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KAREN ANN HEIDELBERG M.D.
NPI 1467406439
Dermatology in Detroit, MI

Active since May 22, 2006PECOS EnrolledAccepts Medicare Assignment
0/100
CMS Quality Rating
20400 LIVERNOIS AVE, DETROIT, MI 48221(313) 864-3766(313) 864-8134 Get Directions Write a Review

NPPES record last updated: May 19, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Karen Ann Heidelberg M.d. NPPES

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

KAREN ANN HEIDELBERG M.D. (NPI 1467406439) is an individual dermatology provider in Detroit, Michigan, licensed in Michigan (4301066952) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with Trinity Health Ann Arbor Hospital, and is a graduate of Howard University College Of Medicine (1993).

NPPES Registry Identity

NPI1467406439
Entity TypeIndividualFemale
Primary Taxonomy207N00000X
Provider Legal NameKAREN ANN HEIDELBERGCredential: M.D.
Location Address20400 LIVERNOIS AVEDetroit, MI 48221-1348
Mailing Address20400 Livernois AveDetroit, MI 48221-1348 · (313) 864-3766 · Fax (313) 864-8134
Phone(313) 864-3766
Fax(313) 864-8134
Sole ProprietorNo
Medical School CMSHoward University College Of MedicineGraduated 1993
Enumeration DateMay 22, 2006
Last NPPES UpdateMay 19, 2020
NPPES CertifiedMay 19, 2020
✔ NPI 1467406439 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in MI · 4301066952
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
20400 LIVERNOIS AVE, Detroit, MI 48221
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Other Identifiers 1

Medicaid3437329MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and more.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

Karen Ann Heidelberg 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 ID7618970930
PECOS Enrollment IDI20120823000281
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 12

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
1,343 services259 patients
Injection into skin growth, more than 7 growths 11901
This procedure involves injecting medication into multiple skin growths (more than 7) to either shrink them or eliminate them. It's a safe, minimally invasive method often used for benign growths. Comfort during the process is ensured.
1,059 services202 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
803 services195 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.
717 services253 patients
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg J3420
This is a procedure where a small dose of Vitamin B-12, also known as Cyanocobalamin, is injected into your body. This vitamin is essential for nerve function and the production of red blood cells. It's often used to treat vitamin B-12 deficiency.
697 services151 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.
383 services222 patients

Hospital Affiliations CMS Care Compare

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

Trinity Health Ann Arbor Hospital

Acute Care Hospitals · Ann Arbor, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number230156
Location5301 E Huron River DrAnn Arbor, MI 48106 · Washtenaw County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48221 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
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.

0/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0

Reported Quality Measures

Biopsy Follow-Up
Percentage of new patients whose biopsy results have been reviewed and communicated to the primary care/referring physician and patient by the performing physician
46%285 patients2/55-star benchmark: 100%
Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
51%1,162 patients3/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
0%10,545 patients1/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
97%9,761 patients4/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
20%901 patients1/55-star benchmark: 100%
One-Time Screening for Hepatitis C Virus (HCV) for Patients at Risk
Percentage of patients aged 18 years and older with one or more of the following: a history of injection drug use, receipt of a blood transfusion prior to 1992, receiving maintenance hemodialysis, OR birthdate in the years 1945-1965 who received one-time…
0%953 patients1/55-star benchmark: 85%
Pain Assessment and Follow-Up
Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present
0%10,545 patients1/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
70%3,342 patients3/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
26%1,164 patients2/55-star benchmark: 95%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
93%214 patients4/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
33%2,497 patients2/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
70%3,342 patients3/55-star benchmark: 100%
Tobacco Use and Help with Quitting Among Adolescents
The percentage of adolescents 12 to 20 years of age with a primary care visit during the measurement year for whom tobacco use status was documented and received help with quitting if identified as a tobacco user
100%440 patients
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.

HEIDELBERG DERMATOLOGY, P.C.
Dermatology
20400 LIVERNOIS AVE
DETROIT, MI 48221
Wayne County (313) 341-4514
AYANA GATES PA-C
Physician Assistant
20400 LIVERNOIS AVE
DETROIT, MI 48221
Wayne County (313) 864-3766

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 Heidelberg's NPI number?

The NPI number for Karen Heidelberg is 1467406439. It was assigned to this individual provider in the NPPES registry on May 22, 2006.

Where is Karen Heidelberg located?

Karen Heidelberg practices at 20400 Livernois Ave, Detroit, MI 48221. The listed phone number is (313) 864-3766.

What is Karen Heidelberg's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Karen Heidelberg enrolled in Medicare?

Yes. Karen Heidelberg 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 Heidelberg accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and UnitedHealthcare list Karen Heidelberg 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 Heidelberg affiliated with any hospitals?

According to CMS data, Karen Heidelberg is affiliated with Trinity Health Ann Arbor Hospital.

When was this NPI record last updated?

The NPPES record for Karen Heidelberg was last updated on May 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.