DR. KARLENE VANESSA ROSS M.D.
NPI 1518187822
Family Medicine in Waldorf, MD
NPI Status: Active since April 27, 2007
Contact Information
3460 OLD WASHINGTON RD
SUITE #103
WALDORF, MD
ZIP 20602
Phone: (301) 638-0001
Fax: (301) 638-5454
- Individual
- Female
- Years of Experience 29
- Family Medicine
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About KARLENE ROSS
This page provides the complete NPI Profile along with additional information for Karlene Ross, a primary care provider established in Waldorf, Maryland with a medical specialization in Family Medicine and more than 29 years of experience. She graduated from State University Of Ny Upstate Medical University in 1997. The healthcare provider is registered in the NPI registry with number 1518187822 assigned on April 2007. The practitioner's primary taxonomy code is 207Q00000X with license number D0066434 (MD). The provider is registered as an individual and her NPI record was last updated 17 years ago.
- NPI
- 1518187822
- Provider Name
- DR. KARLENE VANESSA ROSS M.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 3460 OLD WASHINGTON RD SUITE #103 WALDORF, MD 20602
- Location Phone
- (301) 638-0001
- Location Fax
- (301) 638-5454
- Mailing Address
- 3460 OLD WASHINGTON RD SUITE #103 WALDORF, MD 20602
- Mailing Phone
- (301) 638-0001
- Mailing Fax
- (301) 638-5454
- Medical School Name
- STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
- Graduation Year
- 1997
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-27-2007
- Last Update Date
- 03-11-2008
- Code Navigator
A primary care provider (PCP) like Karlene Ross sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
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
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- D0066434
- License State
- MD
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | 214300 (NY) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*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 |
|---|---|---|---|
| H49353 | MEDICARE UPIN (02) | NY |
Medicare Participation & PECOS Enrollment Status
Karlene Ross 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.
Karlene Ross 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: 3375603244
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: I20081121000402
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.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
DME-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
10 DME suppliers used 32 Medicare Claims 65 Services Paid
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.
Adm sarscov2 50mcg/0.25mlbst
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Fee covid-19 vac 14 res
Insertion of needle into vein for collection of blood sample
Management using the results of remote vital sign monitoring per calendar month, first 20 minutes
New patient office or other outpatient visit, 30-44 minutes
New patient office or other outpatient visit, 45-59 minutes
Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
This procedure involves administering a dose of a SARS-CoV-2 vaccine. The specific dosage is 50 micrograms in a 0.25 milliliter booster shot. This vaccine helps your body build immunity against the COVID-19 virus. It's a key part of global efforts to control the pandemic.
This service was performed 28 times for 28 patientsAn annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
This service was performed 94 times for 94 patientsThis 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.
This service was performed 82 times for 61 patientsThis 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.
This service was performed 135 times for 84 patientsThe "Fee covid-19 vac 14 res" refers to a charge for a specific service related to the COVID-19 vaccine. This could be for administering the vaccine or related care. It's crucial to get vaccinated to protect against the virus. The fee ensures quality service.
This service was performed 29 times for 29 patientsThis procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
This service was performed 164 times for 103 patientsThis service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.
This service was performed 23 times for 11 patientsThis service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
This service was performed 28 times for 28 patientsThis 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.
This service was performed 12 times for 12 patientsRemote monitoring of physiologic parameters involves using special equipment to track vital signs like heart rate and blood pressure from a distance. The initial set-up includes installing the device and teaching the patient how to use it correctly for accurate readings.
This service was performed 16 times for 16 patientsAn electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
This service was performed 58 times for 57 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $22.43 for a new patient copayment and $25.52 for an established patient copayment.
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 20602 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $89.75
- Minimum New Patient Price $57.99
- Maximum New Patient Price $175.57
- Average New Patient Copayment $22.43
- Minimum New Patient Copayment $14.49
- Maximum New Patient Copayment $43.89
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $102.11
- Minimum Established Patient Price $18.66
- Maximum Established Patient Price $143.02
- Average Established Patient Copayment $25.52
- Minimum Established Patient Copayment $4.66
- Maximum Established Patient Copayment $35.75
* 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 provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. 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 |
|---|---|---|
| e-Prescribing | 98% | 3301 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Health Information Exchange | 37% | 707 |
| The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral. | ||
| Immunization Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data. | ||
| Medication Reconciliation | 99% | 404 |
| 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. | ||
| Patient-Specific Education | 78% | 1098 |
| 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. | ||
| Provide Patient Access | 98% | 1058 |
| 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 certain information. | ||
| Secure Messaging | 68% | 1058 |
| 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 message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
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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 | 5 | 1 | 8 | 1 | 8 | 7 | 8 | 2 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 2 | 8 | 2 | 8 | 14 | 8 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 2 + 8 + 2 + 8 + 1 + 4 + 8 + 4 + 24 = 68 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 68 = 2 | 2 | ||||||||
The NPI number 1518187822 is valid because the calculated check digit 2 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 |
|---|---|---|---|
| 1356375513 | OMAR F. AHMAD, M.D., P.C. Organization | Ophthalmology | 3460 OLD WASHINGTON RD SUITE 302 WALDORF, MD 20602 (301) 893-3484 |
| 1528089422 | DR. FELIX JOSEPH AGUTO III D.D.S. Individual | Dentist (Pediatric Dentistry) | 3460 OLD WASHINGTON RD SUITE 200 WALDORF, MD 20602 (301) 645-6556 |
| 1710109327 | HEARING PROFESSIONALS OF WALDORF, INC Organization | Audiologist | 3460 OLD WASHINGTON RD STE 203 WALDORF, MD 20602 (301) 932-4237 |
| 1356598379 | WALDORF PRIMARY CARE LLC Organization | Clinic/Center (Primary Care) | 3460 OLD WASHINGTON RD SUITE 103 WALDORF, MD 20602 (301) 638-0001 |
| 1306099833 | CORYSE BRATHWAITE-DEAN, MD, PC Organization | Clinic/Center (Medical Specialty) | 3460 OLD WASHINGTON RD SUITE 101 WALDORF, MD 20602 (301) 705-6500 |
| 1093947525 | FELIX J AGUTO, DDS, PA Organization | Dentist | 3460 OLD WASHINGTON RD SUITE #200 WALDORF, MD 20602 (301) 645-6556 |
| 1720387517 | JOANNA KEMPLER DDS Individual | Dentist (Prosthodontics) | 3460 OLD WASHINGTON RD SUITE 102 WALDORF, MD 20602 (410) 591-5516 |
| 1932489523 | DENTAL & PROSTHODONTICS REHAB INC. Organization | Clinic/Center (Dental) | 3460 OLD WASHINGTON RD SUITE 102 WALDORF, MD 20602 (301) 638-1420 |
| 1831386630 | SOUTHERN MARYLAND PRIMARY CARE, LLC Organization | Family Medicine | 3460 OLD WASHINGTON RD SUITE 203A WALDORF, MD 20602 (301) 638-9670 |
| 1750314399 | ARUORIWO M OBOH-WEILKE MD Individual | Ophthalmology | 3460 OLD WASHINGTON RD SUITE 302 WALDORF, MD 20602 (301) 292-3535 |
| 1851720239 | YUEN LING WONG KONG P.A-C Individual | Physician Assistant | 3460 OLD WASHINGTON RD SUITE 203A WALDORF, MD 20602 (301) 638-0602 |
| 1851709760 | DOCTORS OF AUDIOLOGY, LLC Organization | Audiologist | 3460 OLD WASHINGTON RD 203 WALDORF, MD 20602 (301) 932-4237 |
| 1790169308 | DR. MANISHA K CHAWLA Individual | Dentist | 3460 OLD WASHINGTON RD SUITE 102 WALDORF, MD 20602 (301) 638-1420 |
| 1437458809 | CENTER FOR PAIN MANAGEMENT ,LLC Organization | Pain Medicine (Interventional Pain Medicine) | 3460 OLD WASHINGTON RD SUITE 300 WALDORF, MD 20602 (301) 645-1523 |
| 1629147632 | MS. LILLIE MARQUE WALKER PA-C Individual | Physician Assistant (Medical) | 3460 OLD WASHINGTON RD SUITE 300 WALDORF, MD 20602 (301) 645-1523 |
| 1962793810 | MS. COLLEEN INGRID RITA NANTON PA Individual | Physician Assistant (Medical) | 3460 OLD WASHINGTON RD SUITE 300 WALDORF, MD 20602 (301) 645-1523 |
| 1508200163 | PHARMVUE CORPORATION Organization | Pharmacy | 3460 OLD WASHINGTON RD SUITE 103 WALDORF, MD 20602 (301) 645-2400 |
| 1588979538 | DR. KARIM ELRAFEI D.D.S Individual | Dentist | 3460 OLD WASHINGTON RD WALDORF, MD 20602 (301) 645-6556 |
| 1699769554 | COLLINS P SEIN MD Individual | Internal Medicine | 3460 OLD WASHINGTON RD SUITE 203A WALDORF, MD 20602 (301) 934-8811 |
| 1700868205 | DR. RONALD IRA ACKERMAN D.D.S. Individual | Dentist (Orthodontics and Dentofacial Orthopedics) | 3460 OLD WASHINGTON RD SUITE 301 WALDORF, MD 20602 (301) 645-8222 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1518187822, enumerated in the NPI registry as an "individual" on April 27, 2007
The provider is located at 3460 Old Washington Rd Suite #103 Waldorf, Md 20602 and the phone number is (301) 638-0001
The provider's speciality is Family Medicine with taxonomy code 207Q00000X
The provider has more than 29 years of experience. She graduated from State University Of Ny Upstate Medical University in 1997.
The provider might be accepting Accepts: Medicare and Medicaid. 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, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $89.75 with an average copayment of $22.43 for new patient appointments. Established patients should expect a typical charge of $102.11 and an average copayment of 25.52. 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: Adm sarscov2 50mcg/0.25mlbst, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, Fee covid-19 vac 14 res, Insertion of needle into vein for collection of blood sample, Management using the results of remote vital sign monitoring per calendar month, first 20 minutes, New patient office or other outpatient visit, 30-44 minutes, New patient office or other outpatient visit, 45-59 minutes, Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment and Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report.
This NPI record was last updated on April 27, 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].
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