2026 NPPES data Internal Medicine Physician NPI 1417062357 MD
Verify on CMS →

ROBERT FALES, MD

Internal Medicine Physician in MIDDLETOWN, Connecticut. 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
6K
Medicare Part D claims · 457 beneficiaries · Internal Medicine Physician avg: 3K
Generic prescribing
91%
generic claims · 9% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
22.4178/100
▼ 61 pts below national avg 83.1 · [object Object]

What the federal data shows

ROBERT FALES, MD reported a CMS MIPS final score of 22.4178/100 — below the 83.1 national average — and filed 6,474 Medicare Part D claims in 2023.

22.4178/100
MIPS score · -61 vs avg
6K
Part D claims, 2023
91%
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.

ROBERT FALES, MD's MIPS score vs every scored U.S. clinician

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

22 3rd percentile higher than 3% 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%). This entry sits in this band. 30–40: 2,746 scored providers (1%). Above this entry. 40–50: 2,928 scored providers (1%). Above this entry. 50–60: 5,882 scored providers (1%). Above this entry. 60–70: 13,906 scored providers (3%). Above this entry. 70–80: 118,074 scored providers (25%). Above this entry. 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

Board certification likely (heuristic — not verified)

ROBERT FALES, 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 ROBERT FALES, MD?

Below national average

NPI registry status

Active

Issued 08/20/2006

NPI 1417062357

Primary specialty

Internal Medicine Physician

High-volume

172,858 US NPIs in this specialty

Medicare Part D claims

6,474 138% vs specialty avg

2023 prescription claims

Specialty avg: 2,716

MIPS final score

22.4178/100 60.682199999999995% pts

Below average band

vs 83.1 national avg

Specialty distribution in Connecticut

How Internal Medicine Physician compares to other specialties among Connecticut providers

Connecticut providers

Internal Medicine Physician share within Connecticut

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

Medicare quality performance — MIPS

ROBERT FALES, MD's 2023 MIPS final score plotted against the Internal Medicine Physician national average

Below national average
MIPS Final Score
22.4178/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Internal Medicine Physician) — 22.4178/100 vs national avg 83.1

0%100%National avg83%22.4%
MIPS final score (Internal Medicine Physician) — 22.4178/100 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).

ROBERT FALES, MD appears in the CMS NPPES registry as a Internal Medicine Physician provider holding MD credentials at 85 CHURCH ST, MIDDLETOWN, CT, 06457, with a listed phone of (860) 344-8606. NPI 1417062357 was issued on 08/20/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what FALES 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 6,474 prescription claims written by this provider, covering 457 Medicare beneficiaries and totaling roughly $429K in drug spend, split 9% brand-name and 91% generic by claim count, with an opioid prescribing rate of 0.9%. 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 22.4178/100 for the 2023 performance year (Quality 0, Cost 74.726), compared with the national average of 83.1.

Internal Medicine Physician is a high-volume specialty nationwide, with 172,858 enrolled providers across 56 states and an average of 2,716 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

85 CHURCH ST
MIDDLETOWN, CT 06457

Provider Details

NPI 1417062357
Specialty Internal Medicine Physician
Credentials MD
Gender Male
NPI Issued 08/20/2006

CMS Quality Score (MIPS)

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

22.4178
Final Score
Avg: 83.1
0
Quality
74.726
Cost

Reporting: Individual

Brand vs generic prescribing mix · Generic-heavy

ROBERT FALES, MD — brand share 9.0%
Specialty average (est.)

9% brand-name claims vs 91% generic, on 6,474 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.

6,474
Total Claims
$429K
Total Drug Cost
457
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
12,131
Total Day Supply
344,075
Brand vs Generic
9% brand / 91% generic
Brand Drug Cost
$284K
Generic Drug Cost
$143K
Opioid Claims
56 (0.9% rate)
Antibiotic Claims
233

Patient Demographics

Average Patient Age
74.4 years
Avg HCC Risk Score
0.90
Gender Split
46% female / 54% male
Age Distribution
<65: 40, 65-74: 174, 75-84: 178, 85+: 65

Top Prescribed Drugs (Medicare Part D)

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

What ROBERT FALES, 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
Atorvastatin Calcium
312
Lisinopril
278
Metformin Hcl
251
Tamsulosin Hcl
223
Hydrochlorothiazide
219
Simvastatin
201
Omeprazole
192
Levothyroxine Sodium
189
Amlodipine Besylate
149
Alprazolam
132

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

Internal Medicine Physician Overview

How ROBERT FALES, MD fits within the Internal Medicine Physician landscape nationally.

172,858
Internal Medicine Physician Providers in US
56
States with Internal Medicine Physician
2,716
Avg Claims per Provider

ROBERT FALES, MD's 6,474 claims are above the specialty average of 2,716.

Nearby Internal Medicine Physician Providers in Connecticut

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

Compare Internal Medicine Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is ROBERT FALES, MD's specialty?
ROBERT FALES, MD specializes in Internal Medicine Physician and practices in MIDDLETOWN, Connecticut. Credentials: MD.
How much does ROBERT FALES, MD prescribe under Medicare Part D?
In 2023, ROBERT FALES, MD wrote 6,474 Medicare Part D claims totaling $429K in drug costs for 457 beneficiaries.
What is ROBERT FALES, MD's Medicare quality score?
ROBERT FALES, MD has a CMS MIPS Final Score of 22.4178/100 (Quality: 0, Cost: 74.726). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is ROBERT FALES, MD located?
ROBERT FALES, MD is located at 85 CHURCH ST, MIDDLETOWN, CT, 06457. Phone: (860) 344-8606.
What is ROBERT FALES, MD's NPI number?
ROBERT FALES, MD's National Provider Identifier (NPI) is 1417062357, issued on 08/20/2006.
Does ROBERT FALES, MD prescribe more brand-name or generic drugs?
ROBERT FALES, MD's prescribing is 9% brand-name and 91% generic drugs by claim count, with $284K in brand drug costs.
Does ROBERT FALES, MD prescribe opioids?
Yes, ROBERT FALES, MD had 56 opioid claims in 2023 with an opioid prescribing rate of 0.9%.
How many Internal Medicine Physician providers are there in the US?
There are 172,858 Internal Medicine Physician providers across 56 states in the US. The average Internal Medicine Physician provider writes 2,716 Medicare Part D claims per year.
What drugs does ROBERT FALES, MD prescribe most often?
Based on 2023 Medicare Part D data, ROBERT FALES, MD's most frequently prescribed drugs include Atorvastatin Calcium, Lisinopril, Metformin Hcl. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does ROBERT FALES, MD accept Medicare?
ROBERT FALES, MD appears in CMS Medicare data with 6,474 Part D claims and 457 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify ROBERT FALES, MD's credentials?
ROBERT FALES, MD's NPI is 1417062357 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