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KARLA JEAN SPIKA MD
NPI 1861427585
Family Medicine in De Pere, WI

Active since July 11, 2006PECOS EnrolledAccepts Medicare Assignment
94.61/100
CMS Quality Rating
1686 EISENHOWER RD, DE PERE, WI 54115(920) 496-4700(920) 431-1982 Get Directions Write a Review

NPPES record last updated: July 22, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Karla Jean Spika Md NPPES

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

KARLA JEAN SPIKA MD (NPI 1861427585) is an individual family medicine provider in De Pere, Wisconsin, licensed in Wisconsin (37928) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS, is affiliated with St Vincent Hospital, and is a graduate of University Of Wisconsin School Of Medicine (1995).

NPPES Registry Identity

NPI1861427585
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameKARLA JEAN SPIKACredential: MD
Location Address1686 EISENHOWER RDDe Pere, WI 54115-8145
Mailing AddressPo Box 19070, Prevea HealthGreen Bay, WI 54307-9070 · (920) 496-4700 · Fax (920) 431-1982
Phone(920) 496-4700
Fax(920) 431-1982
Sole ProprietorNo
Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 1995
Enumeration DateJuly 11, 2006
Last NPPES UpdateJuly 22, 2008
✔ NPI 1861427585 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in WI · 37928
Definition
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.
1686 EISENHOWER RD, De Pere, WI 54115
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Other Identifiers 3

Medicaid33310300WI
Medicare UPING48747
Medicare ID-Type Unspecified07125-0105

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health.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

Karla Jean Spika Md 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 ID3173679222
PECOS Enrollment IDI20090915000637
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 5

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.

Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
86 services62 patients
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.
78 services58 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.
53 services41 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
16 services15 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
12 services12 patients

Hospital Affiliations CMS Care Compare 2

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

St Vincent Hospital

Acute Care Hospitals · Green Bay, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520075
Location835 S Van Buren StGreen Bay, WI 54301 · Brown County
Emergency services Birthing friendly

St Mary's Hospital Medical Center

Acute Care Hospitals · Green Bay, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number520097
Location1726 Shawano AveGreen Bay, WI 54303 · Brown County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54115 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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.

94.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.17
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
4 suppliers13 claims29 services$5.68 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
3 suppliers13 claims13 services$40.11 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
3 suppliers21 claims82 services$2.11 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 10

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

DR. LINDSAY LEA DEUSTER M.D.
Pediatrics
1686 EISENHOWER RD
DE PERE, WI 54115
Brown County (920) 496-4700
PREVEA CLINIC, INC.
Durable Medical Equipment & Medical Supplies
1686 EISENHOWER RD
DE PERE, WI 54115
Brown County (920) 496-4700
MRS. AMY NICOLE MCMAHON OT
Occupational Therapist
1686 EISENHOWER RD
DE PERE, WI 54115
Brown County (920) 496-4700
MICHELLE MARIE HILL M.D.
Pediatrics
1686 EISENHOWER RD
DE PERE, WI 54115
Brown County (920) 496-4700
TODD P REYNOLDS MD
Family Medicine
1686 EISENHOWER RD
DE PERE, WI 54115
Brown County (920) 496-4700
KATHERINE THERESE NIMKE M.D.
Family Medicine
1686 EISENHOWER RD
DE PERE, WI 54115
Brown County (920) 496-4700
JESSICA PROVOST
Speech-Language Pathologist
1686 EISENHOWER RD
DE PERE, WI 54115
Brown County (920) 496-4700
DR. DAVID T. SPIKA MD
Family Medicine
1686 EISENHOWER RD
DE PERE, WI 54115
Brown County (920) 496-4700

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 Karla Spika's NPI number?

The NPI number for Karla Spika is 1861427585. It was assigned to this individual provider in the NPPES registry on July 11, 2006.

Where is Karla Spika located?

Karla Spika practices at 1686 Eisenhower Rd, De Pere, WI 54115. The listed phone number is (920) 496-4700.

What is Karla Spika's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Karla Spika enrolled in Medicare?

Yes. Karla Spika 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 Karla Spika accept?

Health plans from Anthem Blue Cross and Blue Shield and Network Health list Karla Spika 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 Karla Spika affiliated with any hospitals?

According to CMS data, Karla Spika is affiliated with St Vincent Hospital and St Mary's Hospital Medical Center.

When was this NPI record last updated?

The NPPES record for Karla Spika was last updated on July 22, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.