KAROLYN M SENICA MD
NPI 1609855485
Orthopaedic Surgery in Springfield, IL

Q: What is Karolyn Senica's NPI number?

The NPI number for Karolyn Senica is 1609855485. It was assigned to this individual provider in the NPPES registry on January 11, 2006.

Q: What is Karolyn Senica's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Karolyn Senica was last updated on April 13, 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.

Active since January 11, 2006PECOS Enrolled

80.53/100

CMS Quality Rating

1301 S KOKE MILL RD, SPRINGFIELD, IL 62711(217) 547-9100(217) 547-9247 Get Directions Write a Review

NPPES record last updated: April 13, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Karolyn M Senica Md NPPES

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

KAROLYN M SENICA MD (NPI 1609855485) is an individual orthopaedic surgery provider in Springfield, Illinois, licensed in Illinois (036092605) and active in the NPI registry since January 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1609855485

Entity TypeIndividualFemale

Primary Taxonomy207X00000X

Provider Legal NameKAROLYN M SENICACredential: MD

Location Address1301 S KOKE MILL RDSpringfield, IL 62711-9252

Mailing AddressPo Box 9469Springfield, IL 62791-9469 · (217) 547-9100 · Fax (217) 547-9247

Phone(217) 547-9100

Fax(217) 547-9247

Sole ProprietorNo

Enumeration DateJanuary 11, 2006

Last NPPES UpdateApril 13, 2020

NPPES CertifiedApril 13, 2020

✔ NPI 1609855485 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in IL · 036092605

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

1301 S KOKE MILL RD, Springfield, IL 62711

Open in Google Maps ↗

Other Identifiers 2

Other200026707IL · Rr Medicare

Medicaid036092605IL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Karolyn M Senica Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 27

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.

7,080 services408 patients

Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg J3304

Triamcinolone acetonide is a long-lasting, preservative-free steroid injection. It's delivered in tiny, slow-releasing particles (microspheres) to manage inflammation or related conditions. The dose given is 1 mg. It's generally safe with few side effects.

1,728 services18 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

807 services410 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.

593 services407 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.

410 services330 patients

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

183 services181 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

163 services123 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

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.

114 services114 patients

X-ray of knee, 1-2 views 73560

An X-ray of the knee with 1-2 views is a quick, painless test that produces images of the knee bones. It helps identify fractures, infections, or changes in the knee joint. During the procedure, you'll be asked to stay still while the X-ray machine captures the images.

64 services61 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

57 services54 patients

X-ray of wrist, minimum of 3 views 73110

An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.

53 services36 patients

X-ray of hand, minimum of 3 views 73130

An X-ray of the hand, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones in your hand from different angles. This helps in diagnosing fractures, infections, arthritis, or other abnormalities. It's quick and painless.

52 services38 patients

Hyaluronan or derivative, gel-one, for intra-articular injection, per dose J7326

Hyaluronan or Gel-One is a substance injected directly into your joint space. It's aimed to supplement your body's natural joint fluid, helping to lubricate and cushion the joint, reducing pain and improving mobility. It's often used for arthritis relief.

52 services39 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.

47 services47 patients

Mri scan of arm joint without contrast 73221

An MRI scan of the arm joint is a non-invasive imaging procedure that uses magnetic fields and radio waves to create detailed images of the structures within your arm joint. No contrast dye is used in this process. It helps to diagnose or monitor conditions like arthritis, injuries, or infections.

34 services34 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

33 services33 patients

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

30 services30 patients

Mri scan of lower spinal canal without contrast 72148

An MRI scan of the lower spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to produce detailed images of your lower spine. This helps identify issues like disc problems, tumors, or nerve conditions. No dye is used.

28 services28 patients

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

27 services14 patients

X-ray of elbow, minimum of 3 views 73080

An elbow X-ray with a minimum of 3 views is a non-invasive imaging test. It helps visualize the bones of the elbow from different angles. This aids in diagnosing conditions like fractures or arthritis. The procedure is quick, painless, and usually takes around 15 minutes.

26 services18 patients

Mri scan of leg joint without contrast 73721

An MRI scan of your leg joint is a non-invasive procedure that uses magnetic fields and radio waves to create detailed images of the structures within your leg. This helps doctors diagnose or monitor conditions without using contrast dye.

26 services26 patients

Aspiration and/or injection of fluid from medium joint 20605

This procedure involves a needle being inserted into a medium-sized joint, such as a knee or shoulder, to remove (aspirate) excess fluid. Sometimes, medication may also be injected into the joint to reduce inflammation and pain.

19 services14 patients

X-ray of pelvis, 1-2 views 72170

An X-ray of the pelvis, 1-2 views, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the lower part of your torso. These images help to detect any abnormalities or injuries in your hip bones and surrounding structures.

18 services15 patients

X-ray of finger, minimum of 2 views 73140

An X-ray of the finger involves capturing images of your finger from at least two different angles. This non-invasive procedure helps in visualizing the bones and joints, aiding in the diagnosis of fractures, infections, or other abnormalities. Minimal discomfort may be experienced.

18 services15 patients

Injection into tendon or ligament 20550

An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.

15 services14 patients

X-ray of wrist, 2 views 73100

An X-ray of the wrist, 2 views, is a diagnostic procedure where two different images of your wrist are taken using a small amount of radiation. This helps identify any abnormalities or injuries such as fractures or arthritis. It's a quick, non-invasive process.

13 services13 patients

Mri scan of upper spinal canal without contrast 72141

An MRI scan of the upper spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your upper spine. This helps doctors identify issues such as injuries, infections or diseases. No dye is used.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62711 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$68.64 typical visit price

range $17.16 – $136.56

Typical copayment $17.16 (range $4.29 – $34.14)

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.

80.53/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

78.39

Improvement Activities

Cost

74.72

Reported Quality Measures

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

85%561 patients4/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

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…

48%723 patients2/55-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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf L3908

DME-Orthotic Devices · category DF000N

1 supplier14 claims15 services$48.59 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Leave this field empty

Other Providers at the Same Location NPPES 20

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

DR. BRECK A JONES M.D.

Neurological Surgery