KAREN S ANDERSON CNM, APNP
NPI 1306216940
Advanced Practice Midwife in Madison, WI
Quality Rating: 96.44 out of 100 score
NPI Status: Active since September 25, 2015
- Individual
- Female
- Advanced Practice Midwife
- Accepts Insurance
- PECOS Enrolled
About KAREN ANDERSON
This page provides the complete NPI Profile along with additional information for Karen Anderson, a provider established in Madison, Wisconsin with a medical specialization in Advanced Practice Midwife. The healthcare provider is registered in the NPI registry with number 1306216940 assigned on September 2015. The practitioner's primary taxonomy code is 367A00000X with license number 148910-32 (WI). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1306216940
- Provider Name
- KAREN S ANDERSON CNM, APNP
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 2202 S PARK ST MADISON, WI 53713
- Location Phone
- (608) 443-5480
- Mailing Address
- 7974 UW HEALTH CT MIDDLETON, WI 53562
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-25-2015
- Last Update Date
- 12-18-2024
- Code Navigator
Location Map
Secondary Locations
- 2402 Winnebago St
Madison, WI 53704
(608) 242-6840
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
Advanced Practice Midwife
- Taxonomy Code
- 367A00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 148910-32
- License State
- WI
- Taxonomy Description
- Advanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care. Midwives also provide primary care for individuals from adolescence throughout the lifespan as well as care for the healthy newborn during the first 28 days of life. Midwives provide initial and ongoing comprehensive assessment, diagnosis, and treatment. Midwifery care includes health promotion, disease prevention, risk assessment and management, and individualized wellness education and counseling. Source: American College of Nurse-Midwives, www.midwife.org Additional Resources: See the American College of Nurse-Midwives, www.midwife.org, for more information on Certified Nurse-Midwives, Certified Midwives, the American Midwifery Certification Board (AMCB), and licensure.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Priority/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Priority/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Heart Healthy Bronze Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
- Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
- Anthem Heart Healthy Bronze Priority/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
- Anthem Silver Pathway/Lean 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Pathway/Lean 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Bronze First 7500 $25 Generic Drugs - HMO
- Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
- Core Gold 1500 $10 Generic Drugs - HMO
- Core Gold 1500 $10 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
- HDHP Preventive Silver 5500 $0 Select Drugs - 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
- QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE $7250 HSA - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $9200 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD $2500 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $2500 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE $500 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE (DENTAL & VISION) $500 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER $0 DED FLAT RX COPAYS - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER $7000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) $0 DED FLAT RX COPAYS - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) $7000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER STANDARD EASY PRICING - HMO
- QUARTZ ONE ACHIEVE BRONZE (DENTAL & VISION) $9100 DED FLAT RX COPAYS - IL - HMO
- QUARTZ ONE ACHIEVE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - IL - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Value HSA (No Referrals) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Standard (No Referrals) - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Silver Standard (No Referrals) - HMO
- UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Silver Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Karen Anderson 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 and Durable Medical Equipment (DME).
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
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): No
Eligible to Order or Refer Power Mobility Devices: No
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 53713 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $82.92
- Minimum New Patient Price $53.9
- Maximum New Patient Price $163.24
- Average New Patient Copayment $20.73
- Minimum New Patient Copayment $13.47
- Maximum New Patient Copayment $40.81
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $67.37
- Minimum Established Patient Price $17.4
- Maximum Established Patient Price $133.76
- Average Established Patient Copayment $16.84
- Minimum Established Patient Copayment $4.35
- Maximum Established Patient Copayment $33.44
* 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.
Overall MIPS Quality Performance
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 96.44, 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 Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS 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.
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Final Score: 96.44 out of 100
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.
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Quality Score: 80.64
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.
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Promoting Interoperability Score: 100
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 Score: 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 activities measure category compromises 15% providers final MPIS scores.
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 Score: 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. -
Cost Score: 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.
Reviews for KAREN S ANDERSON CNM, APNP
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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 | 3 | 0 | 6 | 2 | 1 | 6 | 9 | 4 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 0 | 6 | 4 | 1 | 12 | 9 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 0 + 6 + 4 + 1 + 1 + 2 + 9 + 8 + 24 = 60 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1306216940 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1922105980 | ANN S PERROTE PA Individual | Physician Assistant (Medical) | 2202 S PARK ST MADISON, WI 53713 (608) 443-5480 |
| 1710078290 | CYNTHIA M LOVELL NP Individual | Registered Nurse (Pediatrics) | 2202 S PARK ST MADISON, WI 53713 (608) 443-5480 |
| 1063635605 | MS. ELIZABETH ANN BRAUN NP Individual | Nurse Practitioner | 2202 S PARK ST SUITE 400 MADISON, WI 53713 (608) 261-9256 |
| 1225231236 | EVA M VIVIAN REGISTERED DIETITIAN Individual | Nutritionist (Nutrition, Education) | 2202 S PARK ST MADISON, WI 53713 (608) 443-5480 |
| 1568474112 | NEFTALI SERRANO PSYD Individual | Psychologist (Clinical) | 2202 S PARK ST MADISON, WI 53713 (608) 443-5480 |
| 1366540858 | LINDA D OAKLEY NP Individual | Nurse Practitioner (Psychiatric/Mental Health) | 2202 S PARK ST MADISON, WI 53713 (608) 443-5480 |
| 1932206059 | SARAH M ROWE NP Individual | Nurse Practitioner (Family) | 2202 S PARK ST MADISON, WI 53713 (608) 443-5480 |
| 1568675858 | ACCESS COMMUNITY HEALTH CENTERS, INC. Organization | Clinic/Center (Federally Qualified Health Center (FQHC)) | 2202 S PARK ST MADISON, WI 53713 (608) 443-5500 |
| 1457370892 | SUSAN SWENSON RD Individual | Nutritionist | 2202 S PARK ST MADISON, WI 53713 (608) 443-5480 |
| 1417461666 | LABORATORY CORPORATION OF AMERICA Organization | Clinical Medical Laboratory | 2202 S PARK ST MADISON, WI 53713 (608) 443-5510 |
| 1982976296 | DR. IXCHEL ALVAREZ D.O., MPH Individual | Family Medicine | 2202 S PARK ST MADISON, WI 53713 (608) 443-5480 |
| 1578043493 | KATRINA JOHNSON PSYD Individual | Psychologist | 2202 S PARK ST MADISON, WI 53713 (608) 443-5480 |
| 1346790334 | ALEXANDER SMITH PSYD Individual | Psychologist | 2202 S PARK ST MADISON, WI 53713 (608) 443-5480 |
| 1659644326 | MARY KATHLEEN COLEMAN MSN, FNP-BC Individual | Nurse Practitioner (Family) | 2202 S PARK ST MADISON, WI 53713 (608) 443-5480 |
| 1154828226 | MISTY M ROMERO RIVERA APNP Individual | Nurse Practitioner (Family) | 2202 S PARK ST MADISON, WI 53713 (608) 443-5480 |
| 1093036790 | ELIZABETH ROSE DOHERTY MD Individual | Internal Medicine | 2202 S PARK ST MADISON, WI 53713 (608) 443-5480 |
| 1801209010 | MRS. MARTHA V SAUCEDO LCSW Individual | Social Worker (Clinical) | 2202 S PARK ST MADISON, WI 53713 (608) 443-5480 |
| 1740635572 | DR. JONATHAN JAMES FRICKE MD, MPH Individual | Family Medicine | 2202 S PARK ST MADISON, WI 53713 (608) 443-5480 |
| 1902254659 | JAMIE COLVIN Individual | Social Worker (Clinical) | 2202 S PARK ST MADISON, WI 53713 (608) 443-5480 |
| 1962500827 | DR. KENNETH R LOVING MD Individual | Family Medicine | 2202 S PARK ST MADISON, WI 53713 (608) 443-5480 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1306216940, enumerated in the NPI registry as an "individual" on September 25, 2015
The provider is located at 2202 S Park St Madison, Wi 53713 and the phone number is (608) 443-5480
The provider's speciality is Advanced Practice Midwife with taxonomy code 367A00000X
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, CareSource,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 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 and Durable Medical Equipment (DME).
The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.
Medicare beneficiaries should expect a typical cost of $82.92 with an average copayment of $20.73 for new patient appointments. Established patients should expect a typical charge of $67.37 and an average copayment of 16.84. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on September 25, 2015. 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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