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2026 NPPES data Otolaryngology Physician NPI 1225124043 M.D.
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Timothy Downey, M.D.

Otolaryngology Physician in West Grove, Pennsylvania.

This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 11,060 in Otolaryngology 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
816
Medicare Part D claims · 377 beneficiaries · Otolaryngology Physician avg: 536
Generic prescribing
99%
generic claims · 1% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
95.8/100
▲ 12 pts above national avg 83.5 · Exceptional
Verify NPI on CMS Methodology
Compiled from official public sources by the editorial process.

What the federal data shows

Timothy Downey, M.D. reported a CMS MIPS final score of 95.8/100 - above the 83.5 national average - and filed 816 Medicare Part D claims in 2024.

95.8/100
MIPS score · +12 vs avg
816
Part D claims, 2024
99%
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 Timothy Downey, M.D.

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 1225124043), first enumerated 10/05/2006.

    Source: CMS NPPES

  • Reported

    Medicare Part D participation

    Filed 816 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 95.8/100 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

    Hospital affiliations

    2 CMS Care Compare hospital affiliations on record — practice footprint from the Doctors and Clinicians file.

    Source: CMS Care Compare

  • State context

    State board disciplinary context

    Pennsylvania statewide board action statistics are published annually — these figures describe aggregate state activity, not Timothy Downey, M.D.'s individual license status. Verify directly with the state medical board.

    Source: PA-BOM 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 1225124043 · Otolaryngology Physician

NPI-10 · ENUM-LEGACY · TAX-MID · MIPS-ELITE · RX-LIGHT · BOOK-LIGHT · PHOTO-FINISH

  • NPI-10 1225124043
  • ENUM-LEGACY 2006
  • TAX-MID 11K Otolaryngology Physician
  • MIPS-ELITE 95.8/100
  • RX-LIGHT 816
  • BOOK-LIGHT 510 in Pennsylvania
  • PHOTO-FINISH David Huchton, MD · ±0.0

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

Timothy Downey, M.D.'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.

96 ≥ 78th percentile 78% 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%). Below this entry. 80–90: 129,887 measured providers (29%). Below this entry. 90+: 189,403 measured providers (42%). This entry sits in this band. 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 Timothy Downey, M.D. sits

This provider among otolaryngology physician peers

Across the 3,290 otolaryngology physician providers who report both Medicare Part D prescribing and a MIPS quality score, Timothy Downey, M.D. writes more Part D claims than 76% of them and scores higher on MIPS quality than 86% - placing this provider in the high-volume, high-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 quality0255075100024.448.873.297.7Part D claim volume, percentile in specialtyMIPS quality, percentilePoint, Part D claim volume, percentile in specialty: 87 · MIPS quality, percentile: 93Point, Part D claim volume, percentile in specialty: 15 · MIPS quality, percentile: 48Point, Part D claim volume, percentile in specialty: 92 · MIPS quality, percentile: 82Point, Part D claim volume, percentile in specialty: 27 · MIPS quality, percentile: 93Point, Part D claim volume, percentile in specialty: 57 · MIPS quality, percentile: 65Point, Part D claim volume, percentile in specialty: 32 · MIPS quality, percentile: 27Point, Part D claim volume, percentile in specialty: 97 · MIPS quality, percentile: 92Point, Part D claim volume, percentile in specialty: 33 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 45 · MIPS quality, percentile: 55Point, Part D claim volume, percentile in specialty: 48 · MIPS quality, percentile: 33Point, Part D claim volume, percentile in specialty: 18 · MIPS quality, percentile: 68Point, Part D claim volume, percentile in specialty: 28 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 67 · MIPS quality, percentile: 75Point, Part D claim volume, percentile in specialty: 17 · MIPS quality, percentile: 90Point, Part D claim volume, percentile in specialty: 12 · MIPS quality, percentile: 93Point, Part D claim volume, percentile in specialty: 35 · MIPS quality, percentile: 63Point, Part D claim volume, percentile in specialty: 53 · MIPS quality, percentile: 38Point, Part D claim volume, percentile in specialty: 3 · MIPS quality, percentile: 22Point, Part D claim volume, percentile in specialty: 35 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 8 · MIPS quality, percentile: 93Point, Part D claim volume, percentile in specialty: 98 · MIPS quality, percentile: 32Point, Part D claim volume, percentile in specialty: 43 · MIPS quality, percentile: 70Point, Part D claim volume, percentile in specialty: 52 · MIPS quality, percentile: 18Point, Part D claim volume, percentile in specialty: 0 · MIPS quality, percentile: 57Point, Part D claim volume, percentile in specialty: 68 · MIPS quality, percentile: 87Point, Part D claim volume, percentile in specialty: 63 · MIPS quality, percentile: 23Point, Part D claim volume, percentile in specialty: 30 · MIPS quality, percentile: 72Point, Part D claim volume, percentile in specialty: 65 · MIPS quality, percentile: 45Point, Part D claim volume, percentile in specialty: 83 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 38 · MIPS quality, percentile: 87Point, Part D claim volume, percentile in specialty: 58 · MIPS quality, percentile: 80Point, Part D claim volume, percentile in specialty: 47 · MIPS quality, percentile: 85Point, Part D claim volume, percentile in specialty: 25 · MIPS quality, percentile: 50Point, Part D claim volume, percentile in specialty: 20 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 10 · MIPS quality, percentile: 25Point, Part D claim volume, percentile in specialty: 77 · MIPS quality, percentile: 43Point, Part D claim volume, percentile in specialty: 90 · MIPS quality, percentile: 42Point, Part D claim volume, percentile in specialty: 5 · MIPS quality, percentile: 53Point, Part D claim volume, percentile in specialty: 88 · MIPS quality, percentile: 93Point, Part D claim volume, percentile in specialty: 13 · MIPS quality, percentile: 30Point, Part D claim volume, percentile in specialty: 60 · MIPS quality, percentile: 20Point, Part D claim volume, percentile in specialty: 23 · MIPS quality, percentile: 60Point, Part D claim volume, percentile in specialty: 55 · MIPS quality, percentile: 47Point, Part D claim volume, percentile in specialty: 40 · MIPS quality, percentile: 50Point, Part D claim volume, percentile in specialty: 93 · MIPS quality, percentile: 62Point, Part D claim volume, percentile in specialty: 95 · MIPS quality, percentile: 67Point, Part D claim volume, percentile in specialty: 80 · MIPS quality, percentile: 40Point, Part D claim volume, percentile in specialty: 73 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 100 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 7 · MIPS quality, percentile: 28Point, Part D claim volume, percentile in specialty: 78 · MIPS quality, percentile: 78Point, Part D claim volume, percentile in specialty: 75 · MIPS quality, percentile: 35Point, Part D claim volume, percentile in specialty: 50 · MIPS quality, percentile: 17Point, Part D claim volume, percentile in specialty: 22 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 62 · MIPS quality, percentile: 72Point, Part D claim volume, percentile in specialty: 42 · MIPS quality, percentile: 77Point, Part D claim volume, percentile in specialty: 72 · MIPS quality, percentile: 15Point, Part D claim volume, percentile in specialty: 2 · MIPS quality, percentile: 37Point, Part D claim volume, percentile in specialty: 82 · MIPS quality, percentile: 0Point, Part D claim volume, percentile in specialty: 85 · MIPS quality, percentile: 58Timothy Downey, M.D., Part D claim volume, percentile in specialty: 76 · MIPS quality, percentile: 86
Part D claim volume vs MIPS quality, by specialty percentile

Each dot is one otolaryngology physician peer from a representative sample of 60; the gold marker is Timothy Downey, M.D.. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.

✓
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 + 2 hospital affiliations - 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 Timothy Downey, M.D.?

High performer (top quartile)

NPI registry status

Active

Issued 10/05/2006

NPI 1225124043

Primary specialty

Otolaryngology Physician

Mid-sized

11,060 US NPIs in this specialty

Medicare Part D claims

816 52% vs specialty avg

2024 prescription claims

Specialty avg: 536

MIPS final score

95.8/100 12.3 pts vs avg

Exceptional band

vs 83.5 national avg

Specialty distribution in Pennsylvania

How Otolaryngology Physician compares to other specialties among Pennsylvania providers

Pennsylvania providers
Student in an Organized Heal…6%Pharmacist5%Physical Therapist4.8%Mental Health Counselor4%Internal Medicine Physician3.3%Professional Counselor3.2%Otolaryngology Physician0.2%
Largest specialties in Pennsylvania (% of in-state providers)

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
95.8/100
vs 83.5 national avg · 2023 performance year
0%100%National avg84%95.8%
MIPS final score (Otolaryngology Physician) - 95.8/100 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

1 COMMERCE BLVD STE 201
West Grove, PA 19390
(610) 345-0977

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
Measured-score avg: 83.5
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
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 1.0%
Otolaryngology Physician average

1% brand-name claims vs 99% generic, on 816 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.

816
Total Claims
$22K
Total Drug Cost
377
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
1,181.9
Total Day Supply
28,958
Brand vs Generic
1% brand / 99% generic
Brand Drug Cost
$1K
Generic Drug Cost
$20K
Antibiotic Claims
78

Patient Demographics

Average Patient Age
75.4 years
Avg HCC Risk Score
1.13
Gender Split
56% female / 44% male
Age Distribution
<65: 11, 65-74: 168, 75-84: 156, 85+: 42

Top Prescribed Drugs (Medicare Part D)

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

What Timothy Downey, M.D. 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
Ipratropium Bromide
 346
Prednisone
 75
Azelastine Hcl
 54
Fluocinolone Acetonide Oil
 37
Meclizine Hcl
 28
Montelukast Sodium
 27
Amoxicillin
 26
Triamcinolone Acetonide
 18
Clotrimazole-Betamethasone
Clotrimazole/Betamethasone Dip
16
Neomycin-Polymyxin-Hydrocort
Neomycin/Polymyxin B/Hydrocort
16

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

More Otolaryngology Physician in PA → All providers in Pennsylvania → Compare specialties →

Otolaryngology Physician Overview

How Timothy Downey, M.D. fits within the Otolaryngology Physician landscape nationally.

11,060
Otolaryngology Physician Providers in US
54
States with Otolaryngology Physician
536
Avg Claims per Provider

Timothy Downey, M.D.'s 816 claims are above the specialty average of 536.

Nationwide Otolaryngology Physician peers with similar MIPS or enrollment year

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

Similar MIPS final score

Nearest same-specialty clinicians by CMS MIPS final score (95.8 here).

David Huchton 95.8 TX Rohan Joshi 95.8 TX Barcleigh Landau 95.8 TX John Lasiter 95.8 TX

Same NPPES enumeration year (2006)

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

James Klein San Francisco, CA A. Pinheiro Springfield, MO Jason H Kim Fullerton, CA John Nash Fond Du Lac, WI

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.

One of 510 Otolaryngology Physician providers enrolled in Pennsylvania, 5 are shown here.

Dr. Soo Abboud
MD
Philadelphia, PA
Allyson Abell
Sayre, PA
Ahmad Abualsoud
MBBCH
Bethlehem, PA
Dr. Nithin Adappa
MD
Philadelphia, PA
Dr. Robert Adelson
MD
Philadelphia, PA

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 2024, Timothy Downey, M.D. wrote 816 Medicare Part D claims totaling $22K in drug costs for 377 beneficiaries.
What is Timothy Downey, M.D.'s Medicare quality score? ▼
Timothy Downey, M.D. has a CMS MIPS Final Score of 95.8/100. 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 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 1% brand-name and 99% generic drugs by claim count, with $1K in brand drug costs.
How many Otolaryngology Physician providers are there in the US? ▼
There are 11,060 Otolaryngology Physician providers across 54 states in the US. The average Otolaryngology Physician provider writes 536 Medicare Part D claims per year.
What drugs does Timothy Downey, M.D. prescribe most often? ▼
Based on 2024 Medicare Part D data, Timothy Downey, M.D.'s most frequently prescribed drugs include Ipratropium Bromide, Prednisone, Azelastine Hcl. 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 816 Part D claims and 377 Medicare beneficiaries in 2024. 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

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.