NPI registry status
Active
2026 NPPES data Allergy & Immunology Physician NPI 1912967464 MD
Verify on CMS → Theodore Falk, MD
Allergy & Immunology Physician in River Edge, New Jersey.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 3,390 in Allergy & Immunology 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
2K
Medicare Part D claims · 263 beneficiaries · Allergy & Immunology Physician avg: 764
Generic prescribing
59%
generic claims · 41% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
75/100
▼ 8 pts below national avg 83.1 · Above neutral
Industry payments
$2.1K
123 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
Theodore Falk, MD reported a CMS MIPS final score of 75/100 - below the 83.1 national average - and filed 1,890 Medicare Part D claims in 2023.
- 75/100
- MIPS score · -8 vs avg
- 2K
- Part D claims, 2023
- 59%
- 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.
Theodore Falk, MD's MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
75 15th percentile higher than 15% 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 Theodore Falk, MD sits
This provider among allergy & immunology physician peers
Across the 740 allergy & immunology physician providers who report both Medicare Part D prescribing and a MIPS quality score, Theodore Falk, MD writes more Part D claims than 86% of them and scores higher on MIPS quality than 27% - 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 allergy & immunology physician peer from a representative sample of 60; the gold marker is Theodore Falk, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Theodore Falk, 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 Theodore Falk, MD?
Below national averagePrimary specialty
Allergy & Immunology Physician
Medicare Part D claims
1,890 147% vs specialty avg
MIPS final score
75/100 8.1 pts vs avg
Specialty distribution in New Jersey
How Allergy & Immunology Physician compares to other specialties among New Jersey providers
Medicare quality performance, MIPS
Theodore Falk, MD's 2023 MIPS final score plotted against the Allergy & Immunology Physician national average
- MIPS Final Score
- 75/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Allergy & Immunology Physician) - 75/100 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).
Theodore Falk, MD appears in the CMS NPPES registry as a Allergy & Immunology Physician provider holding MD credentials at 63 GRAND AVE, River Edge, NJ, 07661, with a listed phone of (201) 487-2900. NPI 1912967464 was issued on 03/27/2006.
Medicare Part D records for calendar year 2023 show 1,890 prescription claims written by this provider, covering 263 Medicare beneficiaries and totaling roughly $1.6 million in drug spend, split 41% brand-name and 59% generic by claim count. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 75/100 for the 2023 performance year, compared with the national average of 83.1.
Allergy & Immunology Physician is a narrow specialty nationwide, with 3,390 enrolled providers across 52 states and an average of 764 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 | 1912967464 |
|---|---|
| Specialty | Allergy & Immunology Physician |
| Credentials | MD |
| Gender | Male |
| NPI Issued | 03/27/2006 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
75
Final Score
Avg: 83.1
Reporting: Individual
Hospital and facility affiliations
Facilities where Theodore Falk, 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.
Jeffrey Weiss, M.D., P.A.
Riverdale, NJ
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 Theodore Falk, MD. Source: openpaymentsdata.cms.gov.
Total received
$2.1K
Largest payer
AstraZeneca Pharmaceuticals LP
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 · Above average
Theodore Falk, MD - brand share 41.0%
Allergy & Immunology Physician average
41% brand-name claims vs 59% generic, on 1,890 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.
1,890
Total Claims
$1.6M
Total Drug Cost
263
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 3,146
- Total Day Supply
- 87,969
- Brand vs Generic
- 41% brand / 59% generic
- Brand Drug Cost
- $1.2M
- Generic Drug Cost
- $395K
- Antibiotic Claims
- 108
Patient Demographics
- Average Patient Age
- 73.6 years
- Avg HCC Risk Score
- 1.11
- Gender Split
- 64% female / 36% male
- Age Distribution
- <65: 18, 65-74: 124, 75-84: 97, 85+: 24
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Theodore Falk, MD prescribes most
Top Medicare Part D drugs by claim count, 2023
- Montelukast Sodium
Montelukast Sodium
166 claims
- Fluticasone Propio…
Fluticasone Propionate
160 claims
- Albuterol Sulfate …
Albuterol Sulfate Hfa
149 claims
- Azelastine Hcl
Azelastine Hcl
113 claims
- Trelegy Ellipta
Trelegy Ellipta
103 claims
- Methylprednisolone
Methylprednisolone
88 claims
- Breo Ellipta
Breo Ellipta
78 claims
- Symbicort
Symbicort
75 claims
| Drug | Claims |
|---|---|
| Montelukast Sodium | 166 |
| Fluticasone Propionate | 160 |
| Albuterol Sulfate Hfa Albuterol Sulfate | 149 |
| Azelastine Hcl | 113 |
| Trelegy Ellipta Fluticasone/Umeclidin/Vilanter | 103 |
| Methylprednisolone | 88 |
| Breo Ellipta Fluticasone/Vilanterol | 78 |
| Symbicort Budesonide/Formoterol Fumarate | 75 |
| Fluticasone-Salmeterol Fluticasone Propion/Salmeterol | 67 |
| Advair Hfa Fluticasone Propion/Salmeterol | 66 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Allergy & Immunology Physician Overview
How Theodore Falk, MD fits within the Allergy & Immunology Physician landscape nationally.
3,390
Allergy & Immunology Physician Providers in US
52
States with Allergy & Immunology Physician
764
Avg Claims per Provider
Theodore Falk, MD's 1,890 claims are above the specialty average of 764.
Nearby Allergy & Immunology Physician Providers in New Jersey
Other clinicians with the same primary specialty enrolled in New Jersey, drawn from the same CMS NPPES roster as Falk.
Dr. Yuliya Afinogenova
MD
Morristown, NJ
Dr. Sreenivasrao Amara
M.D.
East Brunswick, NJ
Dr. Patrick Ambrosio
DO
Old Bridge, NJ
Dr. Sara Axelrod-Malagold
M.D., M.P.H.
East Brunswick, NJ
Dr. Veronica Azmy
M.D.
Paramus, NJ
Compare Allergy & Immunology 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 New Jersey medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Allergy & Immunology 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 Theodore Falk, MD's specialty? ▼
Theodore Falk, MD specializes in Allergy & Immunology Physician and practices in River Edge, New Jersey. Credentials: MD.
How much does Theodore Falk, MD prescribe under Medicare Part D? ▼
In 2023, Theodore Falk, MD wrote 1,890 Medicare Part D claims totaling $1.6M in drug costs for 263 beneficiaries.
What is Theodore Falk, MD's Medicare quality score? ▼
Theodore Falk, MD has a CMS MIPS Final Score of 75/100. The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Theodore Falk, MD located? ▼
Theodore Falk, MD is located at 63 GRAND AVE, River Edge, NJ, 07661. Phone: (201) 487-2900.
What is Theodore Falk, MD's NPI number? ▼
Theodore Falk, MD's National Provider Identifier (NPI) is 1912967464, issued on 03/27/2006.
Does Theodore Falk, MD prescribe more brand-name or generic drugs? ▼
Theodore Falk, MD's prescribing is 41% brand-name and 59% generic drugs by claim count, with $1.2M in brand drug costs.
How many Allergy & Immunology Physician providers are there in the US? ▼
There are 3,390 Allergy & Immunology Physician providers across 52 states in the US. The average Allergy & Immunology Physician provider writes 764 Medicare Part D claims per year.
What drugs does Theodore Falk, MD prescribe most often? ▼
Based on 2023 Medicare Part D data, Theodore Falk, MD's most frequently prescribed drugs include Montelukast Sodium, Fluticasone Propionate, Albuterol Sulfate Hfa. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Theodore Falk, MD accept Medicare? ▼
Theodore Falk, MD appears in CMS Medicare data with 1,890 Part D claims and 263 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Theodore Falk, MD's credentials? ▼
Theodore Falk, MD's NPI is 1912967464 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.