2026 NPPES data Emergency Medicine Physician NPI 1437107695 DO
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SCOTT BALONIER, DO

Emergency Medicine Physician in KETTERING, Ohio. 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
221
Medicare Part D claims · 168 beneficiaries · Emergency Medicine Physician avg: 352
MIPS score
94.6395/100
▲ 12 pts above national avg 83.1 · [object Object]
What the federal data reveals: SCOTT BALONIER, DO is a Emergency Medicine Physician ([object Object]) practicing in KETTERING, Ohio with a Medicare Part D prescribing footprint of 221 claims across 168 beneficiaries . Their CMS MIPS Final Score of 94.6395/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities .

What stands out: SCOTT BALONIER, DO reported a CMS MIPS final score of 94.6395 out of 100, above the 83.1 national average, and filed 221 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)

SCOTT BALONIER, DO 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).

SCOTT BALONIER, DO at a glance

High performer (top quartile)

NPI registry status

Active

Issued 05/04/2006

NPI 1437107695

Primary specialty

Emergency Medicine Physician

High-volume

64,398 US NPIs in this specialty

Medicare Part D claims

221 37% vs specialty avg

2023 prescription claims

Specialty avg: 352

MIPS final score

94.6395/100 11.539500000000004% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Ohio

How Emergency Medicine Physician compares to other specialties among Ohio providers

Ohio providers

Emergency Medicine Physician share within Ohio

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

Medicare quality performance — MIPS

SCOTT BALONIER, DO's 2023 MIPS final score plotted against the Emergency Medicine Physician national average

High performer (top quartile)
MIPS Final Score
94.6395/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Emergency Medicine Physician) — 94.6395/100 vs national avg 83.1

0%100%National avg83%94.6%
MIPS final score (Emergency Medicine Physician) — 94.6395/100 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).

SCOTT BALONIER, DO is a Emergency Medicine Physician provider practicing in KETTERING, Ohio, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: DO. NPI: 1437107695. 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.

SCOTT BALONIER, DO appears in the CMS NPPES registry as a Emergency Medicine Physician provider holding DO credentials at 3535 SOUTHERN BLVD, KETTERING, OH, 45429, with a listed phone of (937) 436-4658. NPI 1437107695 was issued on 05/04/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BALONIER 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 221 prescription claims written by this provider, covering 168 Medicare beneficiaries and totaling roughly $5K in drug spend, with an opioid prescribing rate of 7.7%. 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 94.6395/100 for the 2023 performance year (Quality 90.644), 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

3535 SOUTHERN BLVD
KETTERING, OH 45429

Provider Details

NPI 1437107695
Specialty Emergency Medicine Physician
Credentials DO
Gender Male
NPI Issued 05/04/2006

CMS Quality Score (MIPS)

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

94.6395
Final Score
Avg: 83.1
90.644
Quality

Reporting: Group practice

Hospital and facility affiliations

Facilities where SCOTT BALONIER, DO 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.

EMERGENCY MEDICINE SPECIALISTS INC
KETTERING, OH

Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).

License & disciplinary context — Ohio OMB 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 ~48K Ohio medical licensees in 2023 — they are NOT specific to SCOTT BALONIER, DO. To verify SCOTT BALONIER, DO's current license status, search the OMB public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

158
Total board actions, Ohio 2023
Across 154 cases
3.29
Actions per 1,000 licensees
Ohio statewide rate
probation
Most common action type
56 cases

OMB 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 Ohio disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

221
Total Claims
$5K
Total Drug Cost
168
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
221
Total Day Supply
2,091
Generic Drug Cost
$2K
Opioid Claims
17 (7.7% rate)
Antibiotic Claims
98

Patient Demographics

Average Patient Age
69.1 years
Avg HCC Risk Score
1.72
Gender Split
59% female / 41% male
Age Distribution
<65: 44, 65-74: 66, 75-84: 42, 85+: 16

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Prednisone
26
Cephalexin
18
Cefuroxime
Cefuroxime Axetil
17
Amoxicillin-Clavulanate Potass
Amoxicillin/Potassium Clav
16
Sulfamethoxazole-Trimethoprim
Sulfamethoxazole/Trimethoprim
16
Hydrocodone-Acetaminophen
Hydrocodone/Acetaminophen
12

* 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 SCOTT BALONIER, DO 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

SCOTT BALONIER, DO's 221 claims are below the specialty average of 352.

Nearby Emergency Medicine Physician Providers in Ohio

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

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

Frequently Asked Questions

What is SCOTT BALONIER, DO's specialty?
SCOTT BALONIER, DO specializes in Emergency Medicine Physician and practices in KETTERING, Ohio. Credentials: DO.
How much does SCOTT BALONIER, DO prescribe under Medicare Part D?
In 2023, SCOTT BALONIER, DO wrote 221 Medicare Part D claims totaling $5K in drug costs for 168 beneficiaries.
What is SCOTT BALONIER, DO's Medicare quality score?
SCOTT BALONIER, DO has a CMS MIPS Final Score of 94.6395/100 (Quality: 90.644). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is SCOTT BALONIER, DO located?
SCOTT BALONIER, DO is located at 3535 SOUTHERN BLVD, KETTERING, OH, 45429. Phone: (937) 436-4658.
What is SCOTT BALONIER, DO's NPI number?
SCOTT BALONIER, DO's National Provider Identifier (NPI) is 1437107695, issued on 05/04/2006.
Does SCOTT BALONIER, DO prescribe opioids?
Yes, SCOTT BALONIER, DO had 17 opioid claims in 2023 with an opioid prescribing rate of 7.7%.
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 SCOTT BALONIER, DO prescribe most often?
Based on 2023 Medicare Part D data, SCOTT BALONIER, DO's most frequently prescribed drugs include Prednisone, Cephalexin, Cefuroxime. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does SCOTT BALONIER, DO accept Medicare?
SCOTT BALONIER, DO appears in CMS Medicare data with 221 Part D claims and 168 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify SCOTT BALONIER, DO's credentials?
SCOTT BALONIER, DO's NPI is 1437107695 with credentials DO. 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