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KAREN TSAI M.D.
NPI 1265973416
Internal Medicine - Endocrinology, Diabetes & Metabolism in Duarte, CA

Active since March 20, 2017PECOS EnrolledAccepts Medicare Assignment
99.12/100
CMS Quality Rating
1500 DUARTE RD, DUARTE, CA 91010(626) 256-4673 Get Directions Write a Review

NPPES record last updated: November 14, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 14, 2024, Jun 6, 2022, Jun 22, 2020 and 2 more (5 updates tracked since 2017).

About Karen Tsai M.d. NPPES

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

KAREN TSAI M.D. (NPI 1265973416) is an individual endocrinology, diabetes & metabolism provider in Duarte, California, licensed in California (A157548) and active in the NPI registry since March 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1265973416
Entity TypeIndividualFemale
Primary Taxonomy207RE0101X
Provider Legal NameKAREN TSAICredential: M.D.
Location Address1500 DUARTE RDDuarte, CA 91010-3012
Mailing AddressPo Box 512185Los Angeles, CA 90051-0185
Phone(626) 256-4673
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateMarch 20, 2017
Last NPPES UpdateNovember 14, 20245 updates tracked since enumeration
NPPES CertifiedNovember 14, 2024
✔ NPI 1265973416 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in CA · A157548
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
1500 DUARTE RD, Duarte, CA 91010
Open in Google Maps ↗

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

Karen Tsai 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 ID8729332655
PECOS Enrollment IDI20220615003315
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 Karen Tsai reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

City Of Hope Medical Foundation
0.2 mi
Hematology & Oncology
1500 DUARTE RD
Duarte, CA 91010
  • Reassigned Medicare billing, California enrollment
  • 1,335 clinicians in this Medicare group
NPI 1871886366 (626) 256-4673

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.

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.
357 services251 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.
306 services76 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.
164 services98 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
151 services87 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.
124 services124 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
96 services68 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91010 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
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
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.

99.12/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality85.23
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.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
11 suppliers17 claims60 services$5.29 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier23 claims23 services$183.93 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 20

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

SASAN FAZELI M.D.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1500 DUARTE RD
DUARTE, CA 91010
Los Angeles County (626) 256-4673
SKAI MINDY FU PHARMD
Pharmacist
1500 DUARTE RD
DUARTE, CA 91010
Los Angeles County (626) 500-5461
JIMMIE WONG MD
Radiology (Diagnostic Radiology)
1500 DUARTE RD
DUARTE, CA 91010
Los Angeles County (626) 359-8111
TERENCE WILLIAMS M.D.
Radiology (Radiation Oncology)
1500 DUARTE RD
DUARTE, CA 91010
Los Angeles County (626) 256-4673
DR. MUSTAFA RAOOF M.D.
Surgery (Surgical Oncology)
1500 DUARTE RD
DUARTE, CA 91010
Los Angeles County (626) 256-4673
DR. EDNA CLOGG SHENVI M.D.
Surgery
1500 DUARTE RD
DUARTE, CA 91010
Los Angeles County (626) 256-4673
ALAN CHEN TANG M.D.
Anesthesiology
1500 DUARTE RD
DUARTE, CA 91010
Los Angeles County (626) 359-8111
WINSTON YUHSIEN LEE MD, PHD
Pathology (Hematology)
1500 DUARTE RD
DUARTE, CA 91010
Los Angeles County (626) 256-4673

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 Tsai's NPI number?

The NPI number for Karen Tsai is 1265973416. It was assigned to this individual provider in the NPPES registry on March 20, 2017.

Where is Karen Tsai located?

Karen Tsai practices at 1500 Duarte Rd, Duarte, CA 91010. The listed phone number is (626) 256-4673.

What is Karen Tsai's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Karen Tsai enrolled in Medicare?

Yes. Karen Tsai 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 Karen Tsai's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Karen Tsai reassigns Medicare benefits to City Of Hope Medical Foundation (Duarte, CA). 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 Karen Tsai's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Karen Tsai was last updated on November 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.