2026 NPPES data Medical Physician Assistant NPI 1023572849 PA
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SARAH BALKCOM, PA

Medical Physician Assistant in CUMMING, 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
795
Medicare Part D claims · 350 beneficiaries · Medical Physician Assistant avg: 1K
Generic prescribing
94%
generic claims · 6% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
92.9348/100
▲ 10 pts above national avg 83.1 · [object Object]
Industry payments
$2.0K
105 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

SARAH BALKCOM, PA reported a CMS MIPS final score of 92.9348/100 — above the 83.1 national average — and filed 795 Medicare Part D claims in 2023.

92.9348/100
MIPS score · +10 vs avg
795
Part D claims, 2023
94%
generic prescribing
$2.0K
industry payments (Sunshine Act)

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.

SARAH BALKCOM, PA's MIPS score vs every scored U.S. clinician

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

93 Top 32% higher than 68% 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

What does the federal data show about SARAH BALKCOM, PA?

High performer (top quartile)

NPI registry status

Active

Issued 01/25/2019

NPI 1023572849

Primary specialty

Medical Physician Assistant

Mid-sized

40,527 US NPIs in this specialty

Medicare Part D claims

795 26% vs specialty avg

2023 prescription claims

Specialty avg: 1,077

MIPS final score

92.9348/100 9.834800000000001% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Georgia

How Medical Physician Assistant compares to other specialties among Georgia providers

Georgia providers

Medical Physician Assistant share within Georgia

1. Medical Physician Assistant42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Medical Physician Assistant share within Georgia

Medicare quality performance — MIPS

SARAH BALKCOM, PA's 2023 MIPS final score plotted against the Medical Physician Assistant national average

High performer (top quartile)
MIPS Final Score
92.9348/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Medical Physician Assistant) — 92.9348/100 vs national avg 83.1

0%100%National avg83%92.9%
MIPS final score (Medical Physician Assistant) — 92.9348/100 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).

SARAH BALKCOM, PA appears in the CMS NPPES registry as a Medical Physician Assistant provider holding PA credentials at 1800 NORTHSIDE FORSYTH DR STE 450, CUMMING, GA, 30041, with a listed phone of (770) 442-1911. NPI 1023572849 was issued on 01/25/2019. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BALKCOM 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 795 prescription claims written by this provider, covering 350 Medicare beneficiaries and totaling roughly $324K in drug spend, split 6% brand-name and 94% 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 92.9348/100 for the 2023 performance year (Quality 80.3814), compared with the national average of 83.1.

Medical Physician Assistant is a mid-sized specialty nationwide, with 40,527 enrolled providers across 55 states and an average of 1,077 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

1800 NORTHSIDE FORSYTH DR STE 450
CUMMING, GA 30041

Provider Details

NPI 1023572849
Specialty Medical Physician Assistant
Credentials PA
Gender Female
NPI Issued 01/25/2019

CMS Quality Score (MIPS)

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

92.9348
Final Score
Avg: 83.1
80.3814
Quality
100
Promoting Interoperability

Reporting: Alternative Payment Model

Hospital and facility affiliations

Facilities where SARAH BALKCOM, PA 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.

METRODERM, P.C.
DEMOREST, 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 SARAH BALKCOM, PA. Source: openpaymentsdata.cms.gov.

Total received

$2.0K

Largest payer

E.R. Squibb & Sons, L.L.C.

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 · Generic-heavy

SARAH BALKCOM, PA — brand share 6.0%
Specialty average (est.)

6% brand-name claims vs 94% generic, on 795 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.

795
Total Claims
$324K
Total Drug Cost
350
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
843
Total Day Supply
21,471
Brand vs Generic
6% brand / 94% generic
Brand Drug Cost
$304K
Generic Drug Cost
$19K
Antibiotic Claims
47

Patient Demographics

Average Patient Age
73.4 years
Avg HCC Risk Score
1.17
Gender Split
64% female / 36% male
Age Distribution
<65: 34, 65-74: 152, 75-84: 127, 85+: 37

Top Prescribed Drugs (Medicare Part D)

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

What SARAH BALKCOM, PA 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
Ketoconazole
154
Triamcinolone Acetonide
130
Mupirocin
92
Hydrocortisone
90
Fluocinonide
48
Doxycycline Hyclate
38
Clobetasol Propionate
35
Fluorouracil
28
Ciclopirox
24
Metronidazole
18

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

Medical Physician Assistant Overview

How SARAH BALKCOM, PA fits within the Medical Physician Assistant landscape nationally.

40,527
Medical Physician Assistant Providers in US
55
States with Medical Physician Assistant
1,077
Avg Claims per Provider

SARAH BALKCOM, PA's 795 claims are below the specialty average of 1,077.

Nearby Medical Physician Assistant Providers in Georgia

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

Compare Medical Physician Assistant nationally: see state-by-state distribution →

Frequently Asked Questions

What is SARAH BALKCOM, PA's specialty?
SARAH BALKCOM, PA specializes in Medical Physician Assistant and practices in CUMMING, Georgia. Credentials: PA.
How much does SARAH BALKCOM, PA prescribe under Medicare Part D?
In 2023, SARAH BALKCOM, PA wrote 795 Medicare Part D claims totaling $324K in drug costs for 350 beneficiaries.
What is SARAH BALKCOM, PA's Medicare quality score?
SARAH BALKCOM, PA has a CMS MIPS Final Score of 92.9348/100 (Quality: 80.3814). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is SARAH BALKCOM, PA located?
SARAH BALKCOM, PA is located at 1800 NORTHSIDE FORSYTH DR STE 450, CUMMING, GA, 30041. Phone: (770) 442-1911.
What is SARAH BALKCOM, PA's NPI number?
SARAH BALKCOM, PA's National Provider Identifier (NPI) is 1023572849, issued on 01/25/2019.
Does SARAH BALKCOM, PA prescribe more brand-name or generic drugs?
SARAH BALKCOM, PA's prescribing is 6% brand-name and 94% generic drugs by claim count, with $304K in brand drug costs.
How many Medical Physician Assistant providers are there in the US?
There are 40,527 Medical Physician Assistant providers across 55 states in the US. The average Medical Physician Assistant provider writes 1,077 Medicare Part D claims per year.
What drugs does SARAH BALKCOM, PA prescribe most often?
Based on 2023 Medicare Part D data, SARAH BALKCOM, PA's most frequently prescribed drugs include Ketoconazole, Triamcinolone Acetonide, Mupirocin. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does SARAH BALKCOM, PA accept Medicare?
SARAH BALKCOM, PA appears in CMS Medicare data with 795 Part D claims and 350 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify SARAH BALKCOM, PA's credentials?
SARAH BALKCOM, PA's NPI is 1023572849 with credentials PA. 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