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DR. KARLA RENEE SCANLON DPM
NPI 1063412971
Podiatrist in Willimantic, CT

Active since July 21, 2005PECOS EnrolledAccepts Medicare Assignment
79.34/100
CMS Quality Rating
162 MANSFIELD AVE, WILLIMANTIC, CT 06226(860) 456-4250(860) 456-3745 Get Directions Write a Review

NPPES record last updated: July 11, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 11, 2022, Nov 20, 2019, Oct 30, 2019 (3 updates tracked since 2019).

About Dr. Karla Renee Scanlon Dpm NPPES

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

DR. KARLA RENEE SCANLON DPM (NPI 1063412971) is an individual podiatrist in Willimantic, Connecticut, licensed in Connecticut (000656) and active in the NPI registry since July 2005. She is enrolled in Medicare PECOS, maintains a secondary practice location in Storrs, and is a graduate of Other (1991).

NPPES Registry Identity

NPI1063412971
Entity TypeIndividualFemale
Primary Taxonomy213E00000X
Provider Legal NameDR. KARLA RENEE SCANLONCredential: DPM
Location Address162 MANSFIELD AVEWillimantic, CT 06226-2061
Mailing Address162 Mansfield AveWillimantic, CT 06226-2061 · (860) 456-4250 · Fax (860) 456-3745
Phone(860) 456-4250
Fax(860) 456-3745
Sole ProprietorNo
Medical School CMSOtherGraduated 1991
Enumeration DateJuly 21, 2005
Last NPPES UpdateJuly 11, 20223 updates tracked since enumeration
✔ NPI 1063412971 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
License✔ Licensed in CT · 000656
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
162 MANSFIELD AVE, Willimantic, CT 06226
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Secondary Practice Location 1

Location 11 Royce CirStorrs, CT 06268-2260 · Phone (860) 487-9200 · Fax (860) 487-9222

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Karla Renee Scanlon Dpm 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 ID7517969868
PECOS Enrollment IDI20071011000274
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.

Medicare Billing Reassignment

Medicare enrollment records show Karla Scanlon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Of Connecticut Health Center
30 mi
General Practice
263 FARMINGTON AVE
Farmington, CT 06030
  • Reassigned Medicare billing, Connecticut enrollment
  • 788 clinicians in this Medicare group
NPI 1720083769 (860) 679-7503

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 8

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.

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.
138 services98 patients
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.
80 services80 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.
29 services29 patients
Removal of skin and tissue, 20.0 sq cm or less 11042
This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.
28 services11 patients
X-ray of foot, minimum of 3 views 73630
An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.
27 services21 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.
23 services20 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06226 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
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$75.55 typical visit price
range $19.76 – $149.26
Typical copayment $18.88 (range $4.94 – $37.31)
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.

79.34/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality69.22
Promoting Interoperability100
Improvement Activities40
Cost48.08

Reported Quality Measures

Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
82%1,185 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
19%1,286 patients1/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
99%369 patients5/55-star benchmark: 90%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
98%392 patients5/55-star benchmark: 88%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
71%1,286 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
0%1,286 patients1/55-star benchmark: 79%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES

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

DR. ALEXANDER DARIUS SALAMATIAN DPT, PT
Physical Therapist
162 MANSFIELD AVE
WILLIMANTIC, CT 06226
Southeastern Connecticut Planning Region (860) 456-2232

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 Karla Scanlon's NPI number?

The NPI number for Karla Scanlon is 1063412971. It was assigned to this individual provider in the NPPES registry on July 21, 2005.

Where is Karla Scanlon located?

Karla Scanlon practices at 162 Mansfield Ave, Willimantic, CT 06226. The listed phone number is (860) 456-4250.

What is Karla Scanlon's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Is Karla Scanlon enrolled in Medicare?

Yes. Karla Scanlon 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.

Which organization bills Medicare for Karla Scanlon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Karla Scanlon reassigns Medicare benefits to University Of Connecticut Health Center (Farmington, CT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Karla Scanlon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Karla Scanlon accept?

Health plans from Anthem Blue Cross and Blue Shield list Karla Scanlon 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 Karla Scanlon was last updated on July 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.