2026 NPPES data Otolaryngology Physician NPI 1225124043 M.D.
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TIMOTHY DOWNEY, M.D.

Otolaryngology Physician in WEST GROVE, Pennsylvania. 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
649
Medicare Part D claims · 313 beneficiaries · Otolaryngology Physician avg: 509
Generic prescribing
98%
generic claims · 2% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
95.75/100
▲ 13 pts above national avg 83.1 · [object Object]
What the federal data reveals: TIMOTHY DOWNEY, M.D. is a Otolaryngology Physician ([object Object]) practicing in WEST GROVE, Pennsylvania with a Medicare Part D prescribing footprint of 649 claims across 313 beneficiaries — 2% brand-name prescribing . Their CMS MIPS Final Score of 95.75/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities .

What stands out: TIMOTHY DOWNEY, M.D. reported a CMS MIPS final score of 95.75 out of 100, above the 83.1 national average, and filed 649 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)

TIMOTHY DOWNEY, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 3 hospital affiliations — signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).

TIMOTHY DOWNEY, M.D. at a glance

High performer (top quartile)

NPI registry status

Active

Issued 10/05/2006

NPI 1225124043

Primary specialty

Otolaryngology Physician

Mid-sized

10,895 US NPIs in this specialty

Medicare Part D claims

649 28% vs specialty avg

2023 prescription claims

Specialty avg: 509

MIPS final score

95.75/100 12.650000000000006% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Pennsylvania

How Otolaryngology Physician compares to other specialties among Pennsylvania providers

Pennsylvania providers

Otolaryngology Physician share within Pennsylvania

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

Medicare quality performance — MIPS

TIMOTHY DOWNEY, M.D.'s 2023 MIPS final score plotted against the Otolaryngology Physician national average

High performer (top quartile)
MIPS Final Score
95.75/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Otolaryngology Physician) — 95.75/100 vs national avg 83.1

0%100%National avg83%95.8%
MIPS final score (Otolaryngology Physician) — 95.75/100 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).

TIMOTHY DOWNEY, M.D. is a Otolaryngology Physician provider practicing in WEST GROVE, Pennsylvania, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: M.D.. NPI: 1225124043. 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.

TIMOTHY DOWNEY, M.D. appears in the CMS NPPES registry as a Otolaryngology Physician provider holding M.D. credentials at 1 COMMERCE BLVD STE 201, WEST GROVE, PA, 19390, with a listed phone of (610) 345-0977. NPI 1225124043 was issued on 10/05/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what DOWNEY 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 649 prescription claims written by this provider, covering 313 Medicare beneficiaries and totaling roughly $24K in drug spend, split 2% brand-name and 98% 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 95.75/100 for the 2023 performance year, compared with the national average of 83.1.

Otolaryngology Physician is a mid-sized specialty nationwide, with 10,895 enrolled providers across 54 states and an average of 509 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

1 COMMERCE BLVD STE 201
WEST GROVE, PA 19390

Provider Details

NPI 1225124043
Specialty Otolaryngology Physician
Credentials M.D.
Gender Male
NPI Issued 10/05/2006

CMS Quality Score (MIPS)

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

95.75
Final Score
Avg: 83.1
95
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where TIMOTHY DOWNEY, 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.

AGAPE PHYSICAL THERAPY AND SPORTS REHABILITATION LP
FOREST HILL, MD
PHOENIX REHABILITATION AND HEALTH SERVICES INC
CRANBERRY TOWNSHIP, PA
PINNACLE ENT ALLIANCE LLC
EXTON, PA

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

License & disciplinary context — Pennsylvania PA-BOM 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 ~45K Pennsylvania medical licensees in 2023 — they are NOT specific to TIMOTHY DOWNEY, M.D.. To verify TIMOTHY DOWNEY, M.D.'s current license status, search the PA-BOM public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

133
Total board actions, Pennsylvania 2023
Across 129 cases
2.96
Actions per 1,000 licensees
Pennsylvania statewide rate
probation
Most common action type
48 cases

PA-BOM 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 Pennsylvania disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Generic-heavy

TIMOTHY DOWNEY, M.D. — brand share 2.0%
Specialty average (est.)

2% brand-name claims vs 98% generic, on 649 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.

649
Total Claims
$24K
Total Drug Cost
313
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
979
Total Day Supply
23,851
Brand vs Generic
2% brand / 98% generic
Brand Drug Cost
$2K
Generic Drug Cost
$22K
Antibiotic Claims
50

Patient Demographics

Average Patient Age
75.0 years
Avg HCC Risk Score
1.04
Gender Split
63% female / 37% male
Age Distribution
<65: 12, 65-74: 152, 75-84: 107, 85+: 42

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Ipratropium Bromide
244
Prednisone
57
Montelukast Sodium
42
Azelastine Hcl
40
Fluocinolone Acetonide Oil
30
Neomycin-Polymyxin-Hydrocort
Neomycin/Polymyxin B/Hydrocort
24
Nystatin
21
Amoxicillin
18
Triamcinolone Acetonide
15
Clotrimazole-Betamethasone
Clotrimazole/Betamethasone Dip
14

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

Otolaryngology Physician Overview

How TIMOTHY DOWNEY, M.D. fits within the Otolaryngology Physician landscape nationally.

10,895
Otolaryngology Physician Providers in US
54
States with Otolaryngology Physician
509
Avg Claims per Provider

TIMOTHY DOWNEY, M.D.'s 649 claims are above the specialty average of 509.

Nearby Otolaryngology Physician Providers in Pennsylvania

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

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

Frequently Asked Questions

What is TIMOTHY DOWNEY, M.D.'s specialty?
TIMOTHY DOWNEY, M.D. specializes in Otolaryngology Physician and practices in WEST GROVE, Pennsylvania. Credentials: M.D..
How much does TIMOTHY DOWNEY, M.D. prescribe under Medicare Part D?
In 2023, TIMOTHY DOWNEY, M.D. wrote 649 Medicare Part D claims totaling $24K in drug costs for 313 beneficiaries.
What is TIMOTHY DOWNEY, M.D.'s Medicare quality score?
TIMOTHY DOWNEY, M.D. has a CMS MIPS Final Score of 95.75/100. The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is TIMOTHY DOWNEY, M.D. located?
TIMOTHY DOWNEY, M.D. is located at 1 COMMERCE BLVD STE 201, WEST GROVE, PA, 19390. Phone: (610) 345-0977.
What is TIMOTHY DOWNEY, M.D.'s NPI number?
TIMOTHY DOWNEY, M.D.'s National Provider Identifier (NPI) is 1225124043, issued on 10/05/2006.
Does TIMOTHY DOWNEY, M.D. prescribe more brand-name or generic drugs?
TIMOTHY DOWNEY, M.D.'s prescribing is 2% brand-name and 98% generic drugs by claim count, with $2K in brand drug costs.
How many Otolaryngology Physician providers are there in the US?
There are 10,895 Otolaryngology Physician providers across 54 states in the US. The average Otolaryngology Physician provider writes 509 Medicare Part D claims per year.
What drugs does TIMOTHY DOWNEY, M.D. prescribe most often?
Based on 2023 Medicare Part D data, TIMOTHY DOWNEY, M.D.'s most frequently prescribed drugs include Ipratropium Bromide, Prednisone, Montelukast Sodium. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does TIMOTHY DOWNEY, M.D. accept Medicare?
TIMOTHY DOWNEY, M.D. appears in CMS Medicare data with 649 Part D claims and 313 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify TIMOTHY DOWNEY, M.D.'s credentials?
TIMOTHY DOWNEY, M.D.'s NPI is 1225124043 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