DR. KAREN T LEE M.D
NPI 1629124045
Internal Medicine in Elmhurst, NY
NPI Status: Active since January 26, 2007
Contact Information
8324 CORNISH AVE
ELMHURST, NY
ZIP 11373
Phone: (718) 424-0770
Fax: (718) 424-2590
- Individual
- Female
- Years of Experience 24
- Internal Medicine
- PECOS Enrolled
- May Accept Medicare Approved Payment
- Medicare Quality Reporting
About KAREN LEE
Karen Lee is an internist established in Elmhurst, New York and her medical specialization is Internal Medicine with more than 24 years of experience. The healthcare provider is registered in the NPI registry with number 1629124045 assigned on January 2007. The practitioner's primary taxonomy code is 207R00000X with license number 242926 (NY). The provider is registered as an individual and her NPI record was last updated 5 years ago.
- NPI
- 1629124045
- Provider Name
- DR. KAREN T LEE M.D
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 8324 CORNISH AVE ELMHURST, NY 11373
- Location Phone
- (718) 424-0770
- Location Fax
- (718) 424-2590
- Mailing Address
- 8324 CORNISH AVE ELMHURST, NY 11373
- Mailing Phone
- (718) 424-0770
- Mailing Fax
- (718) 424-2590
- Medical School Name
- OTHER
- Graduation Year
- 2000
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 01-26-2007
- Last Update Date
- 05-09-2019
- Code Navigator
An internist like Karen Lee is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Karen Lee is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.
The provider participated in CMS Quality Payment Program and the following quality measures were reported: colorectal cancer screening, preventive care and screening: body mass index (bmi) screening and follow-up plan and preventive care and screening: screening for depression and follow-up plan. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 242926
- License State
- NY
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Medicare
Medicaid
Blue Cross Blue Shield
Cigna
Oxford Health Plans
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 02903226 | MEDICAID (05) | NY | |
| 071128000030 | OTHER (01) | NY | FIDELIS |
| 3680S1 | OTHER (01) | NY | EMPIRE BC/BS |
| 002800132002 | OTHER (01) | NY | UHC COMMUNITY PLAN |
| 193029 | OTHER (01) | NY | ELDER PLAN |
| 6C3272 | OTHER (01) | NY | HEALTHNET |
| 1000049664 | OTHER (01) | NY | AFFINITY |
| 100280013201 | OTHER (01) | NY | AMERICHOICE |
| 6533075 | OTHER (01) | NY | CIGNA |
| P3871911 | OTHER (01) | NY | OXFORD |
| 1011674P | OTHER (01) | NY | EMBLEM HEALTH |
| 242926-A39 | OTHER (01) | NY | HEALTHFIRST |
| 24292601 | OTHER (01) | NY | NEIGHBORHOOD |
| 398900P | OTHER (01) | NY | HIP |
| 537920101 | OTHER (01) | NY | HEALTHPLUS |
PECOS Enrollment and Medicare Participation Status
Karen Lee 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.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 5193892990
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20080919000527
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Maybe
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 to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
Other DME (D1E)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
2 DME suppliers used 19 Medicare Claims 33 Services Paid
Other DME (D1E)
Lancets, per box of 100 (HCPCS:A4259)
1 DME suppliers used 12 Medicare Claims 12 Services Paid
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 11373 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $163.65
- Minimum New Patient Price $71.8
- Maximum New Patient Price $216
- Average New Patient Copayment $40.91
- Minimum New Patient Copayment $17.95
- Maximum New Patient Copayment $54
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $125.27
- Minimum Established Patient Price $22.16
- Maximum Established Patient Price $174.92
- Average Established Patient Copayment $31.31
- Minimum Established Patient Copayment $5.54
- Maximum Established Patient Copayment $43.73
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The following quality measures meet Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Colorectal Cancer Screening | 86% | 35 |
| Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 54% | 69 |
| 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 twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Preventive Care and Screening: Screening for Depression and Follow-Up Plan | 100% | 51 |
| Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen | ||
Clinician Services
The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.
- 94
Urinalysis, manual test (HCPCS:81002)
- 82
Insertion of needle into vein for collection of blood sample (HCPCS:36415)
- 61
Pure tone air conduction threshold hearing assessment (HCPCS:92552)
- 54
Administration of influenza virus vaccine (HCPCS:G0008)
- 49
Vaccine for influenza for injection into muscle (HCPCS:90662)
- 29
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
- 21
Administration of pneumococcal vaccine (HCPCS:G0009)
Reviews for DR. KAREN T LEE M.D
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI Validation Check Digit Calculation
The following table explains the step by step 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. | |||||||||
| 1 | 6 | 2 | 9 | 1 | 2 | 4 | 0 | 4 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 4 | 9 | 2 | 2 | 8 | 0 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 4 + 9 + 2 + 2 + 8 + 0 + 8 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1629124045 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1265793517 | ADVANCED QUALITY MEDICAL PC Organization | Internal Medicine | 8324 CORNISH AVE ELMHURST, NY 11373 (718) 424-0770 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1629124045, enumerated in the NPI registry as an "individual" on January 26, 2007
The provider is located at 8324 Cornish Ave Elmhurst, Ny 11373 and the phone number is (718) 424-0770
The provider's speciality is Internal Medicine with taxonomy code 207R00000X
The provider has more than 24 years of experience.
The provider might be accepting Accepts: Medicare, Medicaid, Blue Cross Blue Shield, Cigna. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of May 10, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.
Medicare beneficiaries should expect a typical cost of $163.65 with an average copayment of $40.91 for new patient appointments. Established patients should expect a typical charge of $125.27 and an average copayment of 31.31. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Urinalysis, manual test, Insertion of needle into vein for collection of blood sample, Pure tone air conduction threshold hearing assessment, Administration of influenza virus vaccine, Vaccine for influenza for injection into muscle, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit and Administration of pneumococcal vaccine.
This NPI record was last updated on January 26, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.