NPI registry status
Active
2026 NPPES data Family Nurse Practitioner NPI 1558818856
Verify on CMS → Shanthi Balaraman
Family Nurse Practitioner in Hockessin, Delaware.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 209,817 in Family Nurse Practitioner, 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
6K
Medicare Part D claims · 837 beneficiaries · Family Nurse Practitioner avg: 1K
Generic prescribing
90%
generic claims · 9% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
62/100
▼ 21 pts below national avg 83.1 · Mid-tier
Industry payments
$157.38
8 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
Shanthi Balaraman reported a CMS MIPS final score of 62/100 - below the 83.1 national average - and filed 5,542 Medicare Part D claims in 2023.
- 62/100
- MIPS score · -21 vs avg
- 6K
- Part D claims, 2023
- 90%
- generic prescribing
- $157.38
- 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.
Shanthi Balaraman's MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
62 6th percentile higher than 6% 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 Shanthi Balaraman sits
This provider among family nurse practitioner peers
Across the 27,154 family nurse practitioner providers who report both Medicare Part D prescribing and a MIPS quality score, Shanthi Balaraman writes more Part D claims than 96% of them and scores higher on MIPS quality than 5% - placing this provider in the high-volume, lower-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 family nurse practitioner peer from a representative sample of 60; the gold marker is Shanthi Balaraman. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
What does the federal data show about Shanthi Balaraman?
Below national averagePrimary specialty
Family Nurse Practitioner
Medicare Part D claims
5,542 354% vs specialty avg
MIPS final score
62/100 21.1 pts vs avg
Specialty distribution in Delaware
How Family Nurse Practitioner compares to other specialties among Delaware providers
Medicare quality performance, MIPS
Shanthi Balaraman's 2023 MIPS final score plotted against the Family Nurse Practitioner national average
- MIPS Final Score
- 62/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Family Nurse Practitioner) - 62/100 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).
Shanthi Balaraman appears in the CMS NPPES registry as a Family Nurse Practitioner provider at 5936 LIMESTONE RD, Hockessin, DE, 19707, with a listed phone of (302) 239-4500. NPI 1558818856 was issued on 09/02/2016.
Medicare Part D records for calendar year 2023 show 5,542 prescription claims written by this provider, covering 837 Medicare beneficiaries and totaling roughly $356K in drug spend, split 9% brand-name and 90% generic by claim count, with an opioid prescribing rate of 0.3%. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 62/100 for the 2023 performance year (Quality 81), compared with the national average of 83.1.
Family Nurse Practitioner is a high-volume specialty nationwide, with 209,817 enrolled providers across 56 states and an average of 1,222 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 | 1558818856 |
|---|---|
| Specialty | Family Nurse Practitioner |
| Gender | Female |
| NPI Issued | 09/02/2016 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
62.0217
Final Score
Avg: 83.1
81.0323
Quality
0
Promoting Interoperability
Reporting: Alternative Payment Model
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 Shanthi Balaraman. Source: openpaymentsdata.cms.gov.
Total received
$157
Largest payer
ABBVIE 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.
Brand vs generic prescribing mix · Generic-heavy
Shanthi Balaraman - brand share 9.0%
Family Nurse Practitioner average
9% brand-name claims vs 90% generic, on 5,542 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.
5,542
Total Claims
$356K
Total Drug Cost
837
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 13,050
- Total Day Supply
- 378,417
- Brand vs Generic
- 9% brand / 90% generic
- Brand Drug Cost
- $262K
- Generic Drug Cost
- $92K
- Opioid Claims
- 19 (0.3% rate)
- Antibiotic Claims
- 246
Patient Demographics
- Average Patient Age
- 73.8 years
- Avg HCC Risk Score
- 1.00
- Gender Split
- 53% female / 47% male
- Age Distribution
- <65: 58, 65-74: 405, 75-84: 280, 85+: 94
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Shanthi Balaraman prescribes most
Top Medicare Part D drugs by claim count, 2023
- Atorvastatin Calcium
Atorvastatin Calcium
496 claims
- Levothyroxine Sodium
Levothyroxine Sodium
301 claims
- Lisinopril 193
Lisinopril
193 claims
- Omeprazole 183
Omeprazole
183 claims
- Alprazolam 182
Alprazolam
182 claims
- Escitalopram Oxalate 147
Escitalopram Oxalate
147 claims
- Rosuvastatin Calcium 139
Rosuvastatin Calcium
139 claims
- Simvastatin 132
Simvastatin
132 claims
| Drug | Claims |
|---|---|
| Atorvastatin Calcium | 496 |
| Levothyroxine Sodium | 301 |
| Lisinopril | 193 |
| Omeprazole | 183 |
| Alprazolam | 182 |
| Escitalopram Oxalate | 147 |
| Rosuvastatin Calcium | 139 |
| Simvastatin | 132 |
| Amlodipine Besylate | 131 |
| Hydrochlorothiazide | 128 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Family Nurse Practitioner Overview
How Shanthi Balaraman fits within the Family Nurse Practitioner landscape nationally.
209,817
Family Nurse Practitioner Providers in US
56
States with Family Nurse Practitioner
1,222
Avg Claims per Provider
Shanthi Balaraman's 5,542 claims are above the specialty average of 1,222.
Nearby Family Nurse Practitioner Providers in Delaware
Other clinicians with the same primary specialty enrolled in Delaware, drawn from the same CMS NPPES roster as Balaraman.
Dr. Sara Abbo
CRNP
Newark, DE
Dr. Jessica Abbott
MSN FNP-BC, NP-C
Milford, DE
Dr. Jillian Abbott
FNP-C
Selbyville, DE
Dr. Jessica Abernathy-Lenowitz
NP
Selbyville, DE
Dr. Katherine Abernethy
NP-C
New Castle, DE
Compare Family Nurse Practitioner 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 Delaware medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Family Nurse Practitioner 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 Shanthi Balaraman's specialty? ▼
Shanthi Balaraman specializes in Family Nurse Practitioner and practices in Hockessin, Delaware.
How much does Shanthi Balaraman prescribe under Medicare Part D? ▼
In 2023, Shanthi Balaraman wrote 5,542 Medicare Part D claims totaling $356K in drug costs for 837 beneficiaries.
What is Shanthi Balaraman's Medicare quality score? ▼
Shanthi Balaraman has a CMS MIPS Final Score of 62/100 (Quality: 81). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Shanthi Balaraman located? ▼
Shanthi Balaraman is located at 5936 LIMESTONE RD, Hockessin, DE, 19707. Phone: (302) 239-4500.
What is Shanthi Balaraman's NPI number? ▼
Shanthi Balaraman's National Provider Identifier (NPI) is 1558818856, issued on 09/02/2016.
Does Shanthi Balaraman prescribe more brand-name or generic drugs? ▼
Shanthi Balaraman's prescribing is 9% brand-name and 90% generic drugs by claim count, with $262K in brand drug costs.
Does Shanthi Balaraman prescribe opioids? ▼
Yes, Shanthi Balaraman had 19 opioid claims in 2023 with an opioid prescribing rate of 0.3%.
How many Family Nurse Practitioner providers are there in the US? ▼
There are 209,817 Family Nurse Practitioner providers across 56 states in the US. The average Family Nurse Practitioner provider writes 1,222 Medicare Part D claims per year.
What drugs does Shanthi Balaraman prescribe most often? ▼
Based on 2023 Medicare Part D data, Shanthi Balaraman's most frequently prescribed drugs include Atorvastatin Calcium, Levothyroxine Sodium, Lisinopril. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Shanthi Balaraman accept Medicare? ▼
Shanthi Balaraman appears in CMS Medicare data with 5,542 Part D claims and 837 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Shanthi Balaraman's credentials? ▼
Shanthi Balaraman's NPI is 1558818856. 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.