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DR. KAREN NICHOLE MCFARLANE M.D.
NPI 1356464770
Surgery in Port Huron, MI

Active since April 09, 2007PECOS EnrolledAccepts Medicare Assignment
1221 RICHARDSON ST, PORT HURON, MI 48060(810) 662-0400(810) 824-3576 Get Directions Write a Review

NPPES record last updated: February 9, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 9, 2022, Dec 11, 2020, Nov 18, 2020 and 1 more (4 updates tracked since 2018).

About Dr. Karen Nichole Mcfarlane M.d. NPPES

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

DR. KAREN NICHOLE MCFARLANE M.D. (NPI 1356464770) is an individual surgery provider in Port Huron, Michigan, licensed in Michigan (4301084126) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS, is affiliated with Mclaren Port Huron, and is a graduate of University Of Iowa, Rj & L Carver College Of Medicine (2004).

NPPES Registry Identity

NPI1356464770
Entity TypeIndividualFemale
Primary Taxonomy208600000X
Provider Legal NameDR. KAREN NICHOLE MCFARLANECredential: M.D.
Location Address1221 RICHARDSON STPort Huron, MI 48060-3548
Mailing Address1221 Richardson StPort Huron, MI 48060-3548 · (810) 662-0400 · Fax (810) 824-3576
Phone(810) 662-0400
Fax(810) 824-3576
Sole ProprietorYes
Medical School CMSUniversity Of Iowa, Rj & L Carver College Of MedicineGraduated 2004
Enumeration DateApril 9, 2007
Last NPPES UpdateFebruary 9, 20224 updates tracked since enumeration
NPPES CertifiedFebruary 9, 2022
✔ NPI 1356464770 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Licenses✔ Licensed in MI · 4301084126✔ Licensed in MN · 52301
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedSurgery · Plastic and Reconstructive SurgeryTaxonomy 2086S0122X · License 14739 (NH)
1221 RICHARDSON ST, Port Huron, MI 48060
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Other Identifiers 1

Medicaid1356464770MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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

Dr. Karen Nichole Mcfarlane 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 ID941359632
PECOS Enrollment IDI20090529000285
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 Mcfarlane reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Hope Surgical, PLLC
Same address
Surgery
1221 RICHARDSON ST
Port Huron, MI 48060
  • Reassigned Medicare billing, Michigan enrollment
NPI 1558972794 (810) 662-0400

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 7

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.

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.
66 services27 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.
45 services26 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.
36 services35 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
17 services15 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
16 services15 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.
12 services11 patients

Hospital Affiliations CMS Care Compare

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

Mclaren Port Huron

Acute Care Hospitals · Port Huron, MI
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230216
Location1221 Pine Grove AvePort Huron, MI 48060 · St. Clair County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48060 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
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
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

Closing the Referral Loop: Receipt of Specialist Report
3%30 patients1/55-star benchmark: 87%
Documentation of Current Medications in the Medical Record
46%163 patients1/55-star benchmark: 100%
e-Prescribing
99%156 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
21%154 patients1/55-star benchmark: 98%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
14%135 patients1/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients screened: 0% · 52 patients
0%52 patients
Provide Patients Electronic Access to Their Health Information
50%298 patients2/55-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.

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.

HOPE SURGICAL, PLLC
Surgery
1221 RICHARDSON ST
PORT HURON, MI 48060
St. Clair County (810) 662-0400
KIMBERLEY CAROL CLARK-PAUL M.D.
Surgery
1221 RICHARDSON ST
PORT HURON, MI 48060
St. Clair County (810) 982-1111

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 Mcfarlane's NPI number?

The NPI number for Karen Mcfarlane is 1356464770. It was assigned to this individual provider in the NPPES registry on April 9, 2007.

Where is Karen Mcfarlane located?

Karen Mcfarlane practices at 1221 Richardson St, Port Huron, MI 48060. The listed phone number is (810) 662-0400.

What is Karen Mcfarlane's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Karen Mcfarlane enrolled in Medicare?

Yes. Karen Mcfarlane 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 Mcfarlane's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Karen Mcfarlane reassigns Medicare benefits to Hope Surgical, PLLC (Port Huron, MI). 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 Mcfarlane's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Karen Mcfarlane accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 2 other insurers list Karen Mcfarlane 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 Mcfarlane affiliated with any hospitals?

According to CMS data, Karen Mcfarlane is affiliated with Mclaren Port Huron.

When was this NPI record last updated?

The NPPES record for Karen Mcfarlane was last updated on February 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.