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2026 NPPES data Gastroenterology Physician NPI 1912311325 M.D.
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Sean Bhalla, M.D.

Gastroenterology Physician in Aurora, Colorado.

This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 16,601 in Gastroenterology 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
230
Medicare Part D claims · 125 beneficiaries · Gastroenterology Physician avg: 833
Generic prescribing
92%
generic claims · 8% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
100/100
▲ 17 pts above national avg 83.5 · Exceptional
Industry payments
$1.3K
12 payments · CMS Open Payments (Sunshine Act)
Verify NPI on CMS Methodology
Compiled from official public sources by the editorial process.

What the federal data shows

Sean Bhalla, M.D. reported a CMS MIPS final score of 100/100 - above the 83.5 national average - and filed 230 Medicare Part D claims in 2023.

100/100
MIPS score · +17 vs avg
230
Part D claims, 2023
92%
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.

Federal trust snapshot

What official records show about Sean Bhalla, M.D.

Federal records show an active NPI with both Medicare prescribing volume and a measured CMS quality score — objective registry data, not patient reviews.

  • Verified

    NPI registry status

    Active listing in the CMS National Provider Identifier Registry (NPI 1912311325), first enumerated 06/13/2014.

    Source: CMS NPPES

  • Reported

    Medicare Part D participation

    Filed 230 Medicare Part D prescription claims in the 2023 CMS public use file — indicates active Medicare prescribing participation.

    Source: CMS Part D Prescriber PUF

  • Reported

    CMS quality reporting (MIPS)

    Reported a CMS MIPS final score of 100/100 in the Quality Payment Program — a federal quality measure, not a patient review.

    Source: CMS Quality Payment Program

  • Reported

    Board certification signal

    Heuristic suggests board-certified status based on ABMS-eligible specialty taxonomy plus active CMS participation signals — not a direct ABMS verification.

    Source: NUCC taxonomy + CMS participation heuristic

  • Reported

    Hospital affiliations

    2 CMS Care Compare hospital affiliations on record — practice footprint from the Doctors and Clinicians file.

    Source: CMS Care Compare

  • Reported

    Industry payment transparency

    $1.3K in reported industry payments (12 transfers) in 2024 under the federal Sunshine Act — disclosed transfers of value, not a quality rating.

    Source: CMS Open Payments

  • Not in federal data

    Individual sanction lookup

    PlainDoctor does not publish per-provider disciplinary determinations. Confirm current license and any individual actions through the state medical board or FSMB verification service.

    Source: State medical board / FSMB

This trust snapshot summarizes only what appears in federal CMS/NPPES public records. It is not a composite score, star rating, patient review, or clinical recommendation. PlainDoctor never fabricates reviews or AggregateRating schema.

CMS NPPES provider registry desk

NPI 1912311325 · Gastroenterology Physician

NPI-10 · ENUM-MID · TAX-MID · MIPS-ELITE · RX-LIGHT · BOOK-THIN · PHOTO-FINISH

  • NPI-10 1912311325
  • ENUM-MID 2014
  • TAX-MID 17K Gastroenterology Physician
  • MIPS-ELITE 100/100
  • RX-LIGHT 230
  • BOOK-THIN 263 in Colorado
  • PHOTO-FINISH Alaa Abousaif · ±0.0

MIPS final-score neighbourhood

Same-specialty nationwide peers by CMS final score, not geographic proximity

MIPS pts

What this shows Nearest measured MIPS peers for this NUCC specialty (2023 performance year).

Source CMS Quality Payment Program (MIPS) As of 2023

Sean Bhalla, M.D.'s MIPS score vs every measured U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure. Clinicians whose score CMS assigned without scoring any category are excluded.

100 ≥ 92nd percentile 92% of 454,083 measured providers are in lower value bands

0–10: 8,684 measured providers (2%). Below this entry. 10–20: 3,008 measured providers (1%). Below this entry. 20–30: 3,069 measured providers (1%). Below this entry. 30–40: 2,746 measured providers (1%). Below this entry. 40–50: 2,928 measured providers (1%). Below this entry. 50–60: 5,882 measured providers (1%). Below this entry. 60–70: 13,906 measured providers (3%). Below this entry. 70–80: 94,570 measured providers (21%). Below this entry. 80–90: 129,887 measured providers (29%). Below this entry. 90+: 189,403 measured providers (42%). This entry sits in this band. This provider 0 100 every measured MIPS clinician, bucketed by value

Each bar is a band; taller bars hold more measured 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.

The percentile is a conservative whole-score-point band: it counts only measured clinicians in lower score bands. A CMS MIPS metric is not a recommendation or a clinical-quality rating by PlainDoctor. See methodology § corpus placement.

Source CMS Merit-based Incentive Payment System (MIPS) · 2023

Where Sean Bhalla, M.D. sits

This provider among gastroenterology physician peers

Across the 5,560 gastroenterology physician providers who report both Medicare Part D prescribing and a MIPS quality score, Sean Bhalla, M.D. writes more Part D claims than 17% of them and scores higher on MIPS quality than 90% - placing this provider in the lower-volume, high-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.

Lower volume · High qualityHigh volume · High qualityLower volume · Lower qualityHigh volume · Lower quality0255075100024.949.974.899.8Part D claim volume, percentile in specialtyMIPS quality, percentilePoint, Part D claim volume, percentile in specialty: 68 · MIPS quality, percentile: 82Point, Part D claim volume, percentile in specialty: 53 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 58 · MIPS quality, percentile: 8Point, Part D claim volume, percentile in specialty: 75 · MIPS quality, percentile: 85Point, Part D claim volume, percentile in specialty: 5 · MIPS quality, percentile: 37Point, Part D claim volume, percentile in specialty: 62 · MIPS quality, percentile: 73Point, Part D claim volume, percentile in specialty: 67 · MIPS quality, percentile: 28Point, Part D claim volume, percentile in specialty: 55 · MIPS quality, percentile: 43Point, Part D claim volume, percentile in specialty: 45 · MIPS quality, percentile: 7Point, Part D claim volume, percentile in specialty: 18 · MIPS quality, percentile: 45Point, Part D claim volume, percentile in specialty: 28 · MIPS quality, percentile: 57Point, Part D claim volume, percentile in specialty: 32 · MIPS quality, percentile: 3Point, Part D claim volume, percentile in specialty: 82 · MIPS quality, percentile: 18Point, Part D claim volume, percentile in specialty: 40 · MIPS quality, percentile: 10Point, Part D claim volume, percentile in specialty: 18 · MIPS quality, percentile: 95Point, Part D claim volume, percentile in specialty: 43 · MIPS quality, percentile: 25Point, Part D claim volume, percentile in specialty: 92 · MIPS quality, percentile: 55Point, Part D claim volume, percentile in specialty: 37 · MIPS quality, percentile: 15Point, Part D claim volume, percentile in specialty: 93 · MIPS quality, percentile: 95Point, Part D claim volume, percentile in specialty: 13 · MIPS quality, percentile: 47Point, Part D claim volume, percentile in specialty: 23 · MIPS quality, percentile: 75Point, Part D claim volume, percentile in specialty: 2 · MIPS quality, percentile: 78Point, Part D claim volume, percentile in specialty: 7 · MIPS quality, percentile: 20Point, Part D claim volume, percentile in specialty: 25 · MIPS quality, percentile: 22Point, Part D claim volume, percentile in specialty: 8 · MIPS quality, percentile: 42Point, Part D claim volume, percentile in specialty: 33 · MIPS quality, percentile: 63Point, Part D claim volume, percentile in specialty: 15 · MIPS quality, percentile: 40Point, Part D claim volume, percentile in specialty: 73 · MIPS quality, percentile: 23Point, Part D claim volume, percentile in specialty: 70 · MIPS quality, percentile: 80Point, Part D claim volume, percentile in specialty: 3 · MIPS quality, percentile: 48Point, Part D claim volume, percentile in specialty: 78 · MIPS quality, percentile: 28Point, Part D claim volume, percentile in specialty: 30 · MIPS quality, percentile: 90Point, Part D claim volume, percentile in specialty: 88 · MIPS quality, percentile: 58Point, Part D claim volume, percentile in specialty: 50 · MIPS quality, percentile: 13Point, Part D claim volume, percentile in specialty: 65 · MIPS quality, percentile: 10Point, Part D claim volume, percentile in specialty: 83 · MIPS quality, percentile: 60Point, Part D claim volume, percentile in specialty: 35 · MIPS quality, percentile: 50Point, Part D claim volume, percentile in specialty: 80 · MIPS quality, percentile: 27Point, Part D claim volume, percentile in specialty: 12 · MIPS quality, percentile: 83Point, Part D claim volume, percentile in specialty: 17 · MIPS quality, percentile: 38Point, Part D claim volume, percentile in specialty: 0 · MIPS quality, percentile: 35Point, Part D claim volume, percentile in specialty: 48 · MIPS quality, percentile: 3Point, Part D claim volume, percentile in specialty: 63 · MIPS quality, percentile: 65Point, Part D claim volume, percentile in specialty: 95 · MIPS quality, percentile: 90Point, Part D claim volume, percentile in specialty: 77 · MIPS quality, percentile: 28Point, Part D claim volume, percentile in specialty: 47 · MIPS quality, percentile: 72Point, Part D claim volume, percentile in specialty: 27 · MIPS quality, percentile: 2Point, Part D claim volume, percentile in specialty: 57 · MIPS quality, percentile: 17Point, Part D claim volume, percentile in specialty: 72 · MIPS quality, percentile: 87Point, Part D claim volume, percentile in specialty: 85 · MIPS quality, percentile: 95Point, Part D claim volume, percentile in specialty: 42 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 10 · MIPS quality, percentile: 62Point, Part D claim volume, percentile in specialty: 90 · MIPS quality, percentile: 87Point, Part D claim volume, percentile in specialty: 60 · MIPS quality, percentile: 28Point, Part D claim volume, percentile in specialty: 87 · MIPS quality, percentile: 50Point, Part D claim volume, percentile in specialty: 100 · MIPS quality, percentile: 93Point, Part D claim volume, percentile in specialty: 38 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 97 · MIPS quality, percentile: 50Point, Part D claim volume, percentile in specialty: 98 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 52 · MIPS quality, percentile: 77Sean Bhalla, M.D., Part D claim volume, percentile in specialty: 17 · MIPS quality, percentile: 90
Part D claim volume vs MIPS quality, by specialty percentile

Each dot is one gastroenterology physician peer from a representative sample of 60; the gold marker is Sean Bhalla, M.D.. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.

✓
Board certification likely (heuristic, not verified)

Sean Bhalla, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 2 hospital affiliations - 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 Sean Bhalla, M.D.?

High performer (top quartile)

NPI registry status

Active

Issued 06/13/2014

NPI 1912311325

Primary specialty

Gastroenterology Physician

Mid-sized

16,601 US NPIs in this specialty

Medicare Part D claims

230 72% vs specialty avg

2023 prescription claims

Specialty avg: 833

MIPS final score

100/100 16.5 pts vs avg

Exceptional band

vs 83.5 national avg

Specialty distribution in Colorado

How Gastroenterology Physician compares to other specialties among Colorado providers

Colorado providers
Behavior Technician7.8%Mental Health Counselor6.2%Physical Therapist4.2%Clinical Social Worker4.2%Professional Counselor3.7%Registered Nurse3.6%Gastroenterology Physician0.2%
Largest specialties in Colorado (% of in-state providers)

Medicare quality performance, MIPS

Sean Bhalla, M.D.'s 2023 MIPS final score plotted against the Gastroenterology Physician national average

High performer (top quartile)
MIPS Final Score
100/100
vs 83.5 national avg · 2023 performance year
0%100%National avg84%99%
MIPS final score (Gastroenterology Physician) - 100/100 vs national avg 83.5
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).

Practice Address

1635 AURORA CT
Aurora, CO 80045
(720) 848-0000

Provider Details

NPI 1912311325
Specialty Gastroenterology Physician
Credentials M.D.
Gender Male
NPI Issued 06/13/2014

CMS Quality Score (MIPS)

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

100
Final Score
Measured-score avg: 83.5
100
Quality
100
Promoting Interoperability

Reporting: Individual

Hospital and facility affiliations

Facilities where Sean Bhalla, 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 OF Miami
Miami, FL
University Physicians Incorporated
Aurora, CO

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 Sean Bhalla, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$1.3K

Largest payer

Olympus Corporation of the Americas

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

Sean Bhalla, M.D. - brand share 8.0%
Gastroenterology Physician average

8% brand-name claims vs 92% generic, on 230 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.

230
Total Claims
$34K
Total Drug Cost
125
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
351
Total Day Supply
7,561
Brand vs Generic
8% brand / 92% generic
Brand Drug Cost
$21K
Generic Drug Cost
$12K
Antibiotic Claims
42

Patient Demographics

Average Patient Age
71.2 years
Avg HCC Risk Score
2.34
Gender Split
55% female / 45% male

Top Prescribed Drugs (Medicare Part D)

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

What Sean Bhalla, M.D. 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
Omeprazole
 30
Pantoprazole Sodium
 26
Famotidine
 14
Gavilyte-G
"Peg3350/Sod Sulf
N/A

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

More Gastroenterology Physician in CO → All providers in Colorado → Compare specialties →

Gastroenterology Physician Overview

How Sean Bhalla, M.D. fits within the Gastroenterology Physician landscape nationally.

16,601
Gastroenterology Physician Providers in US
54
States with Gastroenterology Physician
833
Avg Claims per Provider

Sean Bhalla, M.D.'s 230 claims are below the specialty average of 833.

Nationwide Gastroenterology Physician peers with similar MIPS or enrollment year

Two federal-record peer sets for Bhalla, both outside Colorado so the neighborhoods are not geographic containment.

Similar MIPS final score

Nearest same-specialty clinicians by CMS MIPS final score (100 here).

Alaa Abousaif 100 CA Thomas Aguirre 100 CA Lydia Aye 100 CA Hadiatou Barry 100 AZ

Same NPPES enumeration year (2014)

Same-specialty clinicians who entered the NPI registry in the same calendar year, outside this state.

Sameet Shah Verona, NJ Kylie Swearingen Nashville, TN Shria Kumar Miami, FL James Campbell Plymouth, MN

Nearby Gastroenterology Physician Providers in Colorado

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

One of 263 Gastroenterology Physician providers enrolled in Colorado, 5 are shown here.

Dr. David Adams
MD
U S A F Academy, CO
Dr. Douglas Adler
M.D.
Colorado Springs, CO
Abdullah Al-Shahrani
Aurora, CO
Dr. Sam Anouna
M.D.
Thornton, CO
Dr. Kevin Ashby
M.D.
Durango, CO

Compare Gastroenterology Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is Sean Bhalla, M.D.'s specialty? ▼
Sean Bhalla, M.D. specializes in Gastroenterology Physician and practices in Aurora, Colorado. Credentials: M.D..
How much does Sean Bhalla, M.D. prescribe under Medicare Part D? ▼
In 2023, Sean Bhalla, M.D. wrote 230 Medicare Part D claims totaling $34K in drug costs for 125 beneficiaries.
What is Sean Bhalla, M.D.'s Medicare quality score? ▼
Sean Bhalla, M.D. has a CMS MIPS Final Score of 100/100 (Quality: 100). The average MIPS Final Score across the 454,083 clinicians with at least one published category score is 83.5; clinicians whose score CMS assigned without scoring any category are excluded from that average. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Sean Bhalla, M.D. located? ▼
Sean Bhalla, M.D. is located at 1635 AURORA CT, Aurora, CO, 80045. Phone: (720) 848-0000.
What is Sean Bhalla, M.D.'s NPI number? ▼
Sean Bhalla, M.D.'s National Provider Identifier (NPI) is 1912311325, issued on 06/13/2014.
Does Sean Bhalla, M.D. prescribe more brand-name or generic drugs? ▼
Sean Bhalla, M.D.'s prescribing is 8% brand-name and 92% generic drugs by claim count, with $21K in brand drug costs.
How many Gastroenterology Physician providers are there in the US? ▼
There are 16,601 Gastroenterology Physician providers across 54 states in the US. The average Gastroenterology Physician provider writes 833 Medicare Part D claims per year.
What drugs does Sean Bhalla, M.D. prescribe most often? ▼
Based on 2023 Medicare Part D data, Sean Bhalla, M.D.'s most frequently prescribed drugs include Omeprazole, Pantoprazole Sodium, Famotidine. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Sean Bhalla, M.D. accept Medicare? ▼
Sean Bhalla, M.D. appears in CMS Medicare data with 230 Part D claims and 125 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Sean Bhalla, M.D.'s credentials? ▼
Sean Bhalla, M.D.'s NPI is 1912311325 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

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 editorial process.

Every figure on PlainDoctor is rendered directly from the federal CMS NPPES registry, Medicare Part D, MIPS, and Open Payments records, no number is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of May 2026.