KAREN ANN MCGUIRE APRN NP-C
NPI 1831717420
Nurse Practitioner - Family in Dayton, OH

Active since July 09, 2020PECOS EnrolledAccepts Medicare Assignment
87.27/100
CMS Quality Rating
5981 FAR HILLS AVE, DAYTON, OH 45429(866) 389-2727 Get Directions Write a Review

NPPES record last updated: February 13, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 14, 2020, Jul 9, 2020 (2 updates tracked since 2020).

About Karen Ann Mcguire Aprn Np-c NPPES

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

KAREN ANN MCGUIRE APRN NP-C (NPI 1831717420) is an individual family provider in Dayton, Ohio, licensed in Ohio (APRN.CNP.0026997) and active in the NPI registry since July 2020. She is enrolled in Medicare PECOS, is affiliated with Kettering Health Dayton, and is a graduate of Wright State University Boonshoft School Of Medicine (2020).

NPPES Registry Identity

NPI1831717420
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKAREN ANN MCGUIRECredential: APRN NP-C
Location Address5981 FAR HILLS AVEDayton, OH 45429-2211
Mailing Address5981 Far Hills AveDayton, OH 45429-2211 · (866) 389-2727
Sole ProprietorYes
Medical School CMSWright State University Boonshoft School Of MedicineGraduated 2020
Enumeration DateJuly 9, 2020
Last NPPES UpdateFebruary 13, 20262 updates tracked since enumeration
NPPES CertifiedFebruary 13, 2026
NPI 1831717420 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in OH · APRN.CNP.0026997
5981 FAR HILLS AVE, Dayton, OH 45429

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 Ann Mcguire Aprn Np-c 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 ID42630121
PECOS Enrollment IDI20201009002342
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 2

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 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.
109 services64 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
27 services27 patients

Hospital Affiliations CMS Care Compare 2

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

Kettering Health Dayton

Acute Care Hospitals · Dayton, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number360133
Location405 Grand AvenueDayton, OH 45405 · Montgomery County
Birthing friendly

Kettering Health Miamisburg

Acute Care Hospitals · Miamisburg, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number360239
Location4000 Miamisburg-Centerville RoadMiamisburg, OH 45342 · Montgomery County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45429 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

87.27/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality92.94
Promoting Interoperability100
Improvement Activities40
Cost64.64

Reported Quality Measures

Adult Major Depressive Disorder (MDD): Suicide Risk Assessment
0%36 patients
Breast Cancer Screening
64%257 patients3/55-star benchmark: 93%
Cervical Cancer Screening
38%472 patients2/55-star benchmark: 98%
Colorectal Cancer Screening
56%540 patients3/55-star benchmark: 88%
Controlling High Blood Pressure
87%345 patients4/55-star benchmark: 91%
Diabetes: Eye Exam
19%134 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
34%134 patients3/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
100%2,348 patients5/55-star benchmark: 100%
e-Prescribing
100%3,173 patients5/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
34%187 patients2/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
65%1,032 patients3/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
18%695 patients1/55-star benchmark: 97%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
21%1,433 patients2/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 98% · 1,011 patients
Patients screened: 99% · 1,011 patients
96%139 patients4/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
87%811 patients4/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
76%243 patients3/55-star benchmark: 91%
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 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
5981 FAR HILLS AVE
DAYTON, OH 45429
Nurse Practitioner (Family)
5981 FAR HILLS AVE
DAYTON, OH 45429
Nurse Practitioner (Family)
5981 FAR HILLS AVE
DAYTON, OH 45429
Nurse Practitioner (Family)
5981 FAR HILLS AVE
DAYTON, OH 45429
Pharmacist
5981 FAR HILLS AVE
DAYTON, OH 45429
Pharmacist
5981 FAR HILLS AVE
DAYTON, OH 45429
Pharmacist
5981 FAR HILLS AVE
DAYTON, OH 45429
Nurse Practitioner (Family)
5981 FAR HILLS AVE
DAYTON, OH 45429

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 Mcguire's NPI number?

The NPI number for Karen Mcguire is 1831717420. It was assigned to this individual provider in the NPPES registry on July 9, 2020.

Where is Karen Mcguire located?

Karen Mcguire practices at 5981 Far Hills Ave, Dayton, OH 45429. The listed phone number is (866) 389-2727.

What is Karen Mcguire's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Karen Mcguire enrolled in Medicare?

Yes. Karen Mcguire 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 Mcguire accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource, MedMutual, Molina Healthcare and Oscar Health Insurance and 1 other insurer list Karen Mcguire 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 Mcguire affiliated with any hospitals?

According to CMS data, Karen Mcguire is affiliated with Kettering Health Dayton and Kettering Health Miamisburg.

When was this NPI record last updated?

The NPPES record for Karen Mcguire was last updated on February 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.