MATTHEW E KAREN MD
NPI 1477519833
Otolaryngology in Stockbridge, GA

Active since April 25, 2006PECOS EnrolledAccepts Medicare Assignment
1365 ROCK QUARRY RD STE 300, STOCKBRIDGE, GA 30281(770) 740-1860 Get Directions Write a Review

NPPES record last updated: November 15, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Matthew E Karen Md NPPES

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

MATTHEW E KAREN MD (NPI 1477519833) is an individual otolaryngology provider in Stockbridge, Georgia, licensed in Georgia (93362) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Wellstar West Georgia Medical Center, and is a graduate of Other (1993).

NPPES Registry Identity

NPI1477519833
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameMATTHEW E KARENCredential: MD
Location Address1365 ROCK QUARRY RD STE 300Stockbridge, GA 30281-5024
Mailing Address2365 Old Milton Pkwy Ste 100Alpharetta, GA 30009-2140 · (770) 740-1860
Sole ProprietorYes
Medical School CMSOtherGraduated 1993
Enumeration DateApril 25, 2006
Last NPPES UpdateNovember 15, 2023
NPPES CertifiedNovember 15, 2023
NPI 1477519833 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License Licensed in GA · 93362
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
Also ListedPlastic Surgery · Plastic Surgery Within the Head and NeckTaxonomy 2082S0099X · License 93362 (GA)
1365 ROCK QUARRY RD STE 300, Stockbridge, GA 30281

Accepted 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

Matthew E Karen Md 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 ID2264404763
PECOS Enrollment IDI20221004003979
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.

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.
93 services77 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
84 services84 patients
Removal of impacted ear wax 69210
Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
45 services42 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.
30 services24 patients
Diagnostic exam of nasal passages using an endoscope 31231
A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
27 services19 patients

Hospital Affiliations CMS Care Compare

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

Wellstar West Georgia Medical Center

Acute Care Hospitals · Lagrange, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110016
Location1514 Vernon RoadLagrange, GA 30240 · Troup County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30281 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
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
11%35 patients1/55-star benchmark: 87%
Documentation of Current Medications in the Medical Record
70%530 patients3/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
1%178 patients1/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients screened: 31% · 234 patients
29%234 patients
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 189 patients
Patients totalRate: 1% · 189 patients
1%189 patients4/55-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 4

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

Physician Assistant
1365 ROCK QUARRY RD STE 300
STOCKBRIDGE, GA 30281
Physician Assistant
1365 ROCK QUARRY RD STE 300
STOCKBRIDGE, GA 30281
Audiologist
1365 ROCK QUARRY RD STE 300
STOCKBRIDGE, GA 30281
Otolaryngology
1365 ROCK QUARRY RD STE 300
STOCKBRIDGE, GA 30281

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 Matthew Karen's NPI number?

The NPI number for Matthew Karen is 1477519833. It was assigned to this individual provider in the NPPES registry on April 25, 2006.

Where is Matthew Karen located?

Matthew Karen practices at 1365 Rock Quarry Rd Ste 300, Stockbridge, GA 30281. The listed phone number is (770) 740-1860.

What is Matthew Karen's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Matthew Karen enrolled in Medicare?

Yes. Matthew Karen 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 Matthew Karen accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 3 other insurers list Matthew Karen 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 Matthew Karen affiliated with any hospitals?

According to CMS data, Matthew Karen is affiliated with Wellstar West Georgia Medical Center.

When was this NPI record last updated?

The NPPES record for Matthew Karen was last updated on November 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.