KARL A DUNCAN M.D.
NPI 1265465017
Internal Medicine - Interventional Cardiology in Lake Charles, LA

Active since July 07, 2006PECOS EnrolledAccepts Medicare Assignment
89.76/100
CMS Quality Rating
1717 OAK PARK BLVD FL 2, LAKE CHARLES, LA 70601(337) 494-3278(337) 494-3240 Get Directions Write a Review

NPPES record last updated: April 3, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 3, 2023, Aug 13, 2020, Mar 30, 2020 and 4 more (7 updates tracked since 2015).

About Karl A Duncan M.d. NPPES

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

KARL A DUNCAN M.D. (NPI 1265465017) is an individual interventional cardiology provider in Lake Charles, Louisiana, licensed in Louisiana (MD.204124) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with West Calcasieu Cameron Hospital, and is a graduate of Louisiana State University School Of Medicine In New Orleans (1999).

NPPES Registry Identity

NPI1265465017
Entity TypeIndividualMale
Primary Taxonomy207RI0011X
Provider Legal NameKARL A DUNCANCredential: M.D.
Location Address1717 OAK PARK BLVD FL 2Lake Charles, LA 70601-8990
Mailing AddressPo Box 122152 Dept 2152Dallas, TX 75312-0001 · (337) 494-2921 · Fax (337) 494-6523
Fax(337) 494-3240
Sole ProprietorNo
Medical School CMSLouisiana State University School Of Medicine In New OrleansGraduated 1999
Enumeration DateJuly 7, 2006
Last NPPES UpdateApril 3, 20237 updates tracked since enumeration
NPPES CertifiedApril 3, 2023
NPI 1265465017 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal Medicine · Interventional CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code207RI0011X
Licenses Licensed in LA · MD.204124 Licensed in MS · 27186
Definition
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X · License 58167 (GA), 326121 (NY)
Also ListedNuclear Medicine · Nuclear CardiologyTaxonomy 207UN0901X · License 58167 (GA), 45842 (TN)
1717 OAK PARK BLVD FL 2, Lake Charles, LA 70601

Other Identifiers 1

Other27186MS · Physician License

Accepted 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

Karl A Duncan 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 ID4789680547
PECOS Enrollment IDI20130412000587
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 28

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.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
1,071 services838 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.
396 services216 patients
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
286 services277 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
226 services190 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
133 services75 patients
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
110 services107 patients

Hospital Affiliations CMS Care Compare 4

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

West Calcasieu Cameron Hospital

Acute Care Hospitals · Sulphur, LA
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number190013
Location701 East Cypress StreetSulphur, LA 70663 · Calcasieu County
Emergency services Birthing friendly

Beauregard Memorial Hospital

Acute Care Hospitals · Deridder, LA
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number190050
Location600 S Pine StreetDeridder, LA 70634 · Beauregard County
Emergency services Birthing friendly

Lake Charles Memorial Hospital

Acute Care Hospitals · Lake Charles, LA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number190060
Location1701 Oak Park BlvdLake Charles, LA 70601 · Calcasieu County
Emergency services Birthing friendly

Allen Parish Hospital

Acute Care Hospitals · Kinder, LA
OwnershipGovernment - Hospital District or Authority
CMS Certification Number190133
Location108 6th AvenueKinder, LA 70648 · Allen County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 70601 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
$124.60 typical visit price
range $53.43 – $164.73
Typical copayment $31.15 (range $13.35 – $41.18)
Most-billed visit code 99204
Established Patient
$95.09 typical visit price
range $16.64 – $133.62
Typical copayment $23.77 (range $4.16 – $33.40)
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.

89.76/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality75.59
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 3

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
4 suppliers12 claims12 services$18.09 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
4 suppliers12 claims12 services$96.04 avg. paid by Medicare
Automatic external defibrillator, with integrated electrocardiogram analysis, garment type K0606
DME-Other DME · category DE013N
1 supplier14 claims14 services$2,304.55 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 15

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

Internal Medicine (Interventional Cardiology)
1717 OAK PARK BLVD FL 2
LAKE CHARLES, LA 70601
Nurse Practitioner
1717 OAK PARK BLVD FL 2
LAKE CHARLES, LA 70601
Nurse Practitioner (Family)
1717 OAK PARK BLVD FL 2
LAKE CHARLES, LA 70601
Internal Medicine (Cardiovascular Disease)
1717 OAK PARK BLVD FL 2
LAKE CHARLES, LA 70601
Nurse Practitioner (Family)
1717 OAK PARK BLVD FL 2
LAKE CHARLES, LA 70601
Podiatrist (Foot Surgery)
1717 OAK PARK BLVD FL 2
LAKE CHARLES, LA 70601
Nurse Practitioner (Family)
1717 OAK PARK BLVD FL 2
LAKE CHARLES, LA 70601
Nurse Practitioner (Adult Health)
1717 OAK PARK BLVD FL 2
LAKE CHARLES, LA 70601

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 Karl Duncan's NPI number?

The NPI number for Karl Duncan is 1265465017. It was assigned to this individual provider in the NPPES registry on July 7, 2006.

Where is Karl Duncan located?

Karl Duncan practices at 1717 Oak Park Blvd Fl 2, Lake Charles, LA 70601. The listed phone number is (337) 494-3278.

What is Karl Duncan's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Interventional Cardiology, with taxonomy code 207RI0011X.

Is Karl Duncan enrolled in Medicare?

Yes. Karl Duncan 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 Karl Duncan accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter from Superior HealthPlan and Blue Cross and Blue Shield of Louisiana and 1 other insurer list Karl Duncan 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 Karl Duncan affiliated with any hospitals?

According to CMS data, Karl Duncan is affiliated with West Calcasieu Cameron Hospital, Beauregard Memorial Hospital, Lake Charles Memorial Hospital and Allen Parish Hospital.

When was this NPI record last updated?

The NPPES record for Karl Duncan was last updated on April 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.