MRS. KAREN RENEE STANSBURY FNP-C
NPI 1508271719
Clinical Nurse Specialist - Adult Health in West Monroe, LA

Medicare Participation & PECOS Enrollment Status

Karen Stansbury 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 Stansbury 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: 5294092995

  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: I20171206000049

  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

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Orthotic Devices

• DME-Orthotic Devices (DF008N)

  Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each (HCPCS:A4351)

  1 DME suppliers used 11 Medicare Claims 990 Services Paid

• DME-Orthotic Devices (DF000N)

  Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each (HCPCS:A4357)

  1 DME suppliers used 35 Medicare Claims 70 Services Paid

• DME-Orthotic Devices (DF010N)

  Skin barrier; solid, 4 x 4 or equivalent; each (HCPCS:A4362)

  3 DME suppliers used 35 Medicare Claims 840 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy belt, each (HCPCS:A4367)

  3 DME suppliers used 45 Medicare Claims 51 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy filter, any type, each (HCPCS:A4368)

  1 DME suppliers used 14 Medicare Claims 340 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy skin barrier, powder, per oz (HCPCS:A4371)

  4 DME suppliers used 99 Medicare Claims 103 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each (HCPCS:A4385)

  4 DME suppliers used 112 Medicare Claims 2300 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each (HCPCS:A4390)

  2 DME suppliers used 21 Medicare Claims 420 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce (HCPCS:A4394)

  3 DME suppliers used 117 Medicare Claims 1242 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy skin barrier, pectin-based, paste, per ounce (HCPCS:A4406)

  5 DME suppliers used 92 Medicare Claims 344 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each (HCPCS:A4407)

  4 DME suppliers used 103 Medicare Claims 1960 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each (HCPCS:A4409)

  1 DME suppliers used 89 Medicare Claims 1700 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each (HCPCS:A4419)

  2 DME suppliers used 51 Medicare Claims 3060 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each (HCPCS:A4425)

  2 DME suppliers used 71 Medicare Claims 1310 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each (HCPCS:A4432)

  2 DME suppliers used 17 Medicare Claims 430 Services Paid

• DME-Orthotic Devices (DF010N)

  Stoma cap (HCPCS:A5055)

  1 DME suppliers used 13 Medicare Claims 361 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each (HCPCS:A5056)

  1 DME suppliers used 20 Medicare Claims 450 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each (HCPCS:A5057)

  3 DME suppliers used 39 Medicare Claims 700 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each (HCPCS:A5063)

  2 DME suppliers used 69 Medicare Claims 1330 Services Paid

• DME-Orthotic Devices (DF010N)

  Skin barrier, wipes or swabs, each (HCPCS:A5120)

  5 DME suppliers used 227 Medicare Claims 8425 Services Paid

• DME-Orthotic Devices (DF010N)

  Skin barrier; solid, 6 x 6 or equivalent, each (HCPCS:A5121)

  2 DME suppliers used 13 Medicare Claims 260 Services Paid

Durable Medical Equipment

• DME-Medical/Surgical Supplies (DA000N)

  Adhesive, liquid or equal, any type, per oz (HCPCS:A4364)

  1 DME suppliers used 11 Medicare Claims 56 Services Paid

• DME-Medical/Surgical Supplies (DA000N)

  Tape, non-waterproof, per 18 square inches (HCPCS:A4450)

  2 DME suppliers used 39 Medicare Claims 3200 Services Paid

• DME-Medical/Surgical Supplies (DA000N)

  Tape, waterproof, per 18 square inches (HCPCS:A4452)

  3 DME suppliers used 24 Medicare Claims 1224 Services Paid

• DME-Medical/Surgical Supplies (DA000N)

  Adhesive remover, wipes, any type, each (HCPCS:A4456)

  5 DME suppliers used 208 Medicare Claims 7995 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6216)

  2 DME suppliers used 12 Medicare Claims 3520 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing (HCPCS:A6252)

  1 DME suppliers used 11 Medicare Claims 339 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6402)

  1 DME suppliers used 35 Medicare Claims 8100 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard (HCPCS:A6446)

  1 DME suppliers used 17 Medicare Claims 2136 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Tubular dressing with or without elastic, any width, per linear yard (HCPCS:A6457)

  1 DME suppliers used 17 Medicare Claims 314 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less

This procedure involves applying a skin substitute graft to a wound on the trunk, arms, or legs. The graft, a lab-grown skin, is used to cover a wound area of 25.0 sq cm or less, within a total wound area of 100.0 sq cm or less. It aids in healing and regeneration.

This service was performed 74 times for 15 patients

Application of vein wound compression bandages on lower leg, ankle, and foot

Compression bandages are applied to your lower leg, ankle, and foot to promote healing of vein wounds. The bandages apply pressure to improve blood flow, reduce swelling, and accelerate wound healing. It's a safe, non-invasive treatment.

This service was performed 45 times for 13 patients

Epifix, per square centimeter

Epifix is an advanced wound care treatment, derived from human placental tissue. It helps to promote healing by providing a protective barrier and supplying growth factors. Each square centimeter refers to the size of the Epifix graft needed for your specific wound.

This service was performed 1,505 times for 15 patients

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 14 times for 12 patients

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 503 times for 132 patients

Established patient office or other outpatient visit, 40-54 minutes

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.

This service was performed 229 times for 85 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 37 times for 37 patients

New patient office or other outpatient visit, 60-74 minutes

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 45 times for 45 patients

Removal of tissue from wound, 20.0 sq cm or less

This procedure involves the careful removal of damaged or infected tissue from a wound that's 20.0 square cm or less. It's done to promote healing and prevent further infection. The process is carried out under local anesthesia, ensuring minimal discomfort.

This service was performed 185 times for 58 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.15 for a new patient copayment and $23.77 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 71291 ZIP code area.

* 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.

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