KAREN W SIMPSON MD
NPI 1831264373
Pathology - Anatomic Pathology & Clinical Pathology in Opelousas, LA
NPI Status: Active since November 21, 2006
Contact Information
1268 ATTAKAPAS DR
SUITE 102
OPELOUSAS, LA
ZIP 70570
Phone: (337) 948-8663
Fax: (337) 948-8783
- Individual
- Female
- Years of Experience 25
- Pathology
- Anatomic Pathology & Clinical Pathology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About KAREN SIMPSON
This page provides the complete NPI Profile along with additional information for Karen Simpson, a provider established in Opelousas, Louisiana with a medical specialization in Pathology, focusing in anatomic pathology & clinical pathology and more than 25 years of experience. She graduated from Louisiana State University School Of Medicine In Shreveport in 2001. The healthcare provider is registered in the NPI registry with number 1831264373 assigned on November 2006. The practitioner's primary taxonomy code is 207ZP0102X with license number 025694 (LA). The provider is registered as an individual and her NPI record was last updated 15 years ago.
- NPI
- 1831264373
- Provider Name
- KAREN W SIMPSON MD
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1268 ATTAKAPAS DR SUITE 102 OPELOUSAS, LA 70570
- Location Phone
- (337) 948-8663
- Location Fax
- (337) 948-8783
- Mailing Address
- 1268 ATTAKAPAS DR SUITE 102 OPELOUSAS, LA 70570
- Mailing Phone
- (337) 948-8663
- Mailing Fax
- (337) 948-8783
- Medical School Name
- LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
- Graduation Year
- 2001
- Is Sole Proprietor?
- No
- Enumeration Date
- 11-21-2006
- Last Update Date
- 04-19-2011
- 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
Pathology Anatomic Pathology & Clinical Pathology
- Taxonomy Code
- 207ZP0102X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 025694
- License State
- LA
- Taxonomy Description
- A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Connect 80/60 $3200 with 2 $0 PCP Virtual Visits (L) - POS
- Blue Connect 80/60 $3200 with 2 $0 PCP Virtual Visits (N) - POS
- Blue Connect 80/60 $3200 with 2 $0 PCP Virtual Visits (S) - POS
- Blue Connect Copay (PCP) 50/50 $7500 Standardized (H) HSA Eligible - POS
- Blue Connect Copay (PCP) 50/50 $7500 Standardized (L) HSA Eligible - POS
- Blue Connect Copay (PCP) 50/50 $7500 Standardized (N) HSA Eligible - POS
- Blue Connect Copay (PCP) 50/50 $7500 Standardized (S) HSA Eligible - POS
- Blue Connect Copay (PCP) 60/40 $6000 Standardized (L) - POS
- Blue Connect Copay (PCP) 60/40 $6000 Standardized (N) - POS
- Blue Connect Copay (PCP) 60/40 $6000 Standardized (S) - POS
- Blue Connect Copay (PCP) 75/55 $2000 Standardized (H) - POS
- Blue Connect Copay (PCP) 75/55 $2000 Standardized (L) - POS
- Blue Connect Copay (PCP) 75/55 $2000 Standardized (N) - POS
- Blue Connect Copay (PCP) 75/55 $2000 Standardized (S) - POS
- Blue POS 60/40 $6500 with 2 $0 PCP Virtual Visits HSA Eligible - POS
- Blue POS 80/60 $3200 with 2 $0 PCP Virtual Visits - POS
- Blue POS 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible - POS
- Blue POS Copay (PCP) 50/50 $7500 Standardized HSA Eligible - POS
- Blue POS Copay (PCP) 60/40 $6000 Standardized - POS
- Blue POS Copay (PCP) 75/55 $2000 Standardized - POS
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 |
|---|---|---|---|
| 4K383BD23 | MEDICARE PIN (08) | LA | |
| $$$$$$$$$A | OTHER (01) | LA | BCBS OF LOUISIANA |
| I68130 | MEDICARE UPIN (02) | LA | |
| 1041947 | MEDICAID (05) | LA |
Medicare Participation & PECOS Enrollment Status
Karen Simpson 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.
Karen Simpson 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: 7517069859
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: I20070216000525
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
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $31.15 for a new patient copayment and $23.77 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 70570 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $124.6
- Minimum New Patient Price $53.43
- Maximum New Patient Price $164.73
- Average New Patient Copayment $31.15
- Minimum New Patient Copayment $13.35
- Maximum New Patient Copayment $41.18
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $95.09
- Minimum Established Patient Price $16.64
- Maximum Established Patient Price $133.62
- Average Established Patient Copayment $23.77
- Minimum Established Patient Copayment $4.16
- Maximum Established Patient Copayment $33.4
* 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 |
|---|---|---|
| Completion of training and receipt of approved waiver for provision opioid medication-assisted treatments | Yes | N/A |
| Completion of training and obtaining an approved waiver for provision of medication -assisted treatment of opioid use disorders using buprenorphine. | ||
| Implementation of improvements that contribute to more timely communication of test results | Yes | N/A |
| Timely communication of test results defined as timely identification of abnormal test results with timely follow-up. | ||
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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 1831264373, we treat the final digit (3) 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 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).
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 67 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 5 providers are registered at the same or a nearby location.
OPELOUSAS, LA 70570
OPELOUSAS, LA 70570
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1831264373, enumerated as an "individual" on November 21, 2006.
The provider is located at 1268 ATTAKAPAS DR SUITE 102 OPELOUSAS, LA 70570 and the phone number is (337) 948-8663.
Pathology with taxonomy code 207ZP0102X and a focus in Anatomic Pathology & Clinical Pathology.
The provider might be accepting Accepts: HMO Louisiana, Medicare, Medicaid and Blue Cross. Please consult your insurance carrier or call the provider to verify.
