NPI registry status
Active
2026 NPPES data Internal Medicine Physician NPI 1396959995 MD
Verify on CMS → Toni Pacioles, MD
Internal Medicine Physician in Huntington, West Virginia.
This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 172,737 in Internal Medicine 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 · 305 beneficiaries · Internal Medicine Physician avg: 3K
Generic prescribing
72%
generic claims · 28% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
29.8/100
▼ 53 pts below national avg 83.1 · Below average
Industry payments
$86.94
5 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
Toni Pacioles, MD reported a CMS MIPS final score of 29.8/100 - below the 83.1 national average - and filed 1,587 Medicare Part D claims in 2023.
- 29.8/100
- MIPS score · -53 vs avg
- 2K
- Part D claims, 2023
- 72%
- 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.
Toni Pacioles, MD's MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
30 3rd percentile higher than 3% 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 Toni Pacioles, MD sits
This provider among internal medicine physician peers
Across the 36,260 internal medicine physician providers who report both Medicare Part D prescribing and a MIPS quality score, Toni Pacioles, MD writes more Part D claims than 62% of them and scores higher on MIPS quality than 4% - 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 internal medicine physician peer from a representative sample of 60; the gold marker is Toni Pacioles, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
✓
Board certification likely (heuristic, not verified)
Toni Pacioles, 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 Toni Pacioles, MD?
Below national averagePrimary specialty
Internal Medicine Physician
Medicare Part D claims
1,587 42% vs specialty avg
MIPS final score
29.8/100 53.3 pts vs avg
Specialty distribution in West Virginia
How Internal Medicine Physician compares to other specialties among West Virginia providers
Medicare quality performance, MIPS
Toni Pacioles, MD's 2023 MIPS final score plotted against the Internal Medicine Physician national average
- MIPS Final Score
- 29.8/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Internal Medicine Physician) - 29.8/100 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).
Toni Pacioles, MD appears in the CMS NPPES registry as an Internal Medicine Physician provider holding MD credentials at 1400 HAL GREER BLVD, Huntington, WV, 25701, with a listed phone of (304) 399-6610. NPI 1396959995 was issued on 05/10/2007.
Medicare Part D records for calendar year 2023 show 1,587 prescription claims written by this provider, covering 305 Medicare beneficiaries and totaling roughly $5.7 million in drug spend, split 28% brand-name and 72% generic by claim count, with an opioid prescribing rate of 5.9%. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 29.8/100 for the 2023 performance year (Quality 30, Cost 16.7), compared with the national average of 83.1.
Internal Medicine Physician is a high-volume specialty nationwide, with 172,737 enrolled providers across 56 states and an average of 2,716 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 | 1396959995 |
|---|---|
| Specialty | Internal Medicine Physician |
| Credentials | MD |
| Gender | Male |
| NPI Issued | 05/10/2007 |
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
29.8378
Final Score
Avg: 83.1
30
Quality
16.673
Cost
Reporting: Individual
Hospital and facility affiliations
Facilities where Toni Pacioles, 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.
Cabell Huntington Hospital Inc
Huntington, WV
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 Toni Pacioles, MD. Source: openpaymentsdata.cms.gov.
Total received
$87
Largest payer
Merck Sharp & Dohme LLC
Most common payment type
Education
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
Toni Pacioles, MD - brand share 28.0%
Internal Medicine Physician average
28% brand-name claims vs 72% generic, on 1,587 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.
1,587
Total Claims
$5.7M
Total Drug Cost
305
Medicare Beneficiaries
Prescribing Breakdown
- 30-Day Fills
- 1,904
- Total Day Supply
- 48,175
- Brand vs Generic
- 28% brand / 72% generic
- Brand Drug Cost
- $5.2M
- Generic Drug Cost
- $459K
- Opioid Claims
- 94 (5.9% rate)
- Antibiotic Claims
- 95
Patient Demographics
- Average Patient Age
- 69.7 years
- Avg HCC Risk Score
- 2.39
- Gender Split
- 53% female / 47% male
- Age Distribution
- <65: 69, 65-74: 139, 75-84: 82, 85+: 15
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Toni Pacioles, MD prescribes most
Top Medicare Part D drugs by claim count, 2023
- Xtandi
Xtandi
90 claims
- Ondansetron Hcl
Ondansetron Hcl
83 claims
- Prednisone
Prednisone
80 claims
- Anastrozole
Anastrozole
76 claims
- Gabapentin
Gabapentin
75 claims
- Prochlorperazine M…
Prochlorperazine Maleate
67 claims
- Eliquis
Eliquis
46 claims
- Abiraterone Acetate
Abiraterone Acetate
44 claims
| Drug | Claims |
|---|---|
| Xtandi Enzalutamide | 90 |
| Ondansetron Hcl | 83 |
| Prednisone | 80 |
| Anastrozole | 76 |
| Gabapentin | 75 |
| Prochlorperazine Maleate | 67 |
| Eliquis Apixaban | 46 |
| Abiraterone Acetate | 44 |
| Hydrocodone-Acetaminophen Hydrocodone/Acetaminophen | 39 |
| Levofloxacin | 38 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Internal Medicine Physician Overview
How Toni Pacioles, MD fits within the Internal Medicine Physician landscape nationally.
172,737
Internal Medicine Physician Providers in US
56
States with Internal Medicine Physician
2,716
Avg Claims per Provider
Toni Pacioles, MD's 1,587 claims are below the specialty average of 2,716.
Nearby Internal Medicine Physician Providers in West Virginia
Other clinicians with the same primary specialty enrolled in West Virginia, drawn from the same CMS NPPES roster as Pacioles.
Dr. M Anwar Abdeen
MD
Montgomery, WV
Dr. Mohammed Abdulqader
M.D.
Huntington, WV
Dr. Muhammad Afzal
MD
Charleston, WV
Dr. Krishan Aggarwal
MD
Weirton, WV
Dr. Phillip Aguila
MD
Martinsburg, WV
Compare Internal Medicine 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 West Virginia medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Internal Medicine 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 Toni Pacioles, MD's specialty? ▼
Toni Pacioles, MD specializes in Internal Medicine Physician and practices in Huntington, West Virginia. Credentials: MD.
How much does Toni Pacioles, MD prescribe under Medicare Part D? ▼
In 2023, Toni Pacioles, MD wrote 1,587 Medicare Part D claims totaling $5.7M in drug costs for 305 beneficiaries.
What is Toni Pacioles, MD's Medicare quality score? ▼
Toni Pacioles, MD has a CMS MIPS Final Score of 29.8/100 (Quality: 30, Cost: 16.7). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Toni Pacioles, MD located? ▼
Toni Pacioles, MD is located at 1400 HAL GREER BLVD, Huntington, WV, 25701. Phone: (304) 399-6610.
What is Toni Pacioles, MD's NPI number? ▼
Toni Pacioles, MD's National Provider Identifier (NPI) is 1396959995, issued on 05/10/2007.
Does Toni Pacioles, MD prescribe more brand-name or generic drugs? ▼
Toni Pacioles, MD's prescribing is 28% brand-name and 72% generic drugs by claim count, with $5.2M in brand drug costs.
Does Toni Pacioles, MD prescribe opioids? ▼
Yes, Toni Pacioles, MD had 94 opioid claims in 2023 with an opioid prescribing rate of 5.9%.
How many Internal Medicine Physician providers are there in the US? ▼
There are 172,737 Internal Medicine Physician providers across 56 states in the US. The average Internal Medicine Physician provider writes 2,716 Medicare Part D claims per year.
What drugs does Toni Pacioles, MD prescribe most often? ▼
Based on 2023 Medicare Part D data, Toni Pacioles, MD's most frequently prescribed drugs include Xtandi, Ondansetron Hcl, Prednisone. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Toni Pacioles, MD accept Medicare? ▼
Toni Pacioles, MD appears in CMS Medicare data with 1,587 Part D claims and 305 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Toni Pacioles, MD's credentials? ▼
Toni Pacioles, MD's NPI is 1396959995 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.
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 May 2026.