NPI registry status
Active
2026 NPPES data Pediatrics Physician NPI 1538233184 MD
Verify on CMS → Suzanne Pica, MD
Pediatrics Physician in Winchester, Kentucky.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 80,576 in Pediatrics 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
6K
Medicare Part D claims · 289 beneficiaries · Pediatrics Physician avg: 762
Generic prescribing
80%
generic claims · 18% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
96.7/100
▲ 14 pts above national avg 83.1 · Exceptional
Industry payments
$16.57
1 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
Suzanne Pica, MD reported a CMS MIPS final score of 96.7/100 - above the 83.1 national average - and filed 5,735 Medicare Part D claims in 2023.
- 96.7/100
- MIPS score · +14 vs avg
- 6K
- Part D claims, 2023
- 80%
- 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.
Suzanne Pica, MD's MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
97 Top 17% higher than 83% 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 Suzanne Pica, MD sits
This provider among pediatrics physician peers
Across the 1,120 pediatrics physician providers who report both Medicare Part D prescribing and a MIPS quality score, Suzanne Pica, MD writes more Part D claims than 93% of them and scores higher on MIPS quality than 80% - placing this provider in the high-volume, high-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 pediatrics physician peer from a representative sample of 60; the gold marker is Suzanne Pica, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Suzanne Pica, MD 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 Suzanne Pica, MD?
High performer (top quartile)Primary specialty
Pediatrics Physician
Medicare Part D claims
5,735 8× vs specialty avg
MIPS final score
96.7/100 13.6 pts vs avg
Specialty distribution in Kentucky
How Pediatrics Physician compares to other specialties among Kentucky providers
Medicare quality performance, MIPS
Suzanne Pica, MD's 2023 MIPS final score plotted against the Pediatrics Physician national average
- MIPS Final Score
- 96.7/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Pediatrics Physician) - 96.7/100 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).
Suzanne Pica, MD appears in the CMS NPPES registry as a Pediatrics Physician provider holding MD credentials at 505 SHOPPERS DR, Winchester, KY, 40391, with a listed phone of (859) 744-1358. NPI 1538233184 was issued on 11/17/2006.
Medicare Part D records for calendar year 2023 show 5,735 prescription claims written by this provider, covering 289 Medicare beneficiaries and totaling roughly $858K in drug spend, split 18% brand-name and 80% generic by claim count, with an opioid prescribing rate of 3.7%. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 96.7/100 for the 2023 performance year (Quality 83.7), compared with the national average of 83.1.
Pediatrics Physician is a high-volume specialty nationwide, with 80,576 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
Provider Details
| NPI | 1538233184 |
|---|---|
| Specialty | Pediatrics Physician |
| Credentials | MD |
| Gender | Female |
| NPI Issued | 11/17/2006 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
96.6822
Final Score
Avg: 83.1
83.694
Quality
100
Promoting Interoperability
Reporting: Alternative Payment Model
Hospital and facility affiliations
Facilities where Suzanne Pica, MD 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.
Clark Regional Physician Practices LLC
Winchester, 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).
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 Suzanne Pica, MD. Source: openpaymentsdata.cms.gov.
Total received
$17
Largest payer
Lilly USA, LLC
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 · Typical
Suzanne Pica, MD - brand share 18.0%
Pediatrics Physician average
18% brand-name claims vs 80% generic, on 5,735 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.
5,735
Total Claims
$858K
Total Drug Cost
289
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 12,728
- Total Day Supply
- 364,613
- Brand vs Generic
- 18% brand / 80% generic
- Brand Drug Cost
- $750K
- Generic Drug Cost
- $102K
- Opioid Claims
- 211 (3.7% rate)
- Antibiotic Claims
- 123
Patient Demographics
- Average Patient Age
- 74.1 years
- Avg HCC Risk Score
- 1.10
- Gender Split
- 69% female / 31% male
- Age Distribution
- <65: 21, 65-74: 133, 75-84: 96, 85+: 39
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Suzanne Pica, MD prescribes most
Top Medicare Part D drugs by claim count, 2023
- Levothyroxine Sodium
Levothyroxine Sodium
189 claims
- Rosuvastatin Calcium
Rosuvastatin Calcium
155 claims
- Hydrocodone-Acetam…
Hydrocodone-Acetaminophen
153 claims
- Metformin Hcl Er
Metformin Hcl Er
152 claims
- Amlodipine Besylate
Amlodipine Besylate
145 claims
- Alprazolam
Alprazolam
132 claims
- Losartan Potassium
Losartan Potassium
130 claims
- Pravastatin Sodium
Pravastatin Sodium
127 claims
| Drug | Claims |
|---|---|
| Levothyroxine Sodium | 189 |
| Rosuvastatin Calcium | 155 |
| Hydrocodone-Acetaminophen Hydrocodone/Acetaminophen | 153 |
| Metformin Hcl Er Metformin Hcl | 152 |
| Amlodipine Besylate | 145 |
| Alprazolam | 132 |
| Losartan Potassium | 130 |
| Pravastatin Sodium | 127 |
| Omeprazole | 119 |
| Atorvastatin Calcium | 112 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Pediatrics Physician Overview
How Suzanne Pica, MD fits within the Pediatrics Physician landscape nationally.
80,576
Pediatrics Physician Providers in US
56
States with Pediatrics Physician
762
Avg Claims per Provider
Suzanne Pica, MD's 5,735 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 Pica.
Dr. Katherine Abbott
MD
Louisville, KY
Dr. Arebu Abdu
MD
Lexington, KY
Dr. Karen Abrams
MD
Louisville, KY
Dr. Hadi Abu Rasheed
M.D.
Beattyville, KY
Dr. David Adamkin
MD
Louisville, KY
Compare Pediatrics Physician 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 Kentucky medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Pediatrics Physician 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 Suzanne Pica, MD's specialty? ▼
Suzanne Pica, MD specializes in Pediatrics Physician and practices in Winchester, Kentucky. Credentials: MD.
How much does Suzanne Pica, MD prescribe under Medicare Part D? ▼
In 2023, Suzanne Pica, MD wrote 5,735 Medicare Part D claims totaling $858K in drug costs for 289 beneficiaries.
What is Suzanne Pica, MD's Medicare quality score? ▼
Suzanne Pica, MD has a CMS MIPS Final Score of 96.7/100 (Quality: 83.7). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Suzanne Pica, MD located? ▼
Suzanne Pica, MD is located at 505 SHOPPERS DR, Winchester, KY, 40391. Phone: (859) 744-1358.
What is Suzanne Pica, MD's NPI number? ▼
Suzanne Pica, MD's National Provider Identifier (NPI) is 1538233184, issued on 11/17/2006.
Does Suzanne Pica, MD prescribe more brand-name or generic drugs? ▼
Suzanne Pica, MD's prescribing is 18% brand-name and 80% generic drugs by claim count, with $750K in brand drug costs.
Does Suzanne Pica, MD prescribe opioids? ▼
Yes, Suzanne Pica, MD had 211 opioid claims in 2023 with an opioid prescribing rate of 3.7%.
How many Pediatrics Physician providers are there in the US? ▼
There are 80,576 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 Suzanne Pica, MD prescribe most often? ▼
Based on 2023 Medicare Part D data, Suzanne Pica, MD's most frequently prescribed drugs include Levothyroxine Sodium, Rosuvastatin Calcium, Hydrocodone-Acetaminophen. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Suzanne Pica, MD accept Medicare? ▼
Suzanne Pica, MD appears in CMS Medicare data with 5,735 Part D claims and 289 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Suzanne Pica, MD's credentials? ▼
Suzanne Pica, MD's NPI is 1538233184 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 (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.
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.