2026 NPPES data Pediatrics Physician NPI 1205194693 M.D.
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SPENCER IDSTEIN, M.D.

Pediatrics Physician in PROSPECT, Kentucky. 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
3K
Medicare Part D claims · 331 beneficiaries · Pediatrics Physician avg: 762
Generic prescribing
87%
generic claims · 13% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
95.5077/100
▲ 12 pts above national avg 83.1 · [object Object]

What the federal data shows

SPENCER IDSTEIN, M.D. reported a CMS MIPS final score of 95.5077/100 — above the 83.1 national average — and filed 3,288 Medicare Part D claims in 2023.

95.5077/100
MIPS score · +12 vs avg
3K
Part D claims, 2023
87%
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.

SPENCER IDSTEIN, M.D.'s MIPS score vs every scored U.S. clinician

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

96 Top 21% higher than 79% 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

Board certification likely (heuristic — not verified)

SPENCER IDSTEIN, M.D. 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 SPENCER IDSTEIN, M.D.?

High performer (top quartile)

NPI registry status

Active

Issued 04/24/2012

NPI 1205194693

Primary specialty

Pediatrics Physician

High-volume

80,574 US NPIs in this specialty

Medicare Part D claims

3,288 331% vs specialty avg

2023 prescription claims

Specialty avg: 762

MIPS final score

95.5077/100 12.407700000000006% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Kentucky

How Pediatrics Physician compares to other specialties among Kentucky providers

Kentucky providers

Pediatrics Physician share within Kentucky

1. Pediatrics Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Pediatrics Physician share within Kentucky

Medicare quality performance — MIPS

SPENCER IDSTEIN, M.D.'s 2023 MIPS final score plotted against the Pediatrics Physician national average

High performer (top quartile)
MIPS Final Score
95.5077/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Pediatrics Physician) — 95.5077/100 vs national avg 83.1

0%100%National avg83%95.5%
MIPS final score (Pediatrics Physician) — 95.5077/100 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).

SPENCER IDSTEIN, M.D. appears in the CMS NPPES registry as a Pediatrics Physician provider holding M.D. credentials at 6341 MEETING ST STE 102, PROSPECT, KY, 40059, with a listed phone of (502) 566-0300. NPI 1205194693 was issued on 04/24/2012. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what IDSTEIN 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 3,288 prescription claims written by this provider, covering 331 Medicare beneficiaries and totaling roughly $340K in drug spend, split 13% brand-name and 87% generic by claim count, with an opioid prescribing rate of 0.8%. 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 95.5077/100 for the 2023 performance year (Quality 89.5953), compared with the national average of 83.1.

Pediatrics Physician is a high-volume specialty nationwide, with 80,574 enrolled providers across 56 states and an average of 762 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

6341 MEETING ST STE 102
PROSPECT, KY 40059

Provider Details

NPI 1205194693
Specialty Pediatrics Physician
Credentials M.D.
Gender Male
NPI Issued 04/24/2012

CMS Quality Score (MIPS)

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

95.5077
Final Score
Avg: 83.1
89.5953
Quality
100
Promoting Interoperability

Reporting: Alternative Payment Model

Hospital and facility affiliations

Facilities where SPENCER IDSTEIN, 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.

INTERNAL MEDICINE AND PEDIATRIC PARTNERS PLLC
PROSPECT, KY

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

Brand vs generic prescribing mix · Typical

SPENCER IDSTEIN, M.D. — brand share 13.0%
Specialty average (est.)

13% brand-name claims vs 87% generic, on 3,288 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.

3,288
Total Claims
$340K
Total Drug Cost
331
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
8,019
Total Day Supply
235,009
Brand vs Generic
13% brand / 87% generic
Brand Drug Cost
$275K
Generic Drug Cost
$64K
Opioid Claims
25 (0.8% rate)
Antibiotic Claims
101

Patient Demographics

Average Patient Age
73.0 years
Avg HCC Risk Score
0.98
Gender Split
48% female / 52% male
Age Distribution
<65: 20, 65-74: 173, 75-84: 120, 85+: 18

Top Prescribed Drugs (Medicare Part D)

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

What SPENCER IDSTEIN, 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
Amlodipine Besylate
223
Lisinopril
195
Rosuvastatin Calcium
178
Atorvastatin Calcium
165
Levothyroxine Sodium
155
Pantoprazole Sodium
98
Hydrochlorothiazide
86
Tamsulosin Hcl
76
Losartan Potassium
73
Jardiance
Empagliflozin
65

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

Pediatrics Physician Overview

How SPENCER IDSTEIN, M.D. fits within the Pediatrics Physician landscape nationally.

80,574
Pediatrics Physician Providers in US
56
States with Pediatrics Physician
762
Avg Claims per Provider

SPENCER IDSTEIN, M.D.'s 3,288 claims are above the specialty average of 762.

Nearby Pediatrics Physician Providers in Kentucky

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

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

Frequently Asked Questions

What is SPENCER IDSTEIN, M.D.'s specialty?
SPENCER IDSTEIN, M.D. specializes in Pediatrics Physician and practices in PROSPECT, Kentucky. Credentials: M.D..
How much does SPENCER IDSTEIN, M.D. prescribe under Medicare Part D?
In 2023, SPENCER IDSTEIN, M.D. wrote 3,288 Medicare Part D claims totaling $340K in drug costs for 331 beneficiaries.
What is SPENCER IDSTEIN, M.D.'s Medicare quality score?
SPENCER IDSTEIN, M.D. has a CMS MIPS Final Score of 95.5077/100 (Quality: 89.5953). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is SPENCER IDSTEIN, M.D. located?
SPENCER IDSTEIN, M.D. is located at 6341 MEETING ST STE 102, PROSPECT, KY, 40059. Phone: (502) 566-0300.
What is SPENCER IDSTEIN, M.D.'s NPI number?
SPENCER IDSTEIN, M.D.'s National Provider Identifier (NPI) is 1205194693, issued on 04/24/2012.
Does SPENCER IDSTEIN, M.D. prescribe more brand-name or generic drugs?
SPENCER IDSTEIN, M.D.'s prescribing is 13% brand-name and 87% generic drugs by claim count, with $275K in brand drug costs.
Does SPENCER IDSTEIN, M.D. prescribe opioids?
Yes, SPENCER IDSTEIN, M.D. had 25 opioid claims in 2023 with an opioid prescribing rate of 0.8%.
How many Pediatrics Physician providers are there in the US?
There are 80,574 Pediatrics Physician providers across 56 states in the US. The average Pediatrics Physician provider writes 762 Medicare Part D claims per year.
What drugs does SPENCER IDSTEIN, M.D. prescribe most often?
Based on 2023 Medicare Part D data, SPENCER IDSTEIN, M.D.'s most frequently prescribed drugs include Amlodipine Besylate, Lisinopril, Rosuvastatin Calcium. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does SPENCER IDSTEIN, M.D. accept Medicare?
SPENCER IDSTEIN, M.D. appears in CMS Medicare data with 3,288 Part D claims and 331 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify SPENCER IDSTEIN, M.D.'s credentials?
SPENCER IDSTEIN, M.D.'s NPI is 1205194693 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

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