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KAREN J. NISHIDA MD
NPI 1962509653
Obstetrics & Gynecology - Gynecologic Oncology in Stamford, CT

Active since September 17, 2006PECOS EnrolledAccepts Medicare Assignment
94.3/100
CMS Quality Rating
1290 SUMMER ST STE 5200, STAMFORD, CT 06905(203) 998-0848(203) 323-0566 Get Directions Write a Review

NPPES record last updated: January 15, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Karen J. Nishida Md NPPES

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

KAREN J. NISHIDA MD (NPI 1962509653) is an individual gynecologic oncology provider in Stamford, Connecticut, licensed in Connecticut (052404) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS and is a graduate of Un Of California, Irvine, College Of Medicine (1999).

NPPES Registry Identity

NPI1962509653
Entity TypeIndividualFemale
Primary Taxonomy207VX0201X
Provider Legal NameKAREN J. NISHIDACredential: MD
Location Address1290 SUMMER ST STE 5200Stamford, CT 06905-5339
Mailing Address1290 Summer St Ste 5200Stamford, CT 06905-5339 · (203) 998-0848 · Fax (203) 323-0566
Phone(203) 998-0848
Fax(203) 323-0566
Sole ProprietorNo
Medical School CMSUn Of California, Irvine, College Of MedicineGraduated 1999
Enumeration DateSeptember 17, 2006
Last NPPES UpdateJanuary 15, 2015
✔ NPI 1962509653 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · Gynecologic OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207VX0201X
License✔ Licensed in CT · 052404
Definition
An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications.
1290 SUMMER ST STE 5200, Stamford, CT 06905
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.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. Nishida 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 ID5395746697
PECOS Enrollment IDI20150428000361
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 6

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.
110 services69 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.
46 services42 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.
34 services31 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
30 services30 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
27 services27 patients
Removal of uterus, tubes, and/or ovaries through abdomen using an endoscope, 250.0 g or less 58571
This procedure involves the removal of certain internal structures through small incisions in the abdomen, using a special tool called an endoscope. It's performed when these structures are causing health issues. The weight reference (250.0 g or less) relates to the size of the structures being removed.
12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06905 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
$183.10 typical visit price
range $60.82 – $183.10
Typical copayment $45.77 (range $15.20 – $45.77)
Most-billed visit code 99205
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
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.

94.3/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.58
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
31%156 patients2/55-star benchmark: 85%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
95%351 patients4/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
97%143 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
66%642 patients3/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
41%349 patients2/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
78%642 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
25%642 patients2/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
43%642 patients
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.

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 Nishida's NPI number?

The NPI number for Karen Nishida is 1962509653. It was assigned to this individual provider in the NPPES registry on September 17, 2006.

Where is Karen Nishida located?

Karen Nishida practices at 1290 Summer St Ste 5200, Stamford, CT 06905. The listed phone number is (203) 998-0848.

What is Karen Nishida's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Gynecologic Oncology, with taxonomy code 207VX0201X.

Is Karen Nishida enrolled in Medicare?

Yes. Karen Nishida 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 Nishida accept?

Health plans from Providence Health Plan list Karen Nishida 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.

When was this NPI record last updated?

The NPPES record for Karen Nishida was last updated on January 15, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.