2026 NPPES data Otolaryngology Physician NPI 1952538456 M.D.
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TODD FALCONE, M.D.

Otolaryngology Physician in FARMINGTON, Connecticut. 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
529
Medicare Part D claims · 205 beneficiaries · Otolaryngology Physician avg: 509
Generic prescribing
95%
generic claims · 5% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
79.3496/100
▼ 4 pts below national avg 83.1 · [object Object]
Industry payments
$59.94
2 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: TODD FALCONE, M.D. is a Otolaryngology Physician ([object Object]) practicing in FARMINGTON, Connecticut with a Medicare Part D prescribing footprint of 529 claims across 205 beneficiaries — 5% brand-name prescribing . Their CMS MIPS Final Score of 79.3496/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $59.94 across 2 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: TODD FALCONE, M.D. reported a CMS MIPS final score of 79.3496 out of 100, below the 83.1 national average, and filed 529 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)

TODD FALCONE, 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).

TODD FALCONE, M.D. at a glance

Near national average

NPI registry status

Active

Issued 06/11/2009

NPI 1952538456

Primary specialty

Otolaryngology Physician

Mid-sized

10,895 US NPIs in this specialty

Medicare Part D claims

529 4% vs specialty avg

2023 prescription claims

Specialty avg: 509

MIPS final score

79.3496/100 3.750399999999999% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in Connecticut

How Otolaryngology Physician compares to other specialties among Connecticut providers

Connecticut providers

Otolaryngology Physician share within Connecticut

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

Medicare quality performance — MIPS

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

Near national average
MIPS Final Score
79.3496/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Otolaryngology Physician) — 79.3496/100 vs national avg 83.1

0%100%National avg83%79.3%
MIPS final score (Otolaryngology Physician) — 79.3496/100 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).

TODD FALCONE, M.D. is a Otolaryngology Physician provider practicing in FARMINGTON, Connecticut, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: M.D.. NPI: 1952538456. 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.

TODD FALCONE, M.D. appears in the CMS NPPES registry as a Otolaryngology Physician provider holding M.D. credentials at 263 FARMINGTON AVE, FARMINGTON, CT, 06030, with a listed phone of (860) 679-2804. NPI 1952538456 was issued on 06/11/2009. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what FALCONE 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 529 prescription claims written by this provider, covering 205 Medicare beneficiaries and totaling roughly $91K in drug spend, split 5% brand-name and 95% 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 79.3496/100 for the 2023 performance year (Quality 69.2231, Cost 48.0871), 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

263 FARMINGTON AVE
FARMINGTON, CT 06030

Provider Details

NPI 1952538456
Specialty Otolaryngology Physician
Credentials M.D.
Gender Male
NPI Issued 06/11/2009

CMS Quality Score (MIPS)

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

79.3496
Final Score
Avg: 83.1
69.2231
Quality
48.0871
Cost
100
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where TODD FALCONE, 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.

UNIVERSITY OF CONNECTICUT HEALTH CENTER
FARMINGTON, CT

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 TODD FALCONE, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$60

Largest payer

Stryker Corporation

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 · Generic-heavy

TODD FALCONE, M.D. — brand share 5.0%
Specialty average (est.)

5% brand-name claims vs 95% generic, on 529 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.

529
Total Claims
$91K
Total Drug Cost
205
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
1,015
Total Day Supply
26,781
Brand vs Generic
5% brand / 95% generic
Brand Drug Cost
$73K
Generic Drug Cost
$18K
Antibiotic Claims
67

Patient Demographics

Average Patient Age
71.7 years
Avg HCC Risk Score
1.23
Gender Split
56% female / 44% male
Age Distribution
<65: 37, 65-74: 88, 75-84: 51, 85+: 29

Top Prescribed Drugs (Medicare Part D)

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

Drug Claims
Fluticasone Propionate
131
Ipratropium Bromide
76
Azelastine Hcl
43
Fluocinolone Acetonide Oil
29
Amoxicillin-Clavulanate Potass
Amoxicillin/Potassium Clav
28
Famotidine
25
Doxycycline Hyclate
23
Methylprednisolone
21
Dupixent Pen
Dupilumab
17
Prednisone
16

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

Otolaryngology Physician Overview

How TODD FALCONE, 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

TODD FALCONE, M.D.'s 529 claims are above the specialty average of 509.

Nearby Otolaryngology Physician Providers in Connecticut

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

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

Frequently Asked Questions

What is TODD FALCONE, M.D.'s specialty?
TODD FALCONE, M.D. specializes in Otolaryngology Physician and practices in FARMINGTON, Connecticut. Credentials: M.D..
How much does TODD FALCONE, M.D. prescribe under Medicare Part D?
In 2023, TODD FALCONE, M.D. wrote 529 Medicare Part D claims totaling $91K in drug costs for 205 beneficiaries.
What is TODD FALCONE, M.D.'s Medicare quality score?
TODD FALCONE, M.D. has a CMS MIPS Final Score of 79.3496/100 (Quality: 69.2231, Cost: 48.0871). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is TODD FALCONE, M.D. located?
TODD FALCONE, M.D. is located at 263 FARMINGTON AVE, FARMINGTON, CT, 06030. Phone: (860) 679-2804.
What is TODD FALCONE, M.D.'s NPI number?
TODD FALCONE, M.D.'s National Provider Identifier (NPI) is 1952538456, issued on 06/11/2009.
Does TODD FALCONE, M.D. prescribe more brand-name or generic drugs?
TODD FALCONE, M.D.'s prescribing is 5% brand-name and 95% generic drugs by claim count, with $73K 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 TODD FALCONE, M.D. prescribe most often?
Based on 2023 Medicare Part D data, TODD FALCONE, M.D.'s most frequently prescribed drugs include Fluticasone Propionate, Ipratropium Bromide, Azelastine Hcl. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does TODD FALCONE, M.D. accept Medicare?
TODD FALCONE, M.D. appears in CMS Medicare data with 529 Part D claims and 205 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify TODD FALCONE, M.D.'s credentials?
TODD FALCONE, M.D.'s NPI is 1952538456 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