KAREN M WARBURTON MD
NPI 1619902756
Internal Medicine - Nephrology in Charlottesville, VA

Active since July 11, 2006PECOS EnrolledAccepts Medicare Assignment
79.39/100
CMS Quality Rating
1300 JEFFERSON PARK AVE, WEST COMPLEX, 5TH FLOOR, CHARLOTTESVILLE, VA 22903(434) 924-1984(434) 243-6284 Get Directions Write a Review

NPPES record last updated: October 10, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Karen M Warburton Md NPPES

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

KAREN M WARBURTON MD (NPI 1619902756) is an individual nephrology provider in Charlottesville, Virginia, licensed in Virginia (0101261144) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS, is affiliated with University Of Virginia Medical Center, and is a graduate of University Of North Carolina At Chapel Hill School Of Medicine (1999).

NPPES Registry Identity

NPI1619902756
Entity TypeIndividualFemale
Primary Taxonomy207RN0300X
Provider Legal NameKAREN M WARBURTONCredential: MD
Location Address1300 JEFFERSON PARK AVE, WEST COMPLEX, 5TH FLOORCharlottesville, VA 22903-3363
Mailing AddressPo Box 9007Charlottesville, VA 22906-9007
Fax(434) 243-6284
Sole ProprietorNo
Medical School CMSUniversity Of North Carolina At Chapel Hill School Of MedicineGraduated 1999
Enumeration DateJuly 11, 2006
Last NPPES UpdateOctober 10, 2016
NPI 1619902756 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Licenses Licensed in VA · 0101261144 Licensed in PA · MD419924
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
1300 JEFFERSON PARK AVE, Charlottesville, VA 22903

Other Identifiers 3

Medicare PIN097448PA
Medicare UPINI48281PA
Medicaid101442921PA

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

Karen M Warburton 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 ID8022032770
PECOS Enrollment IDI20161114002321
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 2

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 high level of medical decision making, if using time, 40 minutes or more 99215
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.
44 services25 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
35 services21 patients

Hospital Affiliations CMS Care Compare

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

University Of Virginia Medical Center

Acute Care Hospitals · Charlottesville, VA
4/5 CMS rating
OwnershipGovernment - State
CMS Certification Number490009
Location1215 Lee StreetCharlottesville, VA 22908 · Charlottesville City County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22903 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
$129.04 typical visit price
range $56.19 – $170.30
Typical copayment $32.26 (range $14.04 – $42.57)
Most-billed visit code 99204
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
Most-billed visit code 99214
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.

79.39/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality73.66
Promoting Interoperability100
Improvement Activities40
Cost57.65

Referred Medical Equipment & Supplies CMS DME claims 8

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

Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg J7503
Treatment-Chemotherapy · category RH002N
1 supplier12 claims3,840 services$1.22 avg. paid by Medicare
Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
16 suppliers323 claims20,841 services$0.29 avg. paid by Medicare
Prednisone, immediate release or delayed release, oral, 1 mg J7512
Treatment-Treatment - Miscellaneous · category RX029N
9 suppliers167 claims25,080 services$0.01 avg. paid by Medicare
Cyclosporine, oral, 25 mg J7515
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers28 claims4,800 services$0.60 avg. paid by Medicare
Mycophenolate mofetil, oral, 250 mg J7517
Treatment-Treatment - Miscellaneous · category RX029N
12 suppliers244 claims34,822 services$0.19 avg. paid by Medicare
Mycophenolic acid, oral, 180 mg J7518
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers47 claims5,640 services$0.94 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

Ophthalmology
1300 JEFFERSON PARK AVE
CHARLOTTESVILLE, VA 22903
Ophthalmology
1300 JEFFERSON PARK AVE
CHARLOTTESVILLE, VA 22903
Optometrist
1300 JEFFERSON PARK AVE
CHARLOTTESVILLE, VA 22903
Ophthalmology
1300 JEFFERSON PARK AVE
CHARLOTTESVILLE, VA 22903
Psychiatry & Neurology (Psychiatry)
1300 JEFFERSON PARK AVE
CHARLOTTESVILLE, VA 22903
Transplant Surgery
1300 JEFFERSON PARK AVE
CHARLOTTESVILLE, VA 22903
Dietitian, Registered
1300 JEFFERSON PARK AVE
CHARLOTTESVILLE, VA 22903
Dietitian, Registered
1300 JEFFERSON PARK AVE
CHARLOTTESVILLE, VA 22903

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 Karen Warburton's NPI number?

The NPI number for Karen Warburton is 1619902756. It was assigned to this individual provider in the NPPES registry on July 11, 2006.

Where is Karen Warburton located?

Karen Warburton practices at 1300 Jefferson Park Ave West Complex, 5th Floor, Charlottesville, VA 22903. The listed phone number is (434) 924-1984.

What is Karen Warburton's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Karen Warburton enrolled in Medicare?

Yes. Karen Warburton 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.

Is Karen Warburton affiliated with any hospitals?

According to CMS data, Karen Warburton is affiliated with University Of Virginia Medical Center.

When was this NPI record last updated?

The NPPES record for Karen Warburton was last updated on October 10, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.