1. Home
  2. Directory
  3. Michigan
  4. Detroit
  5. Pediatrics
  6. NPI Profile

KAREN A ALTON MD
NPI 1649264037
Pediatrics in Detroit, MI

Active since August 31, 2005PECOS EnrolledAccepts Medicare Assignment
83.35/100
CMS Quality Rating
22201 MOROSS RD, DETROIT, MI 48236(313) 343-3481(313) 343-7937 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Karen A Alton Md NPPES

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

KAREN A ALTON MD (NPI 1649264037) is an individual pediatrics provider in Detroit, Michigan, licensed in Michigan (4301066273) and active in the NPI registry since August 2005. She is enrolled in Medicare PECOS and is a graduate of Other (1995).

NPPES Registry Identity

NPI1649264037
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameKAREN A ALTONCredential: MD
Location Address22201 MOROSS RDDetroit, MI 48236-2169
Mailing Address43800 Garfield RdClinton Twp, MI 48038-1136 · (586) 228-4635 · Fax (586) 228-4520
Phone(313) 343-3481
Fax(313) 343-7937
Sole ProprietorNo
Medical School CMSOtherGraduated 1995
Enumeration DateAugust 31, 2005
Last NPPES UpdateJuly 8, 2007
✔ NPI 1649264037 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in MI · 4301066273
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
22201 MOROSS RD, Detroit, MI 48236
Open in Google Maps ↗

Other Identifiers 3

Medicare ID-Type UnspecifiedM71670049
Medicaid4417590MI
Medicare UPING92317

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

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 A Alton 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 ID8820347479
PECOS Enrollment IDI20180815002883
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48236 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
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.

83.35/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality68.06
Promoting Interoperability100
Improvement Activities40
Cost60.61

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
20%157 patients1/55-star benchmark: 95%
Documentation of Current Medications in the Medical Record
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.
98%105 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
97%1,101 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
64%114 patients3/55-star benchmark: 88%
Medication Reconciliation
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.
96%45 patients4/55-star benchmark: 100%
Patient-Specific Education
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.
56%1,318 patients3/55-star benchmark: 97%
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…
59%91 patients3/55-star benchmark: 97%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
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
26%391 patients2/55-star benchmark: 96%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
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
Patients screenedForUse: 75% · 53 patients
70%53 patients3/55-star benchmark: 98%
Provide Patient Access
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…
84%1,318 patients4/55-star benchmark: 100%
Secure Messaging
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…
13%1,318 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
19%1,318 patients
Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents
Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.
Patients nutrition: 45% · 657 patients
Patients physicalActivity: 42% · 657 patients
94%657 patients
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.

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.

RUDOLPH MENCHL JR. MD
Internal Medicine
22201 MOROSS RD, SUITE 150
DETROIT, MI 48236
Wayne County (313) 886-8787
DR. SAJITHAA VARADARASA M.D.
Student in an Organized Health Care Education/Training Program
22201 MOROSS RD, SUITE 50
DETROIT, MI 48236
Wayne County (313) 343-7774
DEEPAK GOPALBHAI PATEL MD
Pediatrics (Neonatal-Perinatal Medicine)
22201 MOROSS RD, 270
DETROIT, MI 48236
Wayne County (313) 343-3481
DR. ANDREY ALEX VOLKOV D.O
Neurological Surgery
22201 MOROSS RD, SUITE 352
DETROIT, MI 48236
Wayne County (313) 343-7900
JOHN THOMAS ADAMS MD
Pediatrics (Neonatal-Perinatal Medicine)
22201 MOROSS RD, 270
DETROIT, MI 48236
Wayne County (313) 343-3481
ST. JOHN HOSPITAL & MEDICAL CENTER
General Acute Care Hospital
22201 MOROSS RD, SUITE 50
DETROIT, MI 48236
Wayne County (313) 343-7774
ST. JOHN HOSPITAL AND MEDICAL CENTER
General Acute Care Hospital
22201 MOROSS RD, PROFESSIONAL BUILDING TWO, SUITE 50
DETROIT, MI 48236
Wayne County (313) 343-7774
NATALIE RENEE KONTOS DO
Pediatrics
22201 MOROSS RD, PROFESSIONAL BUILDING 2, SUITE 70
DETROIT, MI 48236
Wayne County (313) 343-4279

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 Alton's NPI number?

The NPI number for Karen Alton is 1649264037. It was assigned to this individual provider in the NPPES registry on August 31, 2005.

Where is Karen Alton located?

Karen Alton practices at 22201 Moross Rd, Detroit, MI 48236. The listed phone number is (313) 343-3481.

What is Karen Alton's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Karen Alton enrolled in Medicare?

Yes. Karen Alton 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.

What insurance does Karen Alton accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 2 other insurers list Karen Alton as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Karen Alton was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.