MRS. KAREN E. BALLARD-MONTGOMERY MD NPI 1699869321

Family Medicine in Woodstock, AL

NPI 1699869321 Individual Female Years of Experience 29 Family Medicine PECOS Enrolled Accepts Medicare Approved Payment Medicare Quality Reporting

About KAREN BALLARD-MONTGOMERY

Karen Ballard-montgomery is a primary care provider established in Woodstock, Alabama and her medical specialization is family medicine with more than 29 years of experience. She graduated from Mercer University School Of Medicine in 1993. The NPI number of Karen Ballard-montgomery is 1699869321 and was assigned on October 2006. The practitioner's primary taxonomy code is 207Q00000X with license number MD.20185 (AL). The provider is registered as an individual and her NPI record was last updated 5 years ago.

A primary care provider (PCP) like Mrs. Karen E. Ballard-montgomery Md 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

Karen Ballard-montgomery is enrolled in PECOS and is eligible to order or refer healthcare 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

Karen Ballard-montgomery is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data she has hospital affiliations with Bibb Medical Center, Dch Regional Medical Center, Medical West, An Affiliate Of Uab Health System and Shelby Baptist Medical Center.

The provider participated in Medicare's Quality Payment Program and the following quality measures were reported: breast cancer screening, chronic care and preventative care management for empaneled patients, colorectal cancer screening, diabetes: eye exam, e-prescribing, health information exchange, immunization registry reporting, implementation of medication management practice improvements, measurement and improvement at the practice and panel level, medication reconciliation, onc direct review attestation, onc-acb surveillance attestation (optional), patient-specific education, provide patient access, secure messaging, security risk analysis, specialized registry reporting, specialized registry reporting for multiple registry engagement, use of decision support and standardized treatment protocols and view, download, or transmit (vdt). The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.

NPI

1699869321

Provider NameMRS. KAREN E. BALLARD-MONTGOMERY MD
Provider Location Address28921 HIGHWAY 5 WOODSTOCK, AL 35188
Provider Mailing Address405 BELCHER STREET CENTREVILLE, AL 35042
GenderFemale
NPI Entity TypeIndividual
Medical School NameMERCER UNIVERSITY SCHOOL OF MEDICINE
Graduation Year1993
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date10-03-2006
Last Update Date07-28-2016


Primary Taxonomy

Taxonomy Code207Q00000X
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.MD.20185
License StateAL
Taxonomy DescriptionFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Business Address

MRS. KAREN E. BALLARD-MONTGOMERY MD
28921 HIGHWAY 5
WOODSTOCK, AL
ZIP 35188
Phone: (205) 938-9348
Fax: (205) 938-9020

Get Directions


Mailing Address

MRS. KAREN E. BALLARD-MONTGOMERY MD
405 BELCHER STREET
CENTREVILLE, AL
ZIP 35042
Phone: (205) 926-2992
Fax: (205) 316-7675



Medicare Participation

Registered in PECOS? Yes What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
PECOS PAC ID2264482645
PECOS Enrollment IDI20050419001386
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 order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 17Insertion of needle into vein for collection of blood sample (HCPCS:36415)

Quality Reporting

The following quality measures meets Medicare's statistical reporting standards for the year 2018. 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 Rate Number of Patients
Breast Cancer Screening 68% 271
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
Colorectal Cancer Screening 61% 444
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Diabetes: Eye Exam 27% 170
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
e-Prescribing 98% 6036
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Health Information Exchange 42% 575
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 at least one transition of care or referral.
Medication Reconciliation 100% 200
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 98% 1235
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.
Provide Patient Access 100% 1235
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 8% 1235
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.
View, Download, or Transmit (VDT) 23% 1235
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.

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare 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. Karen Ballard-montgomery is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
BIBB MEDICAL CENTER208 PIERSON AVE
CENTREVILLE, AL 35042
(205) 926-4881Acute Care Hospitals10058
DCH REGIONAL MEDICAL CENTER809 UNIVERSITY BOULEVARD EAST
TUSCALOOSA, AL 35401
(205) 759-7111Acute Care Hospitals10092
MEDICAL WEST, AN AFFILIATE OF UAB HEALTH SYSTEM995 9TH AVENUE SOUTHWEST
BESSEMER, AL 35021
(205) 481-7000Acute Care Hospitals10114
SHELBY BAPTIST MEDICAL CENTER1000 FIRST STREET NORTH
ALABASTER, AL 35007
(205) 620-8100Acute Care Hospitals10016

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine00020185ALNo

Taxonomy Description: family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
169257MEDICAID (05)AL

Other Providers at the same location


The following 6 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1578863213WOODSTOCK FAMILY MEDICINE, PC
Organization
Family Medicine28921 HIGHWAY 5
WOODSTOCK, AL 35188
(205) 938-9348
1053738732MS. ALICE SPRINGER BRISTOW CRNP
Individual
Nurse Practitioner (Family)28921 HIGHWAY 5
WOODSTOCK, AL 35188
(205) 938-9348
1114476553MRS. ALEXANDRA CLIFTON PA-C
Individual
Physician Assistant28921 HIGHWAY 5
WOODSTOCK, AL 35188
(205) 938-9348
1982255675 ANNA LOCKHART
Individual
Nurse Practitioner (Family)28921 HIGHWAY 5
WOODSTOCK, AL 35188
(205) 938-9348
1730255217WOODSTOCK HEALTHCARE, LLC
Organization
Family Medicine28921 HIGHWAY 5
WOODSTOCK, AL 35188
(205) 333-4655
1386118792MRS. LINDZI ERIN LEE CRNP, FNP-BC
Individual
Nurse Practitioner28921 HIGHWAY 5
WOODSTOCK, AL 35188
(205) 938-9348

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.