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KAREN SANTOS MCCLOUD OD
NPI 1033102249
Optometrist in Lexington, KY

Active since August 24, 2005PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
110 CONN TER STE 550, LEXINGTON, KY 40508(859) 323-5867(859) 323-8510 Get Directions Write a Review

NPPES record last updated: July 17, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 17, 2023, Mar 7, 2023 (2 updates tracked since 2023).

About Karen Santos Mccloud Od NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KAREN SANTOS MCCLOUD OD (NPI 1033102249) is an individual optometrist in Lexington, Kentucky, licensed in Kentucky (1628 DT) and active in the NPI registry since August 2005. She is enrolled in Medicare PECOS and is a graduate of Illinois College Of Optometry At Chicago (2004).

NPPES Registry Identity

NPI1033102249
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameKAREN SANTOS MCCLOUDCredential: OD
Location Address110 CONN TER STE 550Lexington, KY 40508-3206
Mailing Address110 Conn Ter Ste 550Lexington, KY 40508-3206 · (859) 323-5867 · Fax (859) 323-8510
Phone(859) 323-5867
Fax(859) 323-8510
Sole ProprietorNo
Medical School CMSIllinois College Of Optometry At ChicagoGraduated 2004
Enumeration DateAugust 24, 2005
Last NPPES UpdateJuly 17, 20232 updates tracked since enumeration
NPPES CertifiedJuly 17, 2023
✔ NPI 1033102249 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in KY · 1628 DT
Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

110 CONN TER STE 550, Lexington, KY 40508
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Other Names 1

Other Name (5)Karen Santos Mccloud O.d.

Other Identifiers 4

Other000000362108KY · Anthem
Medicaid77001303KY
Other4589534KY · Cigna
Other7643688KY · Aetna

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Karen Santos Mccloud Od is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5395794101
PECOS Enrollment IDI20050119000740
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
119 services119 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
110 services93 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
36 services36 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
26 services25 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
23 services22 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
16 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40508 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
Established Patient
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHADEN HAMDY FATHY YASSIN MD
Ophthalmology (Retina Specialist)
110 CONN TER STE 550
LEXINGTON, KY 40508
Fayette County (859) 323-5867
DR. PETER JOHN TIMONEY MBBCH
Ophthalmology (Ophthalmic Plastic and Reconstructive Surgery)
110 CONN TER STE 550
LEXINGTON, KY 40508
Fayette County (859) 323-5867
DR. CLAIRE ELIZABETH FRASER M.D., PH.D.
Ophthalmology (Retina Specialist)
110 CONN TER STE 550, UNIVERSITY OF KENTUCKY DEPT OF OPHTHALMOLOGY
LEXINGTON, KY 40508
Fayette County (859) 323-5867
MANOKAMNA AGARWAL MD
Ophthalmology (Cornea and External Diseases Specialist)
110 CONN TER STE 550
LEXINGTON, KY 40508
Fayette County (859) 323-5867
ELIZABETH GAMMELTOFT MD
Student in an Organized Health Care Education/Training Program
110 CONN TER STE 550
LEXINGTON, KY 40508
Fayette County (859) 218-2631
MATTHEW PFANNENSTIEL MD
Ophthalmology
110 CONN TER STE 550
LEXINGTON, KY 40508
Fayette County (859) 323-5867
AMANDA LIMBAUGH MARZOLF M.D.
Ophthalmology (Pediatric Ophthalmology and Strabismus Specialist)
110 CONN TER STE 550
LEXINGTON, KY 40508
Fayette County (859) 323-5867
GARRETT OBERST MD
Ophthalmology
110 CONN TER STE 550
LEXINGTON, KY 40508
Fayette County (859) 323-5867

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Karen Mccloud's NPI number?

The NPI number for Karen Mccloud is 1033102249. It was assigned to this individual provider in the NPPES registry on August 24, 2005. The provider is also known as Karen Santos Mccloud O.D..

Where is Karen Mccloud located?

Karen Mccloud practices at 110 Conn Ter Ste 550, Lexington, KY 40508. The listed phone number is (859) 323-5867.

What is Karen Mccloud's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Karen Mccloud enrolled in Medicare?

Yes. Karen Mccloud is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Karen Mccloud accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and Blue Cross and Blue Shield of Montana and 2 other insurers list Karen Mccloud as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Karen Mccloud was last updated on July 17, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.