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DR. KAREN MARVA BIGBY M.D.
NPI 1952364804
Family Medicine in Bradenton, FL

Active since April 11, 2006PECOS EnrolledAccepts Medicare Assignment
78.8/100
CMS Quality Rating
1040 RIVER HERITAGE BLVD, SUITE 204, BRADENTON, FL 34212(941) 917-7100(941) 917-7142 Get Directions Write a Review

NPPES record last updated: April 16, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Karen Marva Bigby M.d. NPPES

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

DR. KAREN MARVA BIGBY M.D. (NPI 1952364804) is an individual family medicine provider in Bradenton, Florida, licensed in Florida (ME69183) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS, is affiliated with Sarasota Memorial Hospital, and is a graduate of Other (1992).

NPPES Registry Identity

NPI1952364804
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. KAREN MARVA BIGBYCredential: M.D.
Location Address1040 RIVER HERITAGE BLVD, SUITE 204Bradenton, FL 34212-6348
Mailing AddressPo Box 863407Orlando, FL 32886-0001 · (941) 917-2600 · Fax (941) 917-7884
Phone(941) 917-7100
Fax(941) 917-7142
Sole ProprietorNo
Medical School CMSOtherGraduated 1992
Enumeration DateApril 11, 2006
Last NPPES UpdateApril 16, 2018
✔ NPI 1952364804 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in FL · ME69183
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.
1040 RIVER HERITAGE BLVD, Bradenton, FL 34212
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Other Identifiers 2

Medicaid250082500FL
Other27853FL · Bcbs

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama 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

Dr. Karen Marva Bigby M.d. 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 ID2567446156
PECOS Enrollment IDI20040614000274
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 7

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.
530 services235 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.
153 services112 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.
101 services101 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.
29 services23 patients
Urinalysis, manual test 81002
A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
22 services20 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.
22 services18 patients

Hospital Affiliations CMS Care Compare

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

Sarasota Memorial Hospital

Acute Care Hospitals · Sarasota, FL
5/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100087
Location1700 S Tamiami TrlSarasota, FL 34239 · Sarasota County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34212 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

78.8/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.37
Promoting Interoperability99
Improvement Activities40
Cost50.81

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
9 suppliers26 claims47 services$6.18 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
4 suppliers11 claims66 services$1.85 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
2 suppliers16 claims16 services$184.87 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 6

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

MRS. MELISSA BETH BOUDREAUX PA-C
Physician Assistant
1040 RIVER HERITAGE BLVD, SUITE 204
BRADENTON, FL 34212
Manatee County (941) 917-7100
DR. ANDREW E BURG MD
Family Medicine
1040 RIVER HERITAGE BLVD, SUITE 204
BRADENTON, FL 34212
Manatee County (941) 917-7100
SMH PHYSICIAN SERVICES INC
Anesthesiology (Pain Medicine)
1040 RIVER HERITAGE BLVD, SUITE 201
BRADENTON, FL 34212
Manatee County (941) 917-4500
SMH PHYSICIAN SERVICES INC
Obstetrics & Gynecology
1040 RIVER HERITAGE BLVD, SUITE 202
BRADENTON, FL 34212
Manatee County (941) 917-2600
SMH PHYSICIAN SERVICES INC
Family Medicine
1040 RIVER HERITAGE BLVD, SUITE 204
BRADENTON, FL 34212
Manatee County (941) 917-8345
AMANDA HAFER D.O.
Family Medicine
1040 RIVER HERITAGE BLVD
BRADENTON, FL 34212
Manatee County (941) 917-6443

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 Bigby's NPI number?

The NPI number for Karen Bigby is 1952364804. It was assigned to this individual provider in the NPPES registry on April 11, 2006.

Where is Karen Bigby located?

Karen Bigby practices at 1040 River Heritage Blvd Suite 204, Bradenton, FL 34212. The listed phone number is (941) 917-7100.

What is Karen Bigby's specialty?

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

Is Karen Bigby enrolled in Medicare?

Yes. Karen Bigby 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 Bigby accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 1 other insurer list Karen Bigby 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 Bigby affiliated with any hospitals?

According to CMS data, Karen Bigby is affiliated with Sarasota Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Karen Bigby was last updated on April 16, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.