KAREN A FENSTERMACHER NP NPI 1992730303

Nurse Practitioner in Neosho, MO

NPI 1992730303 Individual Female Years of Experience 28 Nurse Practitioner PECOS Enrolled Accepts Medicare Approved Payment MIPS Quality Score 96.9

NPI Profile for KAREN A FENSTERMACHER NP

Karen Fenstermacher is a provider established in Neosho, Missouri and her medical specialization is nurse practitioner with more than 28 years of experience. She graduated from University Of Missouri, Kansas City, School Of Medicine in 1995. The NPI number of Karen Fenstermacher is 1992730303 and was assigned on July 2006. The practitioner's primary taxonomy code is 363L00000X with license number 073207 (MO). The provider is registered as an individual and her NPI record was last updated 6 years ago.

A nurse practitioner (NP) like Karen A Fenstermacher Np is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Karen Fenstermacher is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Karen Fenstermacher is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data she has hospital affiliations with Mercy Hospital Joplin.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 96.9, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The typical physician office visit costs for Medicare beneficiaries in this area are: $21.01 for a new patient copayment and $24.31 for an established patient copayment.

NPI

1992730303

Provider Name KAREN A FENSTERMACHER NP
Provider Location Address2550 LUSK DR NEOSHO, MO 64850
Provider Mailing Address2550 LUSK DR NEOSHO, MO 64850
GenderFemale
NPI Entity TypeIndividual
Medical School NameUNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE
Graduation Year1995
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date07-12-2006
Last Update Date03-17-2016


Primary Taxonomy

Taxonomy Code363L00000X
ClassificationNurse Practitioner
TypePhysician Assistants & Advanced Practice Nursing Providers
License No.073207
License StateMO
Taxonomy Description(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Business Address

KAREN A FENSTERMACHER NP
2550 LUSK DR
NEOSHO, MO
ZIP 64850
Phone: (417) 451-2060
Fax: (417) 451-6214

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Mailing Address

KAREN A FENSTERMACHER NP
2550 LUSK DR
NEOSHO, MO
ZIP 64850
Phone: (417) 451-2060
Fax: (417) 451-6214



PECOS Enrollment and Medicare Participation

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID8224126412
PECOS Enrollment IDI20071126000158
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 64850 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99203
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$54.2 $167.17 $84.04
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$13.55 $41.79 $21.01
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$16.43 $136.28 $97.26
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.1 $34.07 $24.31

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

MIPS Measure Score Weight Score
Quality 40% 100
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
Promoting Interoperability (PI) 25% 79.9
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.
Improvement Activities 15% 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs.

The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.
Cost 20% N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
MIPS Final Score - 96.9
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Karen Fenstermacher is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
MERCY HOSPITAL JOPLIN100 MERCY WAY
JOPLIN, MO 64804
(417) 781-2727Acute Care Hospitals260001

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
S22559MEDICARE UPIN (02)
428635809MEDICAID (05)MO
MA5102005MEDICARE PIN (08)MO

NPI Validation Check Digit Calculation


The following table explains step by step the NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1992730303
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
29182143030
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 1 + 8 + 2 + 1 + 4 + 3 + 0 + 3 + 0 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 33

The NPI number 1992730303 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 14 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1366478554ST. JOHN'S REGIONAL MEDICAL CENTER
Organization
Clinic/Center (Rural Health)2550 LUSK DR
NEOSHO, MO 64850
(417) 451-2060
1417050204DR. STEVEN K YOUNGER M.D.
Individual
Family Medicine2550 LUSK DR
NEOSHO, MO 64850
(417) 451-2060
1134243819MS. SUSAN JENETTE PUMPHREY RN, FNP-C
Individual
Nurse Practitioner (Family)2550 LUSK DR
NEOSHO, MO 64850
(417) 451-2060
1003005471HEART AND VASCULAR CARE, P.C.
Organization
Thoracic Surgery (Cardiothoracic Vascular Surgery)2550 LUSK DR
NEOSHO, MO 64850
(417) 782-2190
1336175942 LEWIS DAVID SHULER DO
Individual
Internal Medicine (Cardiovascular Disease)2550 LUSK DR
NEOSHO, MO 64850
(417) 451-2227
1922329382DR. AMANDA KAY LEWTON M.D.
Individual
Family Medicine2550 LUSK DR
NEOSHO, MO 64850
(417) 451-2060
1053352773 WALTER HARGETT MD
Individual
Family Medicine2550 LUSK DR
NEOSHO, MO 64850
(417) 451-2060
1184178667 JULIE E HINDS APRN-CNP
Individual
Nurse Practitioner (Family)2550 LUSK DR
NEOSHO, MO 64850
(417) 451-2060
1356755177MRS. ASHDEN NICHOLE SMITH FNP-C
Individual
Nurse Practitioner (Family)2550 LUSK DR
NEOSHO, MO 64850
(417) 451-2060
1619926250 BRIAN L SMITH DO
Individual
Family Medicine2550 LUSK DR
NEOSHO, MO 64850
(417) 451-2060
1205162732MERCY HOSPITAL JOPLIN
Organization
Clinic/Center (Rural Health)2550 LUSK DR
NEOSHO, MO 64850
(417) 451-2060
1295344109 KELSEY LYNN HOBBS DNP, APRN
Individual
Nurse Practitioner (Family)2550 LUSK DR
NEOSHO, MO 64850
(174) 512-0604
1205400033 PRESTON L MYERS NP-C
Individual
Nurse Practitioner (Family)2550 LUSK DR
NEOSHO, MO 64850
(174) 512-0604
1053072330 SARAH MILLER DNP, APRN, FNP-C
Individual
Nurse Practitioner (Family)2550 LUSK DR
NEOSHO, MO 64850
(417) 451-2060

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Karen A Fenstermacher Np is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.