NPI registry status
Active
2026 NPPES data Rheumatology Physician NPI 1659427334 MD
Verify on CMS → Robert Koval, MD
Rheumatology Physician in Austin, Texas.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 6,181 in Rheumatology 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
3K
Medicare Part D claims · 602 beneficiaries · Rheumatology Physician avg: 2K
Generic prescribing
80%
generic claims · 19% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
89/100
▲ 6 pts above national avg 83.1 · Above neutral
Industry payments
$45.6K
275 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
Robert Koval, MD reported a CMS MIPS final score of 89/100 - above the 83.1 national average - and filed 3,305 Medicare Part D claims in 2023.
- 89/100
- MIPS score · +6 vs avg
- 3K
- Part D claims, 2023
- 80%
- 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 Koval, MD's MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
89 Top 44% higher than 56% 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 Robert Koval, MD sits
This provider among rheumatology physician peers
Across the 2,181 rheumatology physician providers who report both Medicare Part D prescribing and a MIPS quality score, Robert Koval, MD writes more Part D claims than 76% of them and scores higher on MIPS quality than 59% - placing this provider in the high-volume, high-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 rheumatology physician peer from a representative sample of 60; the gold marker is Robert Koval, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Robert Koval, 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 Robert Koval, MD?
High performer (top quartile)Primary specialty
Rheumatology Physician
Medicare Part D claims
3,305 61% vs specialty avg
MIPS final score
89/100 5.9 pts vs avg
Specialty distribution in Texas
How Rheumatology Physician compares to other specialties among Texas providers
Medicare quality performance, MIPS
Robert Koval, MD's 2023 MIPS final score plotted against the Rheumatology Physician national average
- MIPS Final Score
- 89/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Rheumatology Physician) - 89/100 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).
Robert Koval, MD appears in the CMS NPPES registry as a Rheumatology Physician provider holding MD credentials at 4700 SETON CENTER PKWY, Austin, TX, 78759, with a listed phone of (512) 439-1000. NPI 1659427334 was issued on 01/26/2007.
Medicare Part D records for calendar year 2023 show 3,305 prescription claims written by this provider, covering 602 Medicare beneficiaries and totaling roughly $3.7 million in drug spend, split 19% brand-name and 80% generic by claim count, with an opioid prescribing rate of 7.4%. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 89/100 for the 2023 performance year (Quality 79.9), compared with the national average of 83.1.
Rheumatology Physician is a mid-sized specialty nationwide, with 6,181 enrolled providers across 52 states and an average of 2,054 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 | 1659427334 |
|---|---|
| Specialty | Rheumatology Physician |
| Credentials | MD |
| Gender | Male |
| NPI Issued | 01/26/2007 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
88.952
Final Score
Avg: 83.1
79.9127
Quality
100
Promoting Interoperability
Reporting: Individual
Hospital and facility affiliations
Facilities where Robert Koval, 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.
Ortholonestar PLLC
Austin, TX
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 Robert Koval, MD. Source: openpaymentsdata.cms.gov.
Total received
$45.6K
Largest payer
Janssen Biotech, 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 - Texas TMB 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 ~77K Texas medical licensees in 2023 - they are NOT specific to Robert Koval, MD. To verify Robert Koval, MD's current license status, search the TMB public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.
344
Total board actions, Texas 2023
Across 334 cases
4.47
Actions per 1,000 licensees
Texas statewide rate
probation
Most common action type
94 cases
TMB 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 Texas disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.
Brand vs generic prescribing mix · Typical
Robert Koval, MD - brand share 19.0%
Rheumatology Physician average
19% brand-name claims vs 80% generic, on 3,305 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.
3,305
Total Claims
$3.7M
Total Drug Cost
602
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 5,939
- Total Day Supply
- 173,735
- Brand vs Generic
- 19% brand / 80% generic
- Brand Drug Cost
- $3.7M
- Generic Drug Cost
- $81K
- Opioid Claims
- 245 (7.4% rate)
Patient Demographics
- Average Patient Age
- 72.2 years
- Avg HCC Risk Score
- 1.59
- Gender Split
- 74% female / 26% male
- Age Distribution
- <65: 66, 65-74: 302, 75-84: 200, 85+: 34
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Robert Koval, MD prescribes most
Top Medicare Part D drugs by claim count, 2023
- Methotrexate
Methotrexate
429 claims
- Prednisone
Prednisone
428 claims
- Hydroxychloroquine…
Hydroxychloroquine Sulfate
301 claims
- Tramadol Hcl
Tramadol Hcl
228 claims
- Meloxicam 154
Meloxicam
154 claims
- Gabapentin 132
Gabapentin
132 claims
- Alendronate Sodium 116
Alendronate Sodium
116 claims
- Allopurinol 106
Allopurinol
106 claims
| Drug | Claims |
|---|---|
| Methotrexate Methotrexate Sodium | 429 |
| Prednisone | 428 |
| Hydroxychloroquine Sulfate | 301 |
| Tramadol Hcl | 228 |
| Meloxicam | 154 |
| Gabapentin | 132 |
| Alendronate Sodium | 116 |
| Allopurinol | 106 |
| Enbrel Sureclick Etanercept | 106 |
| Leflunomide | 104 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Rheumatology Physician Overview
How Robert Koval, MD fits within the Rheumatology Physician landscape nationally.
6,181
Rheumatology Physician Providers in US
52
States with Rheumatology Physician
2,054
Avg Claims per Provider
Robert Koval, MD's 3,305 claims are above the specialty average of 2,054.
Nearby Rheumatology Physician Providers in Texas
Other clinicians with the same primary specialty enrolled in Texas, drawn from the same CMS NPPES roster as Koval.
Dr. Michael Abel
MD
Fredericksburg, TX
Dr. Tareq Abou-Khamis
M.D.
Houston, TX
Dr. Robert Abresch
M.D.
El Paso, TX
Dr. Sampada Acharya
MD
Fort Worth, TX
Dr. Waffiyah Afridi
M.D.
Farmers Branch, TX
Compare Rheumatology 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 Texas medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Rheumatology 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 Robert Koval, MD's specialty? ▼
Robert Koval, MD specializes in Rheumatology Physician and practices in Austin, Texas. Credentials: MD.
How much does Robert Koval, MD prescribe under Medicare Part D? ▼
In 2023, Robert Koval, MD wrote 3,305 Medicare Part D claims totaling $3.7M in drug costs for 602 beneficiaries.
What is Robert Koval, MD's Medicare quality score? ▼
Robert Koval, MD has a CMS MIPS Final Score of 89/100 (Quality: 79.9). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Robert Koval, MD located? ▼
Robert Koval, MD is located at 4700 SETON CENTER PKWY, Austin, TX, 78759. Phone: (512) 439-1000.
What is Robert Koval, MD's NPI number? ▼
Robert Koval, MD's National Provider Identifier (NPI) is 1659427334, issued on 01/26/2007.
Does Robert Koval, MD prescribe more brand-name or generic drugs? ▼
Robert Koval, MD's prescribing is 19% brand-name and 80% generic drugs by claim count, with $3.7M in brand drug costs.
Does Robert Koval, MD prescribe opioids? ▼
Yes, Robert Koval, MD had 245 opioid claims in 2023 with an opioid prescribing rate of 7.4%.
How many Rheumatology Physician providers are there in the US? ▼
There are 6,181 Rheumatology Physician providers across 52 states in the US. The average Rheumatology Physician provider writes 2,054 Medicare Part D claims per year.
What drugs does Robert Koval, MD prescribe most often? ▼
Based on 2023 Medicare Part D data, Robert Koval, MD's most frequently prescribed drugs include Methotrexate, Prednisone, Hydroxychloroquine Sulfate. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Robert Koval, MD accept Medicare? ▼
Robert Koval, MD appears in CMS Medicare data with 3,305 Part D claims and 602 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Robert Koval, MD's credentials? ▼
Robert Koval, MD's NPI is 1659427334 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
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.