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ISMO MIKAEL KAARIAINEN MD
NPI 1083615058
Internal Medicine - Nephrology in Boone, NC

Active since August 02, 2005PECOS EnrolledAccepts Medicare Assignment
400 SHADOWLINE DR STE 203, BOONE, NC 28607(828) 263-8707(828) 263-8710 Get Directions Write a Review

NPPES record last updated: May 3, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 3, 2023, Aug 29, 2019 (2 updates tracked since 2019).

About Ismo Mikael Kaariainen Md NPPES

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

ISMO MIKAEL KAARIAINEN MD (NPI 1083615058) is an individual nephrology provider in Boone, North Carolina, licensed in North Carolina (200101075) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Frye Regional Medical Center, and maintains a secondary practice location in Lenoir.

NPPES Registry Identity

NPI1083615058
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameISMO MIKAEL KAARIAINENCredential: MD
Location Address400 SHADOWLINE DR STE 203Boone, NC 28607-5022
Mailing Address400 Shadowline Dr Ste 203Boone, NC 28607-5022 · (828) 263-8707 · Fax (828) 263-8710
Phone(828) 263-8707
Fax(828) 263-8710
Sole ProprietorNo
Medical School CMSOtherGraduated 1995
Enumeration DateAugust 2, 2005
Last NPPES UpdateMay 3, 20232 updates tracked since enumeration
NPPES CertifiedMay 3, 2023
✔ NPI 1083615058 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in NC · 200101075
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Also ListedSpecialistTaxonomy 174400000X · License 200101075 (NC)
Also ListedInternal MedicineTaxonomy 207R00000X · License 200101075 (NC)
Also ListedHospitalistTaxonomy 208M00000X · License 200101075 (NC)
400 SHADOWLINE DR STE 203, Boone, NC 28607
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Secondary Practice Location 1

Location 1504 Mulberry St SW Ste DLenoir, NC 28645-5762 · Phone (828) 263-8707 · Fax (828) 263-8710

Other Identifiers 3

Other14262Ncbc
Medicaid89129PFNC
Other129PFNC · Bcbs - Cvmc

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, Cigna Healthcare.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

Ismo Mikael Kaariainen 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 ID3173535739
PECOS Enrollment IDI20060622000252
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 Reassignments

4

Medicare enrollment records show Ismo Kaariainen reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Dlp Frye Medical Group LLC
0.5 mi
Family Medicine
237 LONGVUE DR STE A
Boone, NC 28607
  • Reassigned Medicare billing, North Carolina enrollment
  • 228 clinicians in this Medicare group
NPI 1861930976 (828) 264-7222
Caldwell Memorial Hospital, Inc.
5.6 mi
Geriatric Medicine
8439 VALLEY BLVD
Blowing Rock, NC 28605
  • Reassigned Medicare billing, North Carolina enrollment
  • 313 clinicians in this Medicare group
NPI 1578949079 (828) 295-3116
Kaariainen Medical Services PLLC
34 mi
Nephrology
321 41ST AVENUE PL NW
Hickory, NC 28601
  • Reassigned Medicare billing, North Carolina enrollment
NPI 1710127824 (828) 322-9164
Geriatric Consultants PLLC
36 mi
Geriatric Medicine
220 13TH AVENUE PL NW
Hickory, NC 28601
  • Reassigned Medicare billing, North Carolina enrollment
  • 67 clinicians in this Medicare group
NPI 1801478086 (914) 843-9637

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 9

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.

Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
175 services53 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.
104 services84 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.
98 services64 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
39 services19 patients
Dialysis services, 2-3 physician visits per month (20 years or older) 90961
Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.
37 services26 patients
Hemodialysis procedure with physician evaluation 90935
Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.
16 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Frye Regional Medical Center

Acute Care Hospitals · Hickory, NC
1/5 CMS rating
OwnershipProprietary
CMS Certification Number340116
Location420 N Center StHickory, NC 28601 · Catawba County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28607 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
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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.

Reported Quality Measures

Breast Cancer Screening
0%101 patients1/55-star benchmark: 93%
Cervical Cancer Screening
0%59 patients1/55-star benchmark: 98%
Controlling High Blood Pressure
67%203 patients3/55-star benchmark: 91%
Diabetes: Eye Exam
0%117 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
100%117 patients1/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
75%797 patients3/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
0%269 patients1/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
19%398 patients1/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
0%394 patients1/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients screened: 5% · 194 patients
5%194 patients
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
83%144 patients4/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 280 patients
Patients totalRate: 0% · 280 patients
0%280 patients5/55-star benchmark: 100%
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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers13 claims13 services$72.35 avg. paid by Medicare
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738
DME-Oxygen and Supplies · category DC000N
1 supplier11 claims11 services$27.84 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

JARED N KEITH MD
Internal Medicine (Nephrology)
400 SHADOWLINE DR STE 203
BOONE, NC 28607
Watauga County (828) 263-8707

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 Ismo Kaariainen's NPI number?

The NPI number for Ismo Kaariainen is 1083615058. It was assigned to this individual provider in the NPPES registry on August 2, 2005.

Where is Ismo Kaariainen located?

Ismo Kaariainen practices at 400 Shadowline Dr Ste 203, Boone, NC 28607. The listed phone number is (828) 263-8707.

What is Ismo Kaariainen's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Ismo Kaariainen enrolled in Medicare?

Yes. Ismo Kaariainen 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 organizations bill Medicare for Ismo Kaariainen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ismo Kaariainen reassigns Medicare benefits to 4 organizations: Dlp Frye Medical Group LLC (Boone, NC), Caldwell Memorial Hospital, Inc. (Blowing Rock, NC), Kaariainen Medical Services PLLC (Hickory, NC) and Geriatric Consultants PLLC (Hickory, NC). Each 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 Ismo Kaariainen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ismo Kaariainen accept?

Health plans from Blue Cross and Blue Shield of NC and Cigna Healthcare list Ismo Kaariainen 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.

Is Ismo Kaariainen affiliated with any hospitals?

According to CMS data, Ismo Kaariainen is affiliated with Frye Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Ismo Kaariainen was last updated on May 3, 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.