KAREN K SHAMBAUGH OTR/L
NPI 1295002111
Occupational Therapist in Cumberland, MD
NPI Status: Active since November 21, 2011
Contact Information
217 GLENN ST STE 301
CUMBERLAND, MD
ZIP 21502
Phone: (301) 777-2170
Fax: (301) 777-2173
- Individual
- Female
- Years of Experience 15
- Occupational Therapist
- Accepts Insurance
- Accepts Medicare Approved Payment
About KAREN SHAMBAUGH
This page provides the complete NPI Profile along with additional information for Karen Shambaugh, a provider established in Cumberland, Maryland with a medical specialization in Occupational Therapist and more than 15 years of experience. She graduated from West Virginia University School Of Medicine in 2011. The healthcare provider is registered in the NPI registry with number 1295002111 assigned on November 2011. The practitioner's primary taxonomy code is 225X00000X with license number 06809 (MD). The provider is registered as an individual and her NPI record was last updated 14 years ago.
- NPI
- 1295002111
- Provider Name
- KAREN K SHAMBAUGH OTR/L
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 217 GLENN ST STE 301 CUMBERLAND, MD 21502
- Location Phone
- (301) 777-2170
- Location Fax
- (301) 777-2173
- Mailing Address
- 217 GLENN ST STE 301 CUMBERLAND, MD 21502
- Mailing Phone
- (301) 722-2170
- Mailing Fax
- (301) 777-2173
- Medical School Name
- WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 2011
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 11-21-2011
- Last Update Date
- 11-21-2011
- Code Navigator
Location Map
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
Occupational Therapist
- Taxonomy Code
- 225X00000X
- Type
- Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- License No.
- 06809
- License State
- MD
- Taxonomy Description
- An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze First 7500 $25 Generic Drugs - HMO
- Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Gold 1500 $15 Generic Drugs - HMO
- Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
- Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services - HMO
- Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services - HMO
- Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Low Deductible Silver 4500 $3 Generic Drugs - HMO
- Low Deductible Silver 4500 $3 Generic Drugs Adult Vision & Fitness - HMO
- Low Premium Silver 6000 $3 Generic Drugs - HMO
- Low Premium Silver 6000 $3 Generic Drugs Adult Vision & Fitness - HMO
- Platinum Zero $5 Generic Drugs - HMO
- Platinum Zero $5 Generic Drugs Adult Vision & Fitness - HMO
- Silver 5000 $20 Generic Drugs - HMO
- Silver 5000 $20 Generic Drugs Adult Vision & Fitness - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Karen Shambaugh is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
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.
PECOS PAC ID: 9931361417
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: I20160404000820
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? 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.
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Application of blood vessel compression device
Application of ultrasound, each 15 minutes
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care
Evaluation for occupational therapy, typically 45 minutes
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes
Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes
Therapy procedure using functional activities
Therapy procedure using manual technique, each 15 minutes
A blood vessel compression device is applied to control bleeding and promote clotting after a procedure. This device applies pressure to your blood vessels, reducing the chance of excessive bleeding. It's a safe, standard part of many medical procedures.
This service was performed 128 times for 19 patientsUltrasound is a medical procedure that uses high-frequency sound waves to capture live images from inside your body. It's a painless process typically lasting 15 minutes per session. This method aids in diagnosing conditions and monitoring health without any radiation exposure.
This service was performed 151 times for 42 patientsElectrical stimulation is a therapy method where mild electrical pulses are used to treat pain or stimulate muscles in certain areas. It's not for wound care but is part of a broader therapy plan. It's safe, non-invasive, and can help improve overall health.
This service was performed 173 times for 46 patientsAn evaluation for occupational therapy is a comprehensive assessment of your physical and mental abilities. In this 45-minute session, the therapist observes your skills and challenges in performing daily tasks. The goal is to identify ways to improve your independence and quality of life.
This service was performed 37 times for 36 patientsThis therapy helps retrain your brain, nerves, and muscles to work together. Through targeted exercises, your body learns to regain lost functions or improve current abilities. Each session lasts 15 minutes.
This service was performed 73 times for 27 patientsThis therapy involves exercises to boost strength, endurance, flexibility, and range of motion. Each session lasts 15 minutes. The goal is to improve physical function and overall health. It's a safe, beneficial method for enhancing well-being and fitness.
This service was performed 470 times for 61 patientsA therapy procedure using functional activities encourages you to use your own body movements in day-to-day tasks to aid recovery. It aims to improve your mobility, strength, and overall health by incorporating therapeutic exercises into your routine.
This service was performed 728 times for 82 patientsThis therapy involves using hands-on techniques to help improve your body's movement and function. These techniques may include stretching, resistance exercises, or gentle pressure. Each session lasts 15 minutes and aims to relieve pain, promote healing, and improve your overall health.
This service was performed 1,295 times for 89 patientsReviews for KAREN K SHAMBAUGH OTR/L
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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 | 2 | 9 | 5 | 0 | 0 | 2 | 1 | 1 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 18 | 5 | 0 | 0 | 4 | 1 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 8 + 5 + 0 + 0 + 4 + 1 + 2 + 24 = 49 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 49 = 1 | 1 | ||||||||
The NPI number 1295002111 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1295002111, enumerated in the NPI registry as an "individual" on November 21, 2011
The provider is located at 217 Glenn St Ste 301 Cumberland, Md 21502 and the phone number is (301) 777-2170
The provider's speciality is Occupational Therapist with taxonomy code 225X00000X
The provider has more than 15 years of experience. She graduated from West Virginia University School Of Medicine in 2011.
The provider might be accepting Accepts: CareSource. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The most common procedures or services performed by this practitioner are: Application of blood vessel compression device, Application of ultrasound, each 15 minutes, Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care, Evaluation for occupational therapy, typically 45 minutes, Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes, Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes, Therapy procedure using functional activities and Therapy procedure using manual technique, each 15 minutes.
This NPI record was last updated on November 21, 2011. 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].
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