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DR. THOMAS E. KARELIS JR. MD
NPI 1053324129
Internal Medicine in Hazard, KY

Active since August 13, 2006PECOS EnrolledAccepts Medicare Assignment
46.84/100
CMS Quality Rating
311 ROY CAMPBELL DR, HAZARD, KY 41701(606) 487-0776(606) 487-0777 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Dr. Thomas E. Karelis Jr. Md NPPES

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

DR. THOMAS E. KARELIS JR. MD (NPI 1053324129) is an individual internal medicine provider in Hazard, Kentucky, licensed in Kentucky (36880) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Kentucky College Of Medicine (1998).

NPPES Registry Identity

NPI1053324129
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. THOMAS E. KARELIS JR.Credential: MD
Location Address311 ROY CAMPBELL DRHazard, KY 41701-9486
Mailing AddressPo Box 1297Hazard, KY 41702-1297 · (606) 487-0776 · Fax (606) 487-0777
Phone(606) 487-0776
Fax(606) 487-0777
Sole ProprietorNo
Medical School CMSUniversity Of Kentucky College Of MedicineGraduated 1998
Enumeration DateAugust 13, 2006
Last NPPES UpdateMarch 7, 2023
NPPES CertifiedMarch 17, 2022
✔ NPI 1053324129 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in KY · 36880
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
311 ROY CAMPBELL DR, Hazard, KY 41701
Open in Google Maps ↗

Other Identifiers 5

OtherP00640620KY · Railroad Medicare
Medicaid64037088KY
Other00216005KY · Medicare Ptan
Other36880KY · State Licence Number
OtherP00693305KY · Railroad Medicare

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

Dr. Thomas E. Karelis Jr. Md 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 ID2466488093
PECOS Enrollment IDI20050714000455
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 11

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.

Testing for presence of drug, by chemistry analyzers 80307
Chemistry analyzers are used to detect the presence of drugs in your system. This test involves taking a small sample of your blood or urine. The sample is then analyzed for specific substances. The results help in understanding your health condition better.
848 services117 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.
541 services103 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.
256 services93 patients
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms G0481
A definitive drug test is a detailed analysis used to identify specific drugs in your system. It uses advanced techniques, such as gc/ms and lc/ms, to detect and distinguish between different drugs, even those with similar structures.
214 services102 patients
Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
70 services25 patients
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211
This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.
54 services46 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41701 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
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
Most-billed visit code 99214
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.

46.84/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality43.33
Improvement Activities0
Cost81.71

Other Providers at the Same Location NPPES 4

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

MRS. ROBETTA MELAINE BAKER APRN
Nurse Practitioner (Family)
311 ROY CAMPBELL DR
HAZARD, KY 41701
Perry County (606) 487-0776
MRS. ELIZABETH SUZANNE CRANK MSN, APRN, RD, LD
Nurse Practitioner
311 ROY CAMPBELL DR
HAZARD, KY 41701
Perry County (606) 487-0776
JEFFREY FUGATE APRN
Nurse Practitioner (Family)
311 ROY CAMPBELL DR, SUITE 100
HAZARD, KY 41701
Perry County (606) 487-7383
KENTUCKY PRIMARY MEDICAL SERVICES LLC
Clinic/Center (Primary Care)
311 ROY CAMPBELL DR
HAZARD, KY 41701
Perry County (606) 487-0776

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 Thomas Karelis's NPI number?

The NPI number for Thomas Karelis is 1053324129. It was assigned to this individual provider in the NPPES registry on August 13, 2006.

Where is Thomas Karelis located?

Thomas Karelis practices at 311 Roy Campbell Dr, Hazard, KY 41701. The listed phone number is (606) 487-0776.

What is Thomas Karelis's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Thomas Karelis enrolled in Medicare?

Yes. Thomas Karelis 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 Thomas Karelis accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health and Ambetter of Tennessee list Thomas Karelis 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 Thomas Karelis was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.