KAREN S. GATES P.A.-C.
NPI 1538253042
Physician Assistant in Lexington, KY

NPI Status: Active since October 02, 2006

Contact Information

3085 LAKECREST CIR
LEXINGTON, KY
ZIP 40513
Phone: (859) 258-8600
Fax: (859) 258-8610

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  • Individual
  • Female
  • Physician Assistant
  • Medicare Quality Reporting

About KAREN GATES

This page provides the complete NPI Profile along with additional information for Karen Gates, a primary care provider established in Lexington, Kentucky with a medical specialization in Physician Assistant. The healthcare provider is registered in the NPI registry with number 1538253042 assigned on October 2006. The practitioner's primary taxonomy code is 363A00000X with license number PA185 (KY). The provider is registered as an individual and her NPI record was last updated 10 years ago.

NPI
1538253042
Provider Name
KAREN S. GATES P.A.-C.
Gender
Female
Entity Type
Individual
Location Address
3085 LAKECREST CIR LEXINGTON, KY 40513
Location Phone
(859) 258-8600
Location Fax
(859) 258-8610
Mailing Address
3085 LAKECREST CIR LEXINGTON, KY 40513
Mailing Phone
(859) 258-8600
Mailing Fax
(859) 258-8610
Is Sole Proprietor?
No
Enumeration Date
10-02-2006
Last Update Date
03-30-2016
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A primary care provider (PCP) like Karen Gates sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

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

Physician Assistant

Taxonomy Code
363A00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
PA185
License State
KY
Taxonomy Description
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1363AM0700XPhysician Assistants & Advanced Practice Nursing Providers

Physician Assistant
Medical

PA185 (KY)

Insurance Plans Accepted

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

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

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

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
36000818OTHER (01)KYASC MEDICAID GROUP
CB5773OTHER (01)KYRR MEDICARE GROUP
0626306MEDICARE ID-TYPE UNSPECIFIED (04)KY 
970020919OTHER (01)KYRR MEDICARE PIN
ASC1019OTHER (01)KYASC MEDICARE GROUP
95001855MEDICAID (05)KY 
4000501OTHER (01)KYMEDICARE LAB GROUP
S52789MEDICARE UPIN (02) 
37903705OTHER (01)KYMEDICAID LAB GROUP

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
Breast Cancer Screening 47% 340
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
Chronic Care and Preventative Care Management for Empaneled PatientsYesN/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.
Colorectal Cancer Screening 61% 554
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Diabetes: Eye Exam 56% 106
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 67% 106
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
Diabetes: Medical Attention for Nephropathy 88% 106
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
Documentation of Current Medications in the Medical Record 100% 1631
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
e-Prescribing 97% 2671
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Immunization Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data.
Implementation of medication management practice improvementsYesN/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Measurement and Improvement at the Practice and Panel LevelYesN/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Medication Reconciliation 100% 22
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 67% 1955
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 75% 369
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 72% 1505
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Preventive Care and Screening: Screening for Depression and Follow-Up Plan 52% 1431
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 73% 110
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
Provide Patient Access 80% 1955
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.
Secure Messaging 70% 1955
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk AnalysisYesN/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.
Specialized Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.
Use of decision support and standardized treatment protocolsYesN/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.

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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 1538253042, we treat the final digit (2) 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 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).

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
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
3
Doubled → 6
Pos 4
8
Unchanged
Pos 5
2
Doubled → 4
Pos 6
5
Unchanged
Pos 7
3
Doubled → 6
Pos 8
0
Unchanged
Pos 9
4
Doubled → 8
Check
2
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 3 → 6 2 → 4 3 → 6 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 6 + 8 + 4 + 5 + 6 + 0 + 8 + 24 = 68

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 68 is 70. The difference is the calculated check digit.

70 - 68 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1538253042.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Family Medicine
3085 LAKECREST CIR
LEXINGTON, KY 40513
Family Medicine
3085 LAKECREST CIR, SUITE 700
LEXINGTON, KY 40513
Family Medicine
3085 LAKECREST CIR
LEXINGTON, KY 40513
Internal Medicine
3085 LAKECREST CIR
LEXINGTON, KY 40513
Pediatrics
3085 LAKECREST CIR
LEXINGTON, KY 40513
Pediatrics
3085 LAKECREST CIR
LEXINGTON, KY 40513
Internal Medicine
3085 LAKECREST CIR
LEXINGTON, KY 40513
Pediatrics
3085 LAKECREST CIR
LEXINGTON, KY 40513
Physician Assistant
3085 LAKECREST CIR
LEXINGTON, KY 40513
Physician Assistant
3085 LAKECREST CIR
LEXINGTON, KY 40513
Physician Assistant
3085 LAKECREST CIR
LEXINGTON, KY 40513
Nurse Practitioner
3085 LAKECREST CIR
LEXINGTON, KY 40513
Physician Assistant
3085 LAKECREST CIR
LEXINGTON, KY 40513
Nurse Practitioner (Family)
3085 LAKECREST CIR
LEXINGTON, KY 40513
Physician Assistant
3085 LAKECREST CIR
LEXINGTON, KY 40513
Nurse Practitioner (Family)
3085 LAKECREST CIR
LEXINGTON, KY 40513
Physician Assistant
3085 LAKECREST CIR, SUITE 100
LEXINGTON, KY 40513
Nurse Practitioner (Family)
3085 LAKECREST CIR
LEXINGTON, KY 40513
Pediatrics
3085 LAKECREST CIR
LEXINGTON, KY 40513
Physician Assistant
3085 LAKECREST CIR
LEXINGTON, KY 40513

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1538253042, enumerated as an "individual" on October 02, 2006.

The provider is located at 3085 LAKECREST CIR LEXINGTON, KY 40513 and the phone number is (859) 258-8600.

Physician Assistant with taxonomy code 363A00000X.

The provider might be accepting Accepts: Medicare, Medicaid and Railroad Medicare. Please consult your insurance carrier or call the provider to verify.