KARL MARTIN DOELLE DO
NPI 1659316842
Radiology - Diagnostic Radiology in Mount Clemens, MI
NPI Status: Active since June 19, 2006
Contact Information
1000 HARRINGTON ST
MOUNT CLEMENS, MI
ZIP 48043
Phone: (586) 493-8098
Fax: (586) 493-8706
- Individual
- Male
- Years of Experience 33
- Radiology
- Diagnostic Radiology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About KARL DOELLE
This page provides the complete NPI Profile along with additional information for Karl Doelle, a provider established in Mount Clemens, Michigan with a medical specialization in Radiology, focusing in diagnostic radiology and more than 33 years of experience. He graduated from Michigan State University College Of Osteopathic Medicine in 1993. The healthcare provider is registered in the NPI registry with number 1659316842 assigned on June 2006. The practitioner's primary taxonomy code is 2085R0202X with license number 5101011989 (MI). The provider is registered as an individual and his NPI record was last updated 19 years ago.
- NPI
- 1659316842
- Provider Name
- KARL MARTIN DOELLE DO
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1000 HARRINGTON ST MOUNT CLEMENS, MI 48043
- Location Phone
- (586) 493-8098
- Location Fax
- (586) 493-8706
- Mailing Address
- PO BOX 1108 ATTENTION: BARBRA SIMMONS ANN ARBOR, MI 48106
- Mailing Phone
- (734) 677-7400
- Mailing Fax
- (586) 493-8706
- Medical School Name
- MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
- Graduation Year
- 1993
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-19-2006
- Last Update Date
- 12-19-2007
- Code Navigator
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
Radiology Diagnostic Radiology
- Taxonomy Code
- 2085R0202X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 5101011989
- License State
- MI
- Taxonomy Description
- A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Cross� Preferred HMO Bronze Extra - HMO
- Blue Cross� Preferred HMO Bronze Saver HSA - HMO
- Blue Cross� Preferred HMO Bronze Secure - HMO
- Blue Cross� Preferred HMO Gold - HMO
- Blue Cross� Preferred HMO Gold Extra - HMO
- Blue Cross� Preferred HMO Silver - HMO
- Blue Cross� Preferred HMO Silver Extra - HMO
- Blue Cross� Preferred HMO Silver Saver - HMO
- Blue Cross� Preferred HMO Value - HMO
- Blue Cross� Select HMO Bronze Extra - HMO
- Blue Cross� Select HMO Bronze Saver HSA - HMO
- Blue Cross� Select HMO Bronze Secure - HMO
- Blue Cross� Select HMO Silver - HMO
- Blue Cross� Select HMO Silver Extra - HMO
- Blue Cross� Select HMO Silver Saver - HMO
- Blue Cross� Select HMO Value - HMO
- Blue Cross� Premier PPO Bronze Extra - PPO
- Blue Cross� Premier PPO Bronze Saver HSA - PPO
- Blue Cross� Premier PPO Bronze Secure - PPO
- Blue Cross� Premier PPO Gold - PPO
- Blue Cross� Premier PPO Gold Extra - PPO
- Blue Cross� Premier PPO Silver - PPO
- Blue Cross� Premier PPO Silver Extra - PPO
- Blue Cross� Premier PPO Silver Saver HSA - PPO
- Blue Cross� Premier PPO Value - PPO
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 |
|---|---|---|---|
| 3155000384 | OTHER (01) | MI | BCBS INDIVIDUAL # |
| 0N78930 | MEDICARE PIN (08) | MI | |
| G82341 | MEDICARE UPIN (02) | ||
| 4423785 | MEDICAID (05) | MI | |
| 0N78920 | MEDICARE PIN (08) | MI | |
| 4458726 | MEDICAID (05) | MI |
Medicare Participation & PECOS Enrollment Status
Karl Doelle 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.
Karl Doelle 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: 1153235809
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: I20031117000597
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
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.
3d radiographic procedure
Ct scan head or brain without contrast
Ct scan of abdomen and pelvis before and after contrast
Ct scan of abdomen and pelvis with contrast
Ct scan of abdomen and pelvis without contrast
Ct scan of blood vessels of chest with contrast
Ct scan of blood vessels of head with contrast
Ct scan of blood vessels of neck with contrast
Ct scan of chest with contrast
Ct scan of chest without contrast
Ct scan of leg without contrast
Ct scan of upper spine without contrast
Dxa bone density measurement of hip, pelvis, spine
Dxa bone density measurement of hip, pelvis, spine
Imaging for evaluation of swallowing function
Low dose ct scan of chest for lung cancer screening
Mri scan of abdomen before and after contrast
Mri scan of brain before and after contrast
Mri scan of brain without contrast
Mri scan of leg joint without contrast
Mri scan of lower spinal canal without contrast
Nuclear medicine studies of heart muscle at rest and with stress and spect
Nuclear medicine study from skull base to mid-thigh with ct scan
X-ray of chest, 1 view
X-ray of chest, 2 views
X-ray of foot, minimum of 3 views
X-ray of hand, minimum of 3 views
X-ray of hip, 2-3 views
X-ray of knee, 3 views
X-ray of pelvis, 1-2 views
X-ray of shoulder, minimum of 2 views
A 3D radiographic procedure is a non-invasive imaging test that helps doctors visualize the internal structures of your body in three dimensions. This advanced technology provides detailed images, aiding in accurate diagnosis and treatment planning. It involves exposure to minimal radiation.
This service was performed 11 times for 11 patientsA CT scan of the head or brain without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed pictures of your brain, skull, and other structures inside your head. It helps to detect conditions like strokes, tumors, or injuries. No dye (contrast) is used in this test.
This service was performed 137 times for 127 patientsA CT scan of your abdomen and pelvis with and without contrast helps visualize your internal organs better. Contrast is a special dye that improves the clarity of the images. It's taken orally or injected into your veins before the scan. The process is painless and quick.
This service was performed 13 times for 13 patientsA CT scan of the abdomen and pelvis with contrast is an imaging procedure. A special dye, called contrast, is used to make certain areas more visible. This can help identify issues such as infections, tumors, or other abnormalities. The procedure is painless and usually takes about 30 minutes.
This service was performed 64 times for 63 patientsA CT scan of the abdomen and pelvis is a non-invasive medical test. It uses special X-ray equipment to create detailed images of your abdominal and pelvic areas. This helps doctors examine organs, tissues, and vessels. No contrast dye is used in this procedure.
This service was performed 45 times for 45 patientsA CT scan of the chest with contrast is a non-invasive imaging test. It uses X-rays and a special dye to get detailed images of your blood vessels in the chest. This helps in diagnosing conditions related to heart and lungs.
This service was performed 39 times for 38 patientsA CT scan of the head's blood vessels with contrast is a diagnostic procedure. A special dye (contrast) is injected into your body to make the blood vessels visible on the scan. This helps identify issues like blockages or abnormalities in your head's blood vessels.
This service was performed 31 times for 30 patientsA CT scan of the neck's blood vessels with contrast is a diagnostic procedure. It uses X-rays and a special dye to create detailed images of your neck's blood vessels. This helps doctors detect issues such as blockages or abnormalities.
This service was performed 30 times for 29 patientsA CT scan of the chest with contrast is an imaging procedure. A special dye (contrast) is used to highlight specific areas in your body, providing clearer pictures of your chest. This helps in diagnosing conditions related to your lungs, heart, and other chest structures.
This service was performed 34 times for 34 patientsA CT scan of the chest without contrast is a non-invasive imaging procedure. It uses special X-ray equipment to produce detailed images of your chest area, including your lungs and heart. It can help diagnose conditions such as lung diseases or heart disorders. It doesn't involve any dyes or contrast agents.
This service was performed 58 times for 56 patientsA CT scan of the leg is a non-invasive imaging test that uses X-rays to capture detailed images of your leg's bones, muscles, and blood vessels. It doesn't use contrast dye and doesn't cause any pain. It helps in diagnosing injuries or diseases.
This service was performed 13 times for 13 patientsA CT scan of the upper spine without contrast is a non-invasive imaging test that uses X-rays to capture detailed images of your neck and upper back. It helps in identifying issues like fractures, tumors, or infections. No dye (contrast) is used in this scan.
This service was performed 30 times for 30 patientsA DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.
This service was performed 119 times for 119 patientsA DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.
This service was performed 19 times for 19 patientsThis process, known as a swallowing study, uses imaging technology to view how food and liquid move from your mouth to your stomach. It helps identify any issues you may have swallowing, which can be crucial for determining the best treatment plan.
This service was performed 17 times for 17 patientsA low-dose CT scan of the chest is a quick, painless procedure that uses a small amount of radiation to create detailed images of your lungs. It's a key tool for early detection of lung cancer, especially for those at high risk.
This service was performed 15 times for 15 patientsAn MRI scan of the abdomen before and after contrast provides detailed images of your abdominal organs. Initially, images are taken without a contrast agent. Then, a safe dye is administered, usually via an IV, to highlight certain areas, giving a clearer picture to help diagnose various conditions.
This service was performed 19 times for 19 patientsAn MRI scan of the brain, both before and after contrast, helps visualize different brain structures. Initially, images are taken without a contrast agent. Then, a safe dye is injected which helps highlight certain areas, providing clearer, more detailed images.
This service was performed 44 times for 43 patientsAn MRI scan of the brain without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your brain. It helps in detecting abnormalities like tumors, stroke, inflammation, or infection.
This service was performed 34 times for 34 patientsAn 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.
This service was performed 13 times for 13 patientsAn 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.
This service was performed 26 times for 26 patientsNuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.
This service was performed 53 times for 53 patientsA nuclear medicine study from skull base to mid-thigh with a CT scan involves using a small amount of radioactive material and CT imaging to examine body tissues and organs. This helps detect any abnormalities by providing detailed images of the body's internal structure.
This service was performed 68 times for 64 patientsA chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.
This service was performed 163 times for 144 patientsA chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.
This service was performed 49 times for 48 patientsAn 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.
This service was performed 11 times for 11 patientsAn 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.
This service was performed 15 times for 12 patientsAn 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.
This service was performed 17 times for 17 patientsAn X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.
This service was performed 26 times for 25 patientsAn 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.
This service was performed 17 times for 17 patientsAn 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.
This service was performed 14 times for 14 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $22.69 for a new patient copayment and $18.09 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 48043 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $90.76
- Minimum New Patient Price $58.04
- Maximum New Patient Price $177.36
- Average New Patient Copayment $22.69
- Minimum New Patient Copayment $14.51
- Maximum New Patient Copayment $44.34
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $72.38
- Minimum Established Patient Price $18.32
- Maximum Established Patient Price $143.49
- Average Established Patient Copayment $18.09
- Minimum Established Patient Copayment $4.58
- Maximum Established Patient Copayment $35.87
* 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.
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 |
|---|
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Karl Doelle is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| MCLAREN BAY REGION | 1900 COLUMBUS AVE BAY CITY, MI 48708 | (989) 894-3000 | Acute Care Hospitals | |
| HENRY FORD MACOMB HOSPITAL | 15855 NINETEEN MILE RD CLINTON TOWNSHIP, MI 48038 | (586) 263-2300 | Acute Care Hospitals | |
| MCLAREN OAKLAND | 50 N PERRY ST PONTIAC, MI 48342 | (248) 338-5000 | Acute Care Hospitals | |
| MYMICHIGAN MEDICAL CENTER MIDLAND | 4000 WELLNESS DRIVE MIDLAND, MI 48670 | (989) 839-3000 | Acute Care Hospitals | |
| MCLAREN MACOMB | 1000 HARRINGTON ST MOUNT CLEMENS, MI 48043 | (586) 493-8000 | Acute Care Hospitals |
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NPI 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 1659316842, 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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
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.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
MOUNT CLEMENS, MI 48043
MOUNT CLEMENS, MI 48043
MOUNT CLEMENS, MI 48043
MOUNT CLEMENS, MI 48043
MOUNT CLEMENS, MI 48043
MOUNT CLEMENS, MI 48043
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1659316842, enumerated as an "individual" on June 19, 2006.
The provider is located at 1000 HARRINGTON ST MOUNT CLEMENS, MI 48043 and the phone number is (586) 493-8098.
Radiology with taxonomy code 2085R0202X and a focus in Diagnostic Radiology.
The provider might be accepting Accepts: Blue Care Network of Michigan, Blue Cross Blue. Please consult your insurance carrier or call the provider to verify.
Karl Doelle is affiliated with: MCLAREN BAY REGION, HENRY FORD MACOMB HOSPITAL, MCLAREN OAKLAND, MYMICHIGAN MEDICAL CENTER MIDLAND and MCLAREN MACOMB.