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DR. KAREN DOROTHY LOUISE SMITH M.D.
NPI 1154317378
Internal Medicine - Rheumatology in Williamsburg, VA

Active since September 22, 2005PECOS EnrolledAccepts Medicare Assignment
96.08/100
CMS Quality Rating
120 KINGS WAY STE 2200, WILLIAMSBURG, VA 23185(757) 645-3460(757) 645-3481 Get Directions Write a Review

NPPES record last updated: October 11, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 11, 2023, Dec 23, 2020, Jul 6, 2020 and 1 more (4 updates tracked since 2020).

About Dr. Karen Dorothy Louise Smith M.d. NPPES

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

DR. KAREN DOROTHY LOUISE SMITH M.D. (NPI 1154317378) is an individual rheumatology provider in Williamsburg, Virginia, licensed in Virginia (0101278515) and active in the NPI registry since September 2005. She is enrolled in Medicare PECOS, is affiliated with Riverside Regional Medical Center, and is a graduate of Georgetown University School Of Medicine (1987).

NPPES Registry Identity

NPI1154317378
Entity TypeIndividualFemale
Primary Taxonomy207RR0500X
Provider Legal NameDR. KAREN DOROTHY LOUISE SMITHCredential: M.D.
Location Address120 KINGS WAY STE 2200Williamsburg, VA 23185-2507
Mailing Address856 J Clyde Morris Blvd Ste ANewport News, VA 23601-1318 · (757) 316-5800
Phone(757) 645-3460
Fax(757) 645-3481
Sole ProprietorNo
Medical School CMSGeorgetown University School Of MedicineGraduated 1987
Enumeration DateSeptember 22, 2005
Last NPPES UpdateOctober 11, 20234 updates tracked since enumeration
NPPES CertifiedOctober 11, 2023
✔ NPI 1154317378 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
License✔ Licensed in VA · 0101278515
Definition
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
120 KINGS WAY STE 2200, Williamsburg, VA 23185
Open in Google Maps ↗

Other Identifiers 3

Medicaid839347SC
OtherSCH7225019SC · Medicare Pin
Medicaid207621801TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, First Choice Next.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. Karen Dorothy Louise Smith M.d. 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 ID6002803640
PECOS Enrollment IDI20230712002584
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 4

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 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.
227 services128 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.
184 services131 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.
86 services86 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.
68 services68 patients

Hospital Affiliations CMS Care Compare 3

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

Riverside Regional Medical Center

Acute Care Hospitals · Newport News, VA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490052
Location500 J Clyde Morris BlvdNewport News, VA 23601 · Newport News City County
Emergency services Birthing friendly

Riverside Walter Reed Hospital

Acute Care Hospitals · Gloucester, VA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490130
Location7519 Hospital RoadGloucester, VA 23061 · Gloucester County
Emergency services

Riverside Doctors' Hospital Of Williamsburg

Acute Care Hospitals · Williamsburg, VA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490143
Location1500 Commonwealth AvenueWilliamsburg, VA 23185 · James City County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23185 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
$129.04 typical visit price
range $56.19 – $170.30
Typical copayment $32.26 (range $14.04 – $42.57)
Most-billed visit code 99204
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
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.

96.08/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality92.17
Promoting Interoperability100
Improvement Activities40

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.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier11 claims11 services$17.61 avg. paid by Medicare
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
1 supplier11 claims11 services$91.11 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 2

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

MISS KIMBERLY EVE FLEMING ARNP
Nurse Practitioner (Acute Care)
120 KINGS WAY STE 2200
WILLIAMSBURG, VA 23185
York County (757) 645-3460
ERICA ELIZABETH SCHNEIDER MD
Internal Medicine (Pulmonary Disease)
120 KINGS WAY STE 2200
WILLIAMSBURG, VA 23185
York County (757) 645-3460

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 Smith's NPI number?

The NPI number for Karen Smith is 1154317378. It was assigned to this individual provider in the NPPES registry on September 22, 2005.

Where is Karen Smith located?

Karen Smith practices at 120 Kings Way Ste 2200, Williamsburg, VA 23185. The listed phone number is (757) 645-3460.

What is Karen Smith's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Karen Smith enrolled in Medicare?

Yes. Karen Smith 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 Smith accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina and First Choice Next list Karen Smith 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 Karen Smith affiliated with any hospitals?

According to CMS data, Karen Smith is affiliated with Riverside Regional Medical Center, Riverside Walter Reed Hospital and Riverside Doctors' Hospital Of Williamsburg.

When was this NPI record last updated?

The NPPES record for Karen Smith was last updated on October 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.