KAREN E LYBOLT P.A.
NPI 1811969280
Physician Assistant in Leominster, MA

Active since February 01, 2006PECOS EnrolledAccepts Medicare Assignment
97.02/100
CMS Quality Rating
50 MEMORIAL DR, LEOMINSTER, MA 01453(978) 466-2052 Get Directions Write a Review

NPPES record last updated: July 26, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 26, 2023, Jun 3, 2023 (2 updates tracked since 2023).

About Karen E Lybolt P.a. NPPES

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

KAREN E LYBOLT P.A. (NPI 1811969280) is an individual physician assistant in Leominster, Massachusetts, licensed in Massachusetts (PA9263) and active in the NPI registry since February 2006. She is enrolled in Medicare PECOS, is affiliated with Umass Memorial Healthalliance Hospitals, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1811969280
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKAREN E LYBOLTCredential: P.A.
Location Address50 MEMORIAL DRLeominster, MA 01453-2238
Mailing AddressPo Box 415348Boston, MA 02241-5348
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateFebruary 1, 2006
Last NPPES UpdateJuly 26, 20232 updates tracked since enumeration
NPPES CertifiedJuly 26, 2023
NPI 1811969280 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in MA · PA9263
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License PA9102676 (FL)
50 MEMORIAL DR, Leominster, MA 01453

Accepted 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 E Lybolt P.a. 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 ID3072590074
PECOS Enrollment IDI20230821001562
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 4

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 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.
210 services170 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.
122 services92 patients
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.
71 services64 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.
20 services14 patients

Hospital Affiliations CMS Care Compare 2

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

Umass Memorial Healthalliance Hospitals

Acute Care Hospitals · Leominster, MA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number220001
Location60 Hospital RoadLeominster, MA 01453 · Worcester County
Emergency services

Umass Memorial Medical Center/University Campus

Acute Care Hospitals · Worcester, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220163
Location55 Lake Avenue NorthWorcester, MA 01655 · Worcester County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01453 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
$90.70 typical visit price
range $58.86 – $177.36
Typical copayment $22.67 (range $14.71 – $44.34)
Most-billed visit code 99203
Established Patient
$73.22 typical visit price
range $19.11 – $144.84
Typical copayment $18.30 (range $4.77 – $36.21)
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.

97.02/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality78.09
Promoting Interoperability100
Improvement Activities40

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.

Internal Medicine
50 MEMORIAL DR, SUITE 210
LEOMINSTER, MA 01453
Family Medicine
50 MEMORIAL DR, SUITE 103
LEOMINSTER, MA 01453
Internal Medicine (Endocrinology, Diabetes & Metabolism)
50 MEMORIAL DR, SUITE 110
LEOMINSTER, MA 01453
Psychiatry & Neurology (Neurology)
50 MEMORIAL DR, SUITE 209
LEOMINSTER, MA 01453
Psychiatry & Neurology (Neurology)
50 MEMORIAL DR, SUITE 211
LEOMINSTER, MA 01453
Clinic/Center (Health Service)
50 MEMORIAL DR, SUITE 110
LEOMINSTER, MA 01453
Plastic Surgery (Plastic Surgery Within the Head and Neck)
50 MEMORIAL DR, SUITE 212
LEOMINSTER, MA 01453
Clinic/Center (Physical Therapy)
50 MEMORIAL DR, SUITE 211
LEOMINSTER, MA 01453

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 Lybolt's NPI number?

The NPI number for Karen Lybolt is 1811969280. It was assigned to this individual provider in the NPPES registry on February 1, 2006.

Where is Karen Lybolt located?

Karen Lybolt practices at 50 Memorial Dr, Leominster, MA 01453. The listed phone number is (978) 466-2052.

What is Karen Lybolt's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Karen Lybolt enrolled in Medicare?

Yes. Karen Lybolt 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 Lybolt accept?

Health plans from Anthem Blue Cross and Blue Shield list Karen Lybolt 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.

Is Karen Lybolt affiliated with any hospitals?

According to CMS data, Karen Lybolt is affiliated with Umass Memorial Healthalliance Hospitals and Umass Memorial Medical Center/University Campus.

When was this NPI record last updated?

The NPPES record for Karen Lybolt was last updated on July 26, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.