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DR. KAREN BARKER CARLSON MD/PHD
NPI 1417114158
Internal Medicine - Hematology & Oncology in Milwaukee, WI

Active since May 20, 2008PECOS EnrolledAccepts Medicare Assignment
80.46/100
CMS Quality Rating
9200 W WISCONSIN AVE, DIVISION OF NEOPLASTIC DISEASES, MILWAUKEE, WI 53226(414) 805-6800(414) 805-6805 Get Directions Write a Review

NPPES record last updated: December 2, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Karen Barker Carlson Md/phd NPPES

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

DR. KAREN BARKER CARLSON MD/PHD (NPI 1417114158) is an individual hematology & oncology provider in Milwaukee, Wisconsin, licensed in Wisconsin (60104) and active in the NPI registry since May 2008. She is enrolled in Medicare PECOS, is affiliated with Froedtert Memorial Lutheran Hospital, and maintains a secondary practice location in New Berlin.

NPPES Registry Identity

NPI1417114158
Entity TypeIndividualFemale
Primary Taxonomy207RH0003X
Provider Legal NameDR. KAREN BARKER CARLSONCredential: MD/PHD
Location Address9200 W WISCONSIN AVE, DIVISION OF NEOPLASTIC DISEASESMilwaukee, WI 53226-3522
Mailing Address9200 W Wisconsin Ave, Division Of Neoplastic DiseasesMilwaukee, WI 53226-3522 · (414) 805-6800 · Fax (414) 805-6805
Phone(414) 805-6800
Fax(414) 805-6805
Sole ProprietorNo
Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 2004
Enumeration DateMay 20, 2008
Last NPPES UpdateDecember 2, 2022
NPPES CertifiedDecember 2, 2022
✔ NPI 1417114158 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0003X
License✔ Licensed in WI · 60104
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
9200 W WISCONSIN AVE, Milwaukee, WI 53226
Open in Google Maps ↗

Secondary Practice Location 1

Location 14805 S Moorland RdNew Berlin, WI 53151-7401 · Phone (262) 798-7200 · Fax (262) 798-7201

Other Identifiers 1

Medicaid1417114158WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Network Health.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 Barker Carlson Md/phd 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 ID2365620754
PECOS Enrollment IDI20130419000319
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 5

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.
136 services29 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.
95 services29 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.
45 services20 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.
40 services24 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 services23 patients

Hospital Affiliations CMS Care Compare

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

Froedtert Memorial Lutheran Hospital

Acute Care Hospitals · Milwaukee, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520177
Location9200 W Wisconsin AveMilwaukee, WI 53226 · Milwaukee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53226 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
$163.24 typical visit price
range $53.90 – $163.24
Typical copayment $40.81 (range $13.47 – $40.81)
Most-billed visit code 99205
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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.

80.46/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality66.24
Promoting Interoperability100
Improvement Activities40
Cost68.64

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.

TRACY BLAIR WANDTKE HERRMANN APNP, CNM
Advanced Practice Midwife
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-4777
DR. ZACHARY SMITH DO
Internal Medicine (Gastroenterology)
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 955-6830
DR. COLLEEN ANN CROWE M.D., M.P.H.
Emergency Medicine
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-6469
ROBERTO MEJIAS APNP
Nurse Practitioner (Pediatrics)
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-6600
MRS. ANNE E B LAKATOS APN-BC, APNP, RN
Nurse Practitioner (Adult Health)
9200 W WISCONSIN AVE, DEPT OF INTERNAL MEDICINE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-6850
MRS. AMANDA M MANDERS APNP
Nurse Practitioner (Adult Health)
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-6850
KATHLEEN A WATERHOUSE-SKIBICKI CRNA
Nurse Anesthetist, Certified Registered
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-5951
ANDREA L BEQUEST PA
Physician Assistant (Medical)
9200 W WISCONSIN AVE, INTERNAL MEDICINE
MILWAUKEE, WI 53226
Milwaukee County (414) 955-0350

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 Carlson's NPI number?

The NPI number for Karen Carlson is 1417114158. It was assigned to this individual provider in the NPPES registry on May 20, 2008.

Where is Karen Carlson located?

Karen Carlson practices at 9200 W Wisconsin Ave Division Of Neoplastic Diseases, Milwaukee, WI 53226. The listed phone number is (414) 805-6800.

What is Karen Carlson's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Is Karen Carlson enrolled in Medicare?

Yes. Karen Carlson 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 Carlson accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan and Network Health list Karen Carlson 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 Carlson affiliated with any hospitals?

According to CMS data, Karen Carlson is affiliated with Froedtert Memorial Lutheran Hospital.

When was this NPI record last updated?

The NPPES record for Karen Carlson was last updated on December 2, 2022. 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.