2026 NPPES data Procedural Dermatology Physician NPI 1063400646 M.D.
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THOMAS BALSHI, M.D.

Procedural Dermatology Physician in DELRAY BEACH, Florida. 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
1K
Medicare Part D claims · 426 beneficiaries · Procedural Dermatology Physician avg: 664
Generic prescribing
94%
generic claims · 6% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
76.5998/100
▼ 7 pts below national avg 83.1 · [object Object]
Industry payments
$1.1K
51 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: THOMAS BALSHI, M.D. is a Procedural Dermatology Physician ([object Object]) practicing in DELRAY BEACH, Florida with a Medicare Part D prescribing footprint of 1K claims across 426 beneficiaries — 6% brand-name prescribing . Their CMS MIPS Final Score of 76.5998/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $1.1K across 51 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: THOMAS BALSHI, M.D. reported a CMS MIPS final score of 76.5998 out of 100, below the 83.1 national average, and filed 1,122 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

Board certification likely (heuristic — not verified)

THOMAS BALSHI, 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).

THOMAS BALSHI, M.D. at a glance

Below national average

NPI registry status

Active

Issued 10/08/2005

NPI 1063400646

Primary specialty

Procedural Dermatology Physician

Niche

679 US NPIs in this specialty

Medicare Part D claims

1,122 69% vs specialty avg

2023 prescription claims

Specialty avg: 664

MIPS final score

76.5998/100 6.500199999999992% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in Florida

How Procedural Dermatology Physician compares to other specialties among Florida providers

Florida providers

Procedural Dermatology Physician share within Florida

1. Procedural Dermatology Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Procedural Dermatology Physician share within Florida

Medicare quality performance — MIPS

THOMAS BALSHI, M.D.'s 2023 MIPS final score plotted against the Procedural Dermatology Physician national average

Below national average
MIPS Final Score
76.5998/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Procedural Dermatology Physician) — 76.5998/100 vs national avg 83.1

0%100%National avg83%76.6%
MIPS final score (Procedural Dermatology Physician) — 76.5998/100 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).

THOMAS BALSHI, M.D. is a Procedural Dermatology Physician provider practicing in DELRAY BEACH, Florida, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: M.D.. NPI: 1063400646. This profile includes practice location, specialty classification, and organizational affiliations from the CMS provider registry. Provider information is self-reported to CMS and updated monthly.

THOMAS BALSHI, M.D. appears in the CMS NPPES registry as a Procedural Dermatology Physician provider holding M.D. credentials at 4665 W ATLANTIC AVE, DELRAY BEACH, FL, 33445, with a listed phone of (561) 272-6000. NPI 1063400646 was issued on 10/08/2005. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BALSHI 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 1,122 prescription claims written by this provider, covering 426 Medicare beneficiaries and totaling roughly $184K in drug spend, split 6% brand-name and 94% generic by claim count. 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 76.5998/100 for the 2023 performance year (Quality 53.1995), compared with the national average of 83.1.

Procedural Dermatology Physician is a narrow specialty nationwide, with 679 enrolled providers across 48 states and an average of 664 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

4665 W ATLANTIC AVE
DELRAY BEACH, FL 33445

Provider Details

NPI 1063400646
Specialty Procedural Dermatology Physician
Credentials M.D.
Gender Male
NPI Issued 10/08/2005

CMS Quality Score (MIPS)

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

76.5998
Final Score
Avg: 83.1
53.1995
Quality

Reporting: Group practice

Hospital and facility affiliations

Facilities where THOMAS BALSHI, 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.

THOMAS C BALSHI MD PA
DELRAY BEACH, FL

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 THOMAS BALSHI, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$1.1K

Largest payer

MERZ NORTH AMERICA, 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 — Florida FLDOH 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 ~75K Florida medical licensees in 2023 — they are NOT specific to THOMAS BALSHI, M.D.. To verify THOMAS BALSHI, M.D.'s current license status, search the FLDOH public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

480
Total board actions, Florida 2023
Across 467 cases
6.40
Actions per 1,000 licensees
Florida statewide rate
monetary fine
Most common action type
138 cases

FLDOH 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 Florida disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Generic-heavy

THOMAS BALSHI, M.D. — brand share 6.0%
Specialty average (est.)

6% brand-name claims vs 94% generic, on 1,122 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.

1,122
Total Claims
$184K
Total Drug Cost
426
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
1,255
Total Day Supply
31,145
Brand vs Generic
6% brand / 94% generic
Brand Drug Cost
$153K
Generic Drug Cost
$31K
Antibiotic Claims
115

Patient Demographics

Average Patient Age
76.0 years
Avg HCC Risk Score
1.48
Gender Split
54% female / 46% male
Age Distribution
<65: 21, 65-74: 175, 75-84: 156, 85+: 74

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Triamcinolone Acetonide
177
Ketoconazole
85
Fluocinonide
73
Clotrimazole-Betamethasone
Clotrimazole/Betamethasone Dip
70
Mometasone Furoate
63
Fluticasone Propionate
51
Ciclopirox
Ciclopirox Olamine
48
Clobetasol Propionate
46
Doxycycline Hyclate
39
Methylprednisolone
39

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

Procedural Dermatology Physician Overview

How THOMAS BALSHI, M.D. fits within the Procedural Dermatology Physician landscape nationally.

679
Procedural Dermatology Physician Providers in US
48
States with Procedural Dermatology Physician
664
Avg Claims per Provider

THOMAS BALSHI, M.D.'s 1,122 claims are above the specialty average of 664.

Nearby Procedural Dermatology Physician Providers in Florida

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

Compare Procedural Dermatology Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is THOMAS BALSHI, M.D.'s specialty?
THOMAS BALSHI, M.D. specializes in Procedural Dermatology Physician and practices in DELRAY BEACH, Florida. Credentials: M.D..
How much does THOMAS BALSHI, M.D. prescribe under Medicare Part D?
In 2023, THOMAS BALSHI, M.D. wrote 1,122 Medicare Part D claims totaling $184K in drug costs for 426 beneficiaries.
What is THOMAS BALSHI, M.D.'s Medicare quality score?
THOMAS BALSHI, M.D. has a CMS MIPS Final Score of 76.5998/100 (Quality: 53.1995). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is THOMAS BALSHI, M.D. located?
THOMAS BALSHI, M.D. is located at 4665 W ATLANTIC AVE, DELRAY BEACH, FL, 33445. Phone: (561) 272-6000.
What is THOMAS BALSHI, M.D.'s NPI number?
THOMAS BALSHI, M.D.'s National Provider Identifier (NPI) is 1063400646, issued on 10/08/2005.
Does THOMAS BALSHI, M.D. prescribe more brand-name or generic drugs?
THOMAS BALSHI, M.D.'s prescribing is 6% brand-name and 94% generic drugs by claim count, with $153K in brand drug costs.
How many Procedural Dermatology Physician providers are there in the US?
There are 679 Procedural Dermatology Physician providers across 48 states in the US. The average Procedural Dermatology Physician provider writes 664 Medicare Part D claims per year.
What drugs does THOMAS BALSHI, M.D. prescribe most often?
Based on 2023 Medicare Part D data, THOMAS BALSHI, M.D.'s most frequently prescribed drugs include Triamcinolone Acetonide, Ketoconazole, Fluocinonide. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does THOMAS BALSHI, M.D. accept Medicare?
THOMAS BALSHI, M.D. appears in CMS Medicare data with 1,122 Part D claims and 426 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify THOMAS BALSHI, M.D.'s credentials?
THOMAS BALSHI, M.D.'s NPI is 1063400646 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