KAREN LEE MACKENNEY RN, FNP
NPI 1003014366
Nurse Practitioner - Family in Shenandoah, TX


Quality Rating: 76.69 out of 100 score

NPI Status: Active since July 10, 2007

Contact Information

135 VISION PARK BLVD
SHENANDOAH, TX
ZIP 77384
Phone: (281) 404-3000
Fax: (281) 290-9824

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  • Individual
  • Female
  • Years of Experience 17
  • Nurse Practitioner
  • Family
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About KAREN MACKENNEY

Karen Mackenney is a provider established in Shenandoah, Texas and her medical specialization is Nurse Practitioner with a focus in family with more than 17 years of experience. She graduated from University Of Texas Medical Branch At Galveston in 2007. The healthcare provider is registered in the NPI registry with number 1003014366 assigned on July 2007. The practitioner's primary taxonomy code is 363LF0000X with license number 564482 (TX). The provider is registered as an individual and her NPI record was last updated 12 years ago.

NPI
1003014366
Provider Name
KAREN LEE MACKENNEY RN, FNP
Gender
Female
Entity Type
Individual
Location Address
135 VISION PARK BLVD SHENANDOAH, TX 77384
Location Phone
(281) 404-3000
Location Fax
(281) 290-9824
Mailing Address
135 VISION PARK BLVD SHENANDOAH, TX 77384
Mailing Phone
(281) 404-3000
Mailing Fax
(281) 290-9824
Medical School Name
UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Graduation Year
2007
Is Sole Proprietor?
No
Enumeration Date
07-10-2007
Last Update Date
01-26-2012
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A nurse practitioner (NP) like Karen Mackenney is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Karen Mackenney is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 76.69, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The typical physician office visit costs for Medicare beneficiaries in this area are: $21.84 for a new patient copayment and $25.3 for an established patient copayment.

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Practitioner Family

Taxonomy Code
363LF0000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
564482
License State
TX

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Ambetter from Arizona Complete Health

    • Choice Bronze HSA - HMO
    • Choice Bronze HSA + Vision + Adult Dental - HMO
    • Clear Gold - HMO
    • Clear Gold + Vision + Adult Dental - HMO
    • Clear Silver - HMO
  • Ambetter from Arkansas Health & Wellness

    • Choice Bronze HSA (QualChoice) - POS
    • Complete Gold - PPO
    • Complete Gold + Vision + Adult Dental - PPO
    • Complete Silver - PPO
    • Complete Silver + Vision + Adult Dental - PPO
  • Ambetter from Louisiana Healthcare Connections

    • Clear Silver - EPO
    • Clear Silver + Vision + Adult Dental - EPO
    • Complete Gold - EPO
    • Complete Gold + Vision + Adult Dental - EPO
    • Elite Bronze - EPO
  • Ambetter from Sunshine Health

    • Clear VALUE Silver - HMO
    • Complete VALUE Gold - HMO
    • Complete VALUE Silver - HMO
    • Elite VALUE Bronze - HMO
    • Focused VALUE Silver - HMO
  • Ambetter from Superior HealthPlan

    • Ambetter Virtual Access Gold (Virtual PCP selection required) - HMO
    • Ambetter Virtual Access Silver (Virtual PCP selection required) - HMO
    • Clear Gold - EPO
    • Clear Gold + Vision + Adult Dental - EPO
    • Clear Silver - EPO
  • Ambetter of Oklahoma

    • Clear Gold - PPO
    • Clear Gold + Vision + Adult Dental - PPO
    • Clear Silver - PPO
    • Clear Silver + Vision + Adult Dental - PPO
    • Complete Silver - PPO
  • Blue Cross and Blue Shield of Texas

    • Blue Advantage Bronze HMO℠ 204 - HMO
    • Blue Advantage Bronze HMO℠ 301 - HMO
    • Blue Advantage Bronze HMO℠ 302 - HMO
    • Blue Advantage Bronze HMO℠ 707 - HMO
    • Blue Advantage Gold HMO℠ 206 - HMO
  • Community Health Choice

    • Community Premier Bronze 003 (No deductible for PCP, Free Preventive Care, 24/7 Telehealth) - HMO
    • Community Premier Bronze 018 (No deductible for PCP, Specialists & Generics, Free 24/7 Telehealth) - HMO
    • Community Premier Gold 005 (No Deductible for PCP, Specialists & Generics, Free 24/7 Telehealth) - HMO
    • Community Premier Gold 021 (No Deductible for PCP, Specialists & Generics, Free 24/7 Telehealth) - HMO
    • Community Premier Silver 004 (No deductible for PCP, Specialists, Urgent Care & Generics, Free 24/7 Telehealth) - HMO
  • Molina Healthcare

    • Gold 1 - HMO
    • Gold 1 with Adult Vision Services - HMO
    • Gold 8 - HMO
    • Silver 1 250 - HMO
    • Silver 1 250 with Adult Vision Services - HMO
  • UnitedHealthcare

    • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Insulin) - HMO
    • UHC Bronze Standard - HMO
    • UHC Bronze Value ($0 Virtual Urgent Care + $0 PCP Visits, $3 Tier 2 Rx, $0 Insulin) - HMO
    • UHC Bronze Value HSA - HMO
    • UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, $0 Insulin) - HMO
  • Medicare

  • Medicaid


*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
TXB140990MEDICARE PIN (08)TX 
206017002MEDICAID (05)TX 

PECOS Enrollment and Medicare Participation Status

Karen Mackenney is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 8123179314

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20090629000462

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • Oxygen and supplies (D1C)

    Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

    2 DME suppliers used 13 Medicare Claims 13 Services Paid

  • Other DME (D1E)

    Nebulizer, with compressor (HCPCS:E0570)

    1 DME suppliers used 11 Medicare Claims 11 Services Paid

  • Oxygen and supplies (D1C)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    2 DME suppliers used 25 Medicare Claims 25 Services Paid

  • Oxygen and supplies (D1C)

    Portable oxygen concentrator, rental (HCPCS:E1392)

    1 DME suppliers used 12 Medicare Claims 12 Services Paid

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 77384 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $87.36
  • Minimum New Patient Price $56.75
  • Maximum New Patient Price $172.6
  • Average New Patient Copayment $21.84
  • Minimum New Patient Copayment $14.18
  • Maximum New Patient Copayment $43.15

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $101.2
  • Minimum Established Patient Price $17.72
  • Maximum Established Patient Price $141.29
  • Average Established Patient Copayment $25.3
  • Minimum Established Patient Copayment $4.43
  • Maximum Established Patient Copayment $35.32

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 76.69 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 57.63

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 100

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Reviews for KAREN LEE MACKENNEY RN, FNP

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1003014366
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003018312
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 1 + 8 + 3 + 1 + 2 + 24 = 44
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 44 = 66

The NPI number 1003014366 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 12 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1396836359NORTHWOODS UROLOGY ASSOCIATION
Organization
Specialist135 VISION PARK BLVD
SHENANDOAH, TX 77384
(281) 404-3000
1679862973UROLOGY SURGICAL SERVICES 2, PLLC
Organization
General Acute Care Hospital135 VISION PARK BLVD
SHENANDOAH, TX 77384
(713) 660-1710
1609192558DR. ZEESHAN ASHRAF DANAWALA M.D.
Individual
Urology135 VISION PARK BLVD
SHENANDOAH, TX 77384
(281) 404-3000
1043578859NORTHWOODS UROLOGY OF TEXAS, PLLC
Organization
Urology135 VISION PARK BLVD
SHENANDOAH, TX 77384
(281) 404-3000
1053401588 REBECCA ALEXANDER TURNER ACNP
Individual
Nurse Practitioner (Acute Care)135 VISION PARK BLVD
SHENANDOAH, TX 77384
(281) 404-3000
1295795698 PAUL RICHARD KENWORTHY MD
Individual
Urology135 VISION PARK BLVD
SHENANDOAH, TX 77384
(281) 404-3000
1306806088 RONALD GLOVER HENRY MD
Individual
Urology135 VISION PARK BLVD
SHENANDOAH, TX 77384
(281) 404-3000
1750341434 MICHAEL FRANCIS GRAHAM JR. MD
Individual
Urology135 VISION PARK BLVD
SHENANDOAH, TX 77384
(281) 404-3000
1669523619 ANGELIQUE A TIJERINA PA
Individual
Physician Assistant135 VISION PARK BLVD
SHENANDOAH, TX 77384
(281) 404-3000
1053816702 PAUL RIZK MD
Individual
Urology135 VISION PARK BLVD
SHENANDOAH, TX 77384
(281) 404-3000
1841953189 JOYCELYN MARTIN WALCOTT AGACNP
Individual
135 VISION PARK BLVD
SHENANDOAH, TX 77384
(936) 235-7092
1063472470 JOHN GEORGE GIANNAKIS MD
Individual
Urology135 VISION PARK BLVD
SHENANDOAH, TX 77384
(281) 404-3000

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003014366, enumerated in the NPI registry as an "individual" on July 10, 2007

The provider is located at 135 Vision Park Blvd Shenandoah, Tx 77384 and the phone number is (281) 404-3000

The provider's speciality is Nurse Practitioner with taxonomy code 363LF0000X with a focus in Family

The provider has more than 17 years of experience. She graduated from University Of Texas Medical Branch At Galveston in 2007.

The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of May 10, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The provider has an overall high rating in the following quality measures: uses technology to exchange and make use of healthcare information.

Medicare beneficiaries should expect a typical cost of $87.36 with an average copayment of $21.84 for new patient appointments. Established patients should expect a typical charge of $101.2 and an average copayment of 25.3. Please review your insurance plan or contact the provider directly to determine your specific costs.

This NPI record was last updated on July 10, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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