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2026 NPPES data Retina Specialist (Ophthalmology) Physician NPI 1780670596 MD
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Sumit Bhatia, MD

Retina Specialist (Ophthalmology) Physician in Normal, Illinois.

This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 983 in Retina Specialist (Ophthalmology) 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
287
Medicare Part D claims · 77 beneficiaries · Retina Specialist (Ophthalmology) Physician avg: 593
Generic prescribing
63%
generic claims · 37% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
71.4/100
▼ 12 pts below national avg 83.5 · Mid-tier
Industry payments
$213.84
10 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

Sumit Bhatia, MD reported a CMS MIPS final score of 71.4/100 - below the 83.5 national average - and filed 287 Medicare Part D claims in 2024.

71.4/100
MIPS score · -12 vs avg
287
Part D claims, 2024
63%
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 Sumit Bhatia, MD

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 1780670596), first enumerated 09/27/2005.

    Source: CMS NPPES

  • Reported

    Medicare Part D participation

    Filed 287 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 71.4/100 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

    Industry payment transparency

    $213.84 in reported industry payments (10 transfers) in 2024 under the federal Sunshine Act — disclosed transfers of value, not a quality rating.

    Source: CMS Open Payments

  • State context

    State board disciplinary context

    Illinois statewide board action statistics are published annually — these figures describe aggregate state activity, not Sumit Bhatia, MD's individual license status. Verify directly with the state medical board.

    Source: IDFPR annual report 2023

  • 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 1780670596 · Retina Specialist (Ophthalmology) Physician

NPI-10 · ENUM-LEGACY · TAX-NARROW · MIPS-LOW · RX-LIGHT · BOOK-THIN · PHOTO-FINISH

  • NPI-10 1780670596
  • ENUM-LEGACY 2005
  • TAX-NARROW 983
  • MIPS-LOW 71.4/100
  • RX-LIGHT 287
  • BOOK-THIN 35 in Illinois
  • PHOTO-FINISH Carol Shields, MD · ±0.1

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

Sumit Bhatia, MD'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.

71 ≥ 9th percentile 9% 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%). This entry sits in this band. 80–90: 129,887 measured providers (29%). Above this entry. 90+: 189,403 measured providers (42%). Above this entry. 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 Sumit Bhatia, MD sits

This provider among retina specialist (ophthalmology) physician peers

Across the 573 retina specialist (ophthalmology) physician providers who report both Medicare Part D prescribing and a MIPS quality score, Sumit Bhatia, MD writes more Part D claims than 30% of them and scores higher on MIPS quality than 4% - placing this provider in the lower-volume, lower-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 quality0255075100017.635.252.870.3Part D claim volume, percentile in specialtyMIPS quality, percentilePoint, Part D claim volume, percentile in specialty: 87 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 23 · MIPS quality, percentile: 40Point, Part D claim volume, percentile in specialty: 57 · MIPS quality, percentile: 2Point, Part D claim volume, percentile in specialty: 42 · MIPS quality, percentile: 30Point, Part D claim volume, percentile in specialty: 32 · MIPS quality, percentile: 8Point, Part D claim volume, percentile in specialty: 78 · MIPS quality, percentile: 33Point, Part D claim volume, percentile in specialty: 85 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 62 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 47 · MIPS quality, percentile: 25Point, Part D claim volume, percentile in specialty: 12 · MIPS quality, percentile: 17Point, Part D claim volume, percentile in specialty: 18 · MIPS quality, percentile: 3Point, Part D claim volume, percentile in specialty: 45 · MIPS quality, percentile: 52Point, Part D claim volume, percentile in specialty: 27 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 67 · MIPS quality, percentile: 50Point, Part D claim volume, percentile in specialty: 70 · MIPS quality, percentile: 55Point, Part D claim volume, percentile in specialty: 93 · MIPS quality, percentile: 38Point, Part D claim volume, percentile in specialty: 10 · MIPS quality, percentile: 58Point, Part D claim volume, percentile in specialty: 3 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 82 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 62 · MIPS quality, percentile: 63Point, Part D claim volume, percentile in specialty: 52 · MIPS quality, percentile: 7Point, Part D claim volume, percentile in specialty: 58 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 72 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 15 · MIPS quality, percentile: 62Point, Part D claim volume, percentile in specialty: 25 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 37 · MIPS quality, percentile: 60Point, Part D claim volume, percentile in specialty: 95 · MIPS quality, percentile: 37Point, Part D claim volume, percentile in specialty: 77 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 2 · MIPS quality, percentile: 23Point, Part D claim volume, percentile in specialty: 20 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 28 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 30 · MIPS quality, percentile: 15Point, Part D claim volume, percentile in specialty: 53 · MIPS quality, percentile: 13Point, Part D claim volume, percentile in specialty: 38 · MIPS quality, percentile: 18Point, Part D claim volume, percentile in specialty: 40 · MIPS quality, percentile: 48Point, Part D claim volume, percentile in specialty: 98 · MIPS quality, percentile: 32Point, Part D claim volume, percentile in specialty: 7 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 90 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 80 · MIPS quality, percentile: 12Point, Part D claim volume, percentile in specialty: 43 · MIPS quality, percentile: 42Point, Part D claim volume, percentile in specialty: 0 · MIPS quality, percentile: 47Point, Part D claim volume, percentile in specialty: 73 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 83 · MIPS quality, percentile: 20Point, Part D claim volume, percentile in specialty: 50 · MIPS quality, percentile: 43Point, Part D claim volume, percentile in specialty: 22 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 100 · MIPS quality, percentile: 65Point, Part D claim volume, percentile in specialty: 75 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 68 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 35 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 88 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 65 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 17 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 8 · MIPS quality, percentile: 28Point, Part D claim volume, percentile in specialty: 92 · MIPS quality, percentile: 27Point, Part D claim volume, percentile in specialty: 97 · MIPS quality, percentile: 10Point, Part D claim volume, percentile in specialty: 55 · MIPS quality, percentile: 57Point, Part D claim volume, percentile in specialty: 5 · MIPS quality, percentile: 35Point, Part D claim volume, percentile in specialty: 12 · MIPS quality, percentile: 53Point, Part D claim volume, percentile in specialty: 48 · MIPS quality, percentile: 45Point, Part D claim volume, percentile in specialty: 60 · MIPS quality, percentile: 20Sumit Bhatia, MD, Part D claim volume, percentile in specialty: 30 · MIPS quality, percentile: 4
Part D claim volume vs MIPS quality, by specialty percentile

Each dot is one retina specialist (ophthalmology) physician peer from a representative sample of 60; the gold marker is Sumit Bhatia, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.

✓
Board certification likely (heuristic, not verified)

Sumit Bhatia, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting - 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 Sumit Bhatia, MD?

Below national average

NPI registry status

Active

Issued 09/27/2005

NPI 1780670596

Primary specialty

Retina Specialist (Ophthalmology) Physician

Niche

983 US NPIs in this specialty

Medicare Part D claims

287 52% vs specialty avg

2024 prescription claims

Specialty avg: 593

MIPS final score

71.4/100 12.1 pts vs avg

Mid-tier band

vs 83.5 national avg

Specialty distribution in Illinois

How Retina Specialist (Ophthalmology) Physician compares to other specialties among Illinois providers

Illinois providers
Clinical Social Worker5.2%Physical Therapist4.9%Mental Health Counselor4.5%Speech-Language Pathologist4.2%Student in an Organized Heal…4.1%Pharmacist4.1%Retina Specialist (Ophthalmo…0%
Largest specialties in Illinois (% of in-state providers)

Medicare quality performance, MIPS

Sumit Bhatia, MD's 2023 MIPS final score plotted against the Retina Specialist (Ophthalmology) Physician national average

Below national average
MIPS Final Score
71.4/100
vs 83.5 national avg · 2023 performance year
0%100%National avg84%71.4%
MIPS final score (Retina Specialist (Ophthalmology) Physician) - 71.4/100 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

2010 JACOBSSEN DR STE C
Normal, IL 61761
(815) 390-7271

Provider Details

NPI 1780670596
Specialty Retina Specialist (Ophthalmology) Physician
Credentials MD
Gender Male
NPI Issued 09/27/2005

CMS Quality Score (MIPS)

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

71.4089
Final Score
Measured-score avg: 83.5
99.0146
Quality
19.015
Cost
84
Promoting Interoperability

Reporting: Group practice

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 Sumit Bhatia, MD. Source: openpaymentsdata.cms.gov.

Total received

$214

Largest payer

Apellis Pharmaceuticals, 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.

License & disciplinary context - Illinois IDFPR 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 ~42K Illinois medical licensees in 2023 - they are NOT specific to Sumit Bhatia, MD. To verify Sumit Bhatia, MD's current license status, search the IDFPR public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

106
Total board actions, Illinois 2023
Across 103 cases
2.52
Actions per 1,000 licensees
Illinois statewide rate
probation
Most common action type
38 cases

IDFPR 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 Illinois disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Above average

Sumit Bhatia, MD - brand share 37.0%
Retina Specialist (Ophthalmology) Physician average

37% brand-name claims vs 63% generic, on 287 2024 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 2024.

287
Total Claims
$17K
Total Drug Cost
77
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
410
Total Day Supply
10,957
Brand vs Generic
37% brand / 63% generic
Brand Drug Cost
$14K
Generic Drug Cost
$3K

Patient Demographics

Average Patient Age
73.0 years
Avg HCC Risk Score
0.87
Gender Split
44% female / 56% male

Top Prescribed Drugs (Medicare Part D)

Top drugs by claim count for calendar year 2024. Based on Medicare Part D data only.

What Sumit Bhatia, MD prescribes most

Top Medicare Part D drugs by claim count, 2024

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2024
Drug Claims
Prednisolone Acetate
 83
Atropine Sulfate
 44
Ofloxacin
 41
Dorzolamide Hcl
 33
Latanoprost
 20
Ketorolac Tromethamine
 17
Dorzolamide-Timolol
Dorzolamide Hcl/Timolol Maleat
12
Xiidra
Lifitegrast
12

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

More Retina Specialist (Ophthalmology) Physician in IL → All providers in Illinois → Compare specialties →

Retina Specialist (Ophthalmology) Physician Overview

How Sumit Bhatia, MD fits within the Retina Specialist (Ophthalmology) Physician landscape nationally.

983
Retina Specialist (Ophthalmology) Physician Providers in US
48
States with Retina Specialist (Ophthalmology) Physician
593
Avg Claims per Provider

Sumit Bhatia, MD's 287 claims are below the specialty average of 593.

Nationwide Retina Specialist (Ophthalmology) Physician peers with similar MIPS or enrollment year

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

Similar MIPS final score

Nearest same-specialty clinicians by CMS MIPS final score (71.4 here).

Carol Shields 71.5 PA Gawain Dyer 70.7 TX Deepika Malik 72.3 NY Philip Niles 72.3 NY

Same NPPES enumeration year (2005)

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

Thomas Ciulla Carmel, IN Vrinda Hershberger Melbourne, FL Jerry Blair Columbia, MO Louis Angioletti New York, NY

Nearby Retina Specialist (Ophthalmology) Physician Providers in Illinois

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

One of 35 Retina Specialist (Ophthalmology) Physician providers enrolled in Illinois, 5 are shown here.

Rouzbeh Abbasgholizadeh
Chicago, IL
Dr. Mohamed Adenwalla
M.D.
Elmhurst, IL
Dr. Faisel Ahmad
M.D.
Marion, IL
Dr. Irma Ahmed
MD
Bolingbrook, IL
Dr. Susan Anderson-Nelson
M.D.
Wheaton, IL

Compare Retina Specialist (Ophthalmology) Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is Sumit Bhatia, MD's specialty? ▼
Sumit Bhatia, MD specializes in Retina Specialist (Ophthalmology) Physician and practices in Normal, Illinois. Credentials: MD.
How much does Sumit Bhatia, MD prescribe under Medicare Part D? ▼
In 2024, Sumit Bhatia, MD wrote 287 Medicare Part D claims totaling $17K in drug costs for 77 beneficiaries.
What is Sumit Bhatia, MD's Medicare quality score? ▼
Sumit Bhatia, MD has a CMS MIPS Final Score of 71.4/100 (Quality: 99, Cost: 19). 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 Sumit Bhatia, MD located? ▼
Sumit Bhatia, MD is located at 2010 JACOBSSEN DR STE C, Normal, IL, 61761. Phone: (815) 390-7271.
What is Sumit Bhatia, MD's NPI number? ▼
Sumit Bhatia, MD's National Provider Identifier (NPI) is 1780670596, issued on 09/27/2005.
Does Sumit Bhatia, MD prescribe more brand-name or generic drugs? ▼
Sumit Bhatia, MD's prescribing is 37% brand-name and 63% generic drugs by claim count, with $14K in brand drug costs.
How many Retina Specialist (Ophthalmology) Physician providers are there in the US? ▼
There are 983 Retina Specialist (Ophthalmology) Physician providers across 48 states in the US. The average Retina Specialist (Ophthalmology) Physician provider writes 593 Medicare Part D claims per year.
What drugs does Sumit Bhatia, MD prescribe most often? ▼
Based on 2024 Medicare Part D data, Sumit Bhatia, MD's most frequently prescribed drugs include Prednisolone Acetate, Atropine Sulfate, Ofloxacin. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Sumit Bhatia, MD accept Medicare? ▼
Sumit Bhatia, MD appears in CMS Medicare data with 287 Part D claims and 77 Medicare beneficiaries in 2024. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Sumit Bhatia, MD's credentials? ▼
Sumit Bhatia, MD's NPI is 1780670596 with credentials MD. 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 (2024). 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 August 2026 (NPPES) / 2024 (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 August 2026.