of 95.6914/100 (Quality: 85.2885). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is RAJ BALJEPALLY, M.D. located?
RAJ BALJEPALLY, M.D. is located at 1940 ALCOA HWY, KNOXVILLE, TN, 37920. Phone: (865) 544-2800.
What is RAJ BALJEPALLY, M.D.'s NPI number?
RAJ BALJEPALLY, M.D.'s National Provider Identifier (NPI) is 1598766370, issued on 08/03/2005.
Does RAJ BALJEPALLY, M.D. prescribe more brand-name or generic drugs?
RAJ BALJEPALLY, M.D.'s prescribing is 22% brand-name and 78% generic drugs by claim count, with $396K in brand drug costs.
How many Interventional Cardiology Physician providers are there in the US?
There are 3,382 Interventional Cardiology Physician providers across 53 states in the US. The average Interventional Cardiology Physician provider writes 2,984 Medicare Part D claims per year.
What drugs does RAJ BALJEPALLY, M.D. prescribe most often?
Based on 2023 Medicare Part D data, RAJ BALJEPALLY, M.D.'s most frequently prescribed drugs include Eliquis, Atorvastatin Calcium, Metoprolol Tartrate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does RAJ BALJEPALLY, M.D. accept Medicare?
RAJ BALJEPALLY, M.D. appears in CMS Medicare data with 1,730 Part D claims and 279 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify RAJ BALJEPALLY, M.D.'s credentials?
RAJ BALJEPALLY, M.D.'s NPI is 1598766370 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

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