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

Q: 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.

Q: What is Karl Duncan's specialty?

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

Q: 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.

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: October 18, 2026.

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

On this page

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

Phone(337) 494-3278

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

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Other Identifiers 1

Other27186MS · Physician License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and more.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

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.

Medicare Billing Reassignments

Medicare enrollment records show Karl Duncan reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lake Charles Memorial Heart And Vascular Center

Same address

Cardiovascular Disease

1717 OAK PARK BLVD FL 2
Lake Charles, LA 70601

Reassigned Medicare billing, Louisiana enrollment
16 clinicians in this Medicare group

NPI 1407808405 (337) 494-3278

Southwest Louisiana Hospital Association Inc

Same address

Interventional Cardiology

1701 OAK PARK BLVD
Lake Charles, LA 70601

Reassigned Medicare billing, Louisiana enrollment
20 clinicians in this Medicare group

NPI 1902326572 (337) 494-3200

Hospitalist Medicine Physicians Of Texas, PLLC

125 mi

Internal Medicine

18951 N MEMORIAL DR
Humble, TX 77338

Reassigned Medicare billing, Louisiana enrollment
169 clinicians in this Medicare group

NPI 1629307095 (281) 540-7700

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 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

110 services107 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

64 services63 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.

60 services60 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

56 services54 patients

Injection, regadenoson, 0.1 mg J2785

Regadenoson injection, 0.1 mg, is a medication used to help visualize the heart during a stress test. It works by increasing blood flow in the arteries of the heart. It's injected into a vein and is generally well-tolerated.

52 services13 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.

38 services37 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.

38 services22 patients

Ultrasonic guidance for blood vessel access 76937

Ultrasonic guidance for blood vessel access is a medical procedure where sound waves are used to create images of your blood vessels. This helps doctors to accurately locate and access the vessels for treatments or tests, ensuring safety and precision.

35 services30 patients

Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist 93458

This procedure involves placing a tube into your left lower heart chamber and coronary artery. It helps doctors diagnose heart conditions by allowing them to view these areas in detail. A radiologist will review the images to ensure accurate diagnosis.

34 services33 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

30 services30 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

27 services27 patients

Technetium tc-99m sestamibi, diagnostic, per study dose A9500

Technetium Tc-99m Sestamibi is a diagnostic test used to create images of your heart or breast tissues. It involves a safe radioactive substance injection that helps doctors to detect any abnormalities or changes in these tissues.

26 services15 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

25 services25 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

22 services22 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016

22 services22 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) 93017

An exercise or drug-induced heart stress test with an ECG checks how your heart responds to stress. You'll either exercise on a treadmill or be given medication to stress your heart. An ECG then captures your heart's activity, helping detect any issues.

22 services22 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

22 services22 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

20 services20 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician 93015

An exercise or drug-induced heart stress test with ECG is a procedure performed by a doctor to assess how your heart responds to exertion. It involves monitoring your heart's electrical activity while you exercise or after medication is given to mimic exercise effects.

16 services16 patients

Electrocardiogram (ecg) up to 30 days continuous with review and report by health care professional 93228

An Electrocardiogram (ECG) is a non-invasive test that records the electrical signals in your heart. For up to 30 days, a small device will continuously monitor your heart's activity. A healthcare professional will then review the data and provide a report on your heart's function.

16 services16 patients

Heart rhythm review and interpretation of continous external ekg over 8-15 days 93248

This service involves wearing a device for 8-15 days that continuously records your heart's electrical activity. It helps in identifying irregular heart rhythms. The recorded data is then reviewed and interpreted by a healthcare professional for any abnormalities.

12 services12 patients

Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days 93244

A heart rhythm review involves monitoring your heart's electrical activity for more than 48 hours up to 7 days. Using a device called an external EKG, doctors can track your heartbeats to detect irregularities and help diagnose heart conditions.

11 services11 patients

Heart rhythm recording of continous external ekg over 8-15 days 93246

A heart rhythm recording is a non-invasive procedure where a small device, attached externally, monitors your heart's electrical activity for 8-15 days. It helps detect irregular heart rhythms, assess heart rate, and guide treatment decisions. It's safe, painless, and can be done during normal daily activities.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

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

Quality

75.59

Promoting Interoperability

100

Improvement Activities

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.

DR. JEAN KING WHITE MD

Internal Medicine (Interventional Cardiology)