KAREN WALCZAK NP
NPI 1487068995
Nurse Practitioner - Family in Crown Point, IN

NPI Status: Active since June 12, 2014

Contact Information

2100 N MAIN ST # 304
CROWN POINT, IN
ZIP 46307
Phone: (574) 546-1900
Fax: (574) 546-1999

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Secondary Locations
Medicare Participation & PECOS Status
Physician Visit Costs
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Years of Experience 12
Nurse Practitioner
Family
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About KAREN WALCZAK

This page provides the complete NPI Profile along with additional information for Karen Walczak, a provider established in Crown Point, Indiana with a medical specialization in Nurse Practitioner, focusing in family and more than 12 years of experience. The healthcare provider is registered in the NPI registry with number 1487068995 assigned on June 2014. The practitioner's primary taxonomy code is 363LF0000X with license number 71006129A (IN). The provider is registered as an individual and her NPI record was last updated one year ago.

NPI: 1487068995
Provider Name: KAREN WALCZAK NP
Gender: Female
Entity Type: Individual
Location Address: 2100 N MAIN ST # 304 CROWN POINT, IN 46307
Location Phone: (574) 546-1900
Location Fax: (574) 546-1999
Mailing Address: 2307 PEACH TREE LN DYER, IN 46311
Mailing Phone: (219) 730-2950
Medical School Name: OTHER
Graduation Year: 2014
Is Sole Proprietor?: Yes
Enumeration Date: 06-12-2014
Last Update Date: 03-11-2025
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A nurse practitioner (NP) like Karen Walczak is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

Secondary Locations

3738 Landmark Dr Ste A
Lafayette, IN 47905
(765) 807-2780

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Nurse Practitioner Family
Taxonomy Code: 363LF0000X
Type: Physician Assistants & Advanced Practice Nursing Providers
License No.: 71006129A
License State: IN

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

CareSource

Bronze 7500 $25 Generic Drugs - HMO
Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
Gold 2000 $15 Generic Drugs - HMO
Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
HDHP Preventive Silver 5500 $0 Chronic Care Drugs - HMO
Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services - HMO
Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services - HMO
Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
HSA Eligible Bronze 6000 - HMO
Low Premium Bronze 10600 $25 Generic Drugs - HMO
Low Premium Bronze 10600 $25 Generic Drugs + Adult Vision & Fitness - HMO
Low Premium Silver 6200 $3 Generic Drugs - HMO
Low Premium Silver 6200 $3 Generic Drugs + Adult Vision & Fitness - HMO
Platinum Zero $5 Generic Drugs - HMO
Platinum Zero $5 Generic Drugs + Adult Vision & Fitness - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Karen Walczak is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Karen Walczak is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 6204152309
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20160323000518
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $20.51 for a new patient copayment and $23.55 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 46307 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $82.04
Minimum New Patient Price $53.07
Maximum New Patient Price $161.76

Average New Patient Copayment $20.51
Minimum New Patient Copayment $13.26
Maximum New Patient Copayment $40.44

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $94.22
Minimum Established Patient Price $16.93
Maximum Established Patient Price $132.22

Average Established Patient Copayment $23.55
Minimum Established Patient Copayment $4.23
Maximum Established Patient Copayment $33.05

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
Anticoagulant Management Improvements	Yes	N/A
Individual MIPS eligible clinicians and groups who prescribe oral Vitamin K antagonist therapy (warfarin) must attest that, for 60 percent of practice patients in the transition year and 75 percent of practice patients in Quality Payment Program Year 2 and future years, their ambulatory care patients receiving warfarin are being managed by one or more of the following improvement activities: • Patients are being managed by an anticoagulant management service, that involves systematic and coordinated care, incorporating comprehensive patient education, systematic prothrombin time (PT-INR) testing, tracking, follow-up, and patient communication of results and dosing decisions; • Patients are being managed according to validated electronic decision support and clinical management tools that involve systematic and coordinated care, incorporating comprehensive patient education, systematic PT-INR testing, tracking, follow-up, and patient communication of results and dosing decisions; • For rural or remote patients, patients are managed using remote monitoring or telehealth options that involve systematic and coordinated care, incorporating comprehensive patient education, systematic PT-INR testing, tracking, follow-up, and patient communication of results and dosing decisions; and/or • For patients who demonstrate motivation, competency, and adherence, patients are managed using either a patient self-testing (PST) or patient-self-management (PSM) program.
Chronic Care and Preventative Care Management for Empaneled Patients	Yes	N/A
Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation.
Diabetes screening	Yes	N/A
Diabetes screening for people with schizophrenia or bipolar disease who are using antipsychotic medication.
Diabetes: Eye Exam	19%	26
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
Diabetes: Foot Exam	19%	26
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
Documentation of Current Medications in the Medical Record	97%	189
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. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
Engagement of New Medicaid Patients and Follow-up	Yes	N/A
Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity.
Engagement of patients through implementation of improvements in patient portal	Yes	N/A
Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence.
e-Prescribing	100%	1007
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Falls: Screening for Future Fall Risk	8%	131
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
Implementation of documentation improvements for practice/process improvements	Yes	N/A
Implementation of practices/processes that document care coordination activities (e.g., a documented care coordination encounter that tracks all clinical staff involved and communications from date patient is scheduled for outpatient procedure through day of procedure).
Implementation of fall screening and assessment programs	Yes	N/A
Implementation of fall screening and assessment programs to identify patients at risk for falls and address modifiable risk factors (e.g., Clinical decision support/prompts in the electronic health record that help manage the use of medications, such as benzodiazepines, that increase fall risk).
Implementation of formal quality improvement methods, practice changes, or other practice improvement processes	Yes	N/A
Adopt a formal model for quality improvement and create a culture in which all staff actively participates in improvement activities that could include one or more of the following such as: • Multi-Source Feedback; • Train all staff in quality improvement methods; • Integrate practice change/quality improvement into staff duties; • Engage all staff in identifying and testing practices changes; • Designate regular team meetings to review data and plan improvement cycles; • Promote transparency and accelerate improvement by sharing practice level and panel level quality of care, patient experience and utilization data with staff; and/or • Promote transparency and engage patients and families by sharing practice level quality of care, patient experience and utilization data with patients and families, including activities in which clinicians act upon patient experience data.
Medication Reconciliation	97%	174
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.
Patient-Specific Education	5%	165
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.
Pneumococcal Vaccination Status for Older Adults	60%	131
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Provide Patient Access	9%	165
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 certain information.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Use of High-Risk Medications in the Elderly	8% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better.	131
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1487068995, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 75. The final step is to find the difference between that total and the next multiple of ten (80 - 75 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 16 → 1 + 6

Pos 4

Unchanged

Pos 5

Doubled → 0

Pos 6

Unchanged

Pos 7

Doubled → 16 → 1 + 6

Pos 8

Unchanged

Pos 9

Doubled → 18 → 1 + 8

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 0 → 0 8 → 16 → 7 9 → 18 → 9