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KAREN J PADUA D.O.
NPI 1922273275
Family Medicine in Milwaukee, WI

Active since April 28, 2008PECOS EnrolledAccepts Medicare Assignment
8520 W OKLAHOMA AVE, MILWAUKEE, WI 53227(414) 607-4291(414) 607-4530 Get Directions Write a Review

NPPES record last updated: December 27, 2021. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Dec 27, 2021, Nov 29, 2021, Oct 7, 2021 and 3 more (6 updates tracked since 2019).

About Karen J Padua D.o. NPPES

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

KAREN J PADUA D.O. (NPI 1922273275) is an individual family medicine provider in Milwaukee, Wisconsin, licensed in Wisconsin (54159-21) and active in the NPI registry since April 2008. She is enrolled in Medicare PECOS, is affiliated with Aurora St Lukes Medical Center, and is a graduate of Midwestern University, Chicago College Of Osteopathic Med (2008).

NPPES Registry Identity

NPI1922273275
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameKAREN J PADUACredential: D.O.
Location Address8520 W OKLAHOMA AVEMilwaukee, WI 53227-4604
Mailing Address3301 W Forest Home AveMilwaukee, WI 53215-2843 · (414) 389-2131
Phone(414) 607-4291
Fax(414) 607-4530
Sole ProprietorNo
Medical School CMSMidwestern University, Chicago College Of Osteopathic MedGraduated 2008
Enumeration DateApril 28, 2008
Last NPPES UpdateDecember 27, 20216 updates tracked since enumeration
NPPES CertifiedDecember 27, 2021
✔ NPI 1922273275 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in WI · 54159-21✔ Licensed in CA · 20A15163
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.
Also ListedFamily Medicine · Geriatric MedicineTaxonomy 207QG0300X · License 54159-21 (WI), 20A15163 (CA)
8520 W OKLAHOMA AVE, Milwaukee, WI 53227
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Other Identifiers 1

Medicaid100024987WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.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 J Padua D.o. 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 ID4688822620
PECOS Enrollment IDI20120917000105
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 11

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.
108 services59 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
60 services24 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.
53 services36 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.
38 services38 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
27 services11 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
26 services26 patients

Hospital Affiliations CMS Care Compare 2

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

Aurora St Lukes Medical Center

Acute Care Hospitals · Milwaukee, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520138
Location2900 W Oklahoma AveMilwaukee, WI 53215 · Milwaukee County
Emergency services Birthing friendly

West Allis Memorial Hospital

Acute Care Hospitals · West Allis, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520139
Location8901 W Lincoln AveWest Allis, WI 53227 · Milwaukee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53227 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.

Referred Medical Equipment & Supplies CMS DME claims

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

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers13 claims13 services$55.37 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 20

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

MELISSA MOLITOR PTA
Physical Therapy Assistant
8520 W OKLAHOMA AVE
WEST ALLIS, WI 53227
Milwaukee County (414) 607-4120
MR. DEAN FREELAND PT
Physical Therapist
8520 W OKLAHOMA AVE
MILWAUKEE, WI 53227
Milwaukee County (414) 607-4258
JENNIFER LEE MCFADYEN OT
Occupational Therapist
8520 W OKLAHOMA AVE
WEST ALLIS, WI 53227
Milwaukee County (414) 607-4120
ELIZABETH KRUSER MOORE PT
Physical Therapist
8520 W OKLAHOMA AVE
WEST ALLIS, WI 53227
Milwaukee County (414) 607-4120
NICOLE LYNN ZGANJAR
Occupational Therapy Assistant
8520 W OKLAHOMA AVE
MILWAUKEE, WI 53227
Milwaukee County (414) 607-4120
KAREN KOMORNICKA RN, NP
Nurse Practitioner (Family)
8520 W OKLAHOMA AVE
MILWAUKEE, WI 53227
Milwaukee County (414) 607-4100
GRETCHEN KNIGHT PT
Physical Therapist
8520 W OKLAHOMA AVE
MILWAUKEE, WI 53227
Milwaukee County (414) 607-4120
JAMES EDWARD ZIEGLER PT
Physical Therapist
8520 W OKLAHOMA AVE
WEST ALLIS, WI 53227
Milwaukee County (414) 607-4120

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 Padua's NPI number?

The NPI number for Karen Padua is 1922273275. It was assigned to this individual provider in the NPPES registry on April 28, 2008.

Where is Karen Padua located?

Karen Padua practices at 8520 W Oklahoma Ave, Milwaukee, WI 53227. The listed phone number is (414) 607-4291.

What is Karen Padua's specialty?

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

Is Karen Padua enrolled in Medicare?

Yes. Karen Padua 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 Padua accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and UnitedHealthcare list Karen Padua 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 Padua affiliated with any hospitals?

According to CMS data, Karen Padua is affiliated with Aurora St Lukes Medical Center and West Allis Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Karen Padua was last updated on December 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.