KAREN A THOMAS MD
NPI 1629055983
Family Medicine in Greenville, NC
NPI Status: Active since December 28, 2005
Contact Information
1850 W ARLINGTON BLVD
GREENVILLE, NC
ZIP 27834
Phone: (252) 413-6202
Fax: (252) 758-8333
- Individual
- Female
- Family Medicine
- PECOS Enrolled
- Medicare Quality Reporting
About KAREN THOMAS
This page provides the complete NPI Profile along with additional information for Karen Thomas, a primary care provider established in Greenville, North Carolina with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1629055983 assigned on December 2005. The practitioner's primary taxonomy code is 207Q00000X with license number 33756 (NC). The provider is registered as an individual and her NPI record was last updated 11 years ago.
- NPI
- 1629055983
- Provider Name
- KAREN A THOMAS MD
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1850 W ARLINGTON BLVD GREENVILLE, NC 27834
- Location Phone
- (252) 413-6202
- Location Fax
- (252) 758-8333
- Mailing Address
- 1850 W ARLINGTON BLVD GREENVILLE, NC 27834
- Mailing Phone
- (252) 413-6202
- Mailing Fax
- (252) 758-8333
- Is Sole Proprietor?
- No
- Enumeration Date
- 12-28-2005
- Last Update Date
- 10-09-2014
- Code Navigator
A primary care provider (PCP) like Karen Thomas 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.
- 33756
- License State
- NC
- 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.
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 |
|---|---|---|---|
| 2011406D | OTHER (01) | NC | MEDICARE |
| 891336F | MEDICAID (05) | NC | |
| D79065 | MEDICARE UPIN (02) |
Medicare Participation & PECOS Enrollment Status
Karen Thomas 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
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
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 27834 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $83.9
- Minimum New Patient Price $54.12
- Maximum New Patient Price $165.09
- Average New Patient Copayment $20.97
- Minimum New Patient Copayment $13.53
- Maximum New Patient Copayment $41.27
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $95.94
- Minimum Established Patient Price $17.21
- Maximum Established Patient Price $134.61
- Average Established Patient Copayment $23.98
- Minimum Established Patient Copayment $4.3
- Maximum Established Patient Copayment $33.65
* 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 |
|---|---|---|
| Breast Cancer Screening | 61% | 499 |
| Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer | ||
| Colorectal Cancer Screening | 25% | 650 |
| Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer | ||
| Diabetes: Eye Exam | 2% | 177 |
| Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period | ||
| Diabetes: Foot Exam | 17% | 177 |
| The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year | ||
| Diabetes: Medical Attention for Nephropathy | 77% | 177 |
| The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period | ||
| Documentation of Current Medications in the Medical Record | 99% | 2586 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Electronic submission of Patient Centered Medical Home accreditation | Yes | N/A |
| I attest that I am a Patient Centered Medical Home (PCMH) or Comparable Specialty Practice that has achieved certification from a national program, regional or state program, private payer, or other body that administers patient-centered medical home accreditation and should receive full credit for the Improvement Activities performance category. | ||
| e-Prescribing | 89% | 6880 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Falls: Screening for Future Fall Risk | 2% | 461 |
| Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period | ||
| Health Information Exchange | 80% | 35 |
| 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 | 51% | 386 |
| 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 | 40% | 1375 |
| 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. | ||
| Pneumococcal Vaccination Status for Older Adults | 86% | 461 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Practice Improvements for Bilateral Exchange of Patient Information | Yes | N/A |
| Ensure that there is bilateral exchange of necessary patient information to guide patient care, such as Open Notes, that could include one or more of the following: • Participate in a Health Information Exchange if available; and/or • Use structured referral notes. | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 57% | 977 |
| 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: Influenza Immunization | 40% | 812 |
| Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization | ||
| Preventive Care and Screening: Screening for Depression and Follow-Up Plan | 19% | 831 |
| 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 | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 45% | 49 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user | ||
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
| Provide Patient Access | 95% | 1375 |
| 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. | ||
| Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms. | Yes | N/A |
| Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms. | ||
| Secure Messaging | 26% | 1375 |
| 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. | ||
| Specialized Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI. | ||
| Statin Therapy for the Prevention and Treatment of Cardiovascular Disease | 66% | 234 |
| Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period: - Adults aged >= 21 years who were previously diagnosed with or currently have an active diagnosis of clinical atherosclerotic cardiovascular disease (ASCVD); OR - Adults aged >=21 years who have ever had a fasting or direct low-density lipoprotein cholesterol (LDL-C) level >= 190 mg/dL; OR - Adults aged 40-75 years with a diagnosis of diabetes with a fasting or direct LDL-C level of 70-189 mg/dL | ||
| Use of High-Risk Medications in the Elderly | 15% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 461 |
| Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication | ||
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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 | 6 | 2 | 9 | 0 | 5 | 5 | 9 | 8 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 4 | 9 | 0 | 5 | 10 | 9 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 4 + 9 + 0 + 5 + 1 + 0 + 9 + 1 + 6 + 24 = 67 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 67 = 3 | 3 | ||||||||
The NPI number 1629055983 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 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1053314062 | DR. RICHARD MANN MD Individual | Internal Medicine (Pulmonary Disease) | 1850 W ARLINGTON BLVD GREENVILLE, NC 27834 (252) 752-6101 |
| 1811990062 | DR. THOMAS J CHAPLINSKI MD Individual | Specialist | 1850 W ARLINGTON BLVD GREENVILLE, NC 27834 (252) 752-6101 |
| 1417951260 | HOWARD ROBERTSON MD Individual | Colon & Rectal Surgery | 1850 W ARLINGTON BLVD GREENVILLE, NC 27834 (252) 752-6101 |
| 1598761967 | PHYSICIANS EAST, P.A. Organization | Clinic/Center (Multi-Specialty) | 1850 W ARLINGTON BLVD GREENVILLE, NC 27834 (252) 752-6101 |
| 1306804414 | VICKI MCLAWHORN FNP Individual | Nurse Practitioner (Family) | 1850 W ARLINGTON BLVD GREENVILLE, NC 27834 (252) 752-6101 |
| 1922066281 | SUZANNE WOOLARD FNP Individual | Nurse Practitioner (Family) | 1850 W ARLINGTON BLVD GREENVILLE, NC 27834 (252) 752-6101 |
| 1336107093 | JENNIFER ELIAS LDN Individual | Dietitian, Registered | 1850 W ARLINGTON BLVD GREENVILLE, NC 27834 (252) 752-6101 |
| 1184673378 | QUADRANGLE ENDOSCOPY CENTER, INC. Organization | Clinic/Center (Endoscopy) | 1850 W ARLINGTON BLVD GREENVILLE, NC 27834 (252) 752-6101 |
| 1801812151 | RADHIKA SHAH MD Individual | Internal Medicine | 1850 W ARLINGTON BLVD GREENVILLE, NC 27834 (252) 752-6101 |
| 1912291212 | LIANGYONG JIANG Individual | Internal Medicine (Rheumatology) | 1850 W ARLINGTON BLVD GREENVILLE, NC 27834 (252) 413-6740 |
| 1912334442 | ASHLEY PEADEN RD, LDN Individual | Dietitian, Registered | 1850 W ARLINGTON BLVD GREENVILLE, NC 27834 (252) 413-6683 |
| 1942612262 | PHYSICIANS EAST PA Organization | Non-Pharmacy Dispensing Site | 1850 W ARLINGTON BLVD GREENVILLE, NC 27834 (252) 752-6101 |
| 1932102050 | DR. MARK DELLASEGA MD Individual | Internal Medicine (Gastroenterology) | 1850 W ARLINGTON BLVD GREENVILLE, NC 27834 (252) 752-6101 |
| 1447253588 | DR. RICHARD CROSKERY MD Individual | Internal Medicine | 1850 W ARLINGTON BLVD GREENVILLE, NC 27834 (252) 752-6101 |
| 1871596932 | DR. ROBERT DIETRICH MD Individual | Internal Medicine (Pulmonary Disease) | 1850 W ARLINGTON BLVD GREENVILLE, NC 27834 (252) 752-6101 |
| 1275538639 | PATRICK BRILLANT M.D. Individual | Colon & Rectal Surgery | 1850 W ARLINGTON BLVD GREENVILLE, NC 27834 (252) 752-6101 |
| 1568449080 | DR. RUSSELL JAMES KILPATRICK M.D. Individual | Dermatology | 1850 W ARLINGTON BLVD GREENVILLE, NC 27834 (252) 413-6740 |
| 1164480026 | ROBERT WAYNE COX MD Individual | Family Medicine | 1850 W ARLINGTON BLVD GREENVILLE, NC 27834 (252) 413-6202 |
| 1932306784 | SUSAN L. MCKNIGHT P.A. Individual | Physician Assistant | 1850 W ARLINGTON BLVD GREENVILLE, NC 27834 (252) 413-6740 |
| 1033112081 | DR. JOHN PATRICK FOGARTY MD Individual | Internal Medicine (Pulmonary Disease) | 1850 W ARLINGTON BLVD GREENVILLE, NC 27834 (252) 752-6101 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1629055983, enumerated in the NPI registry as an "individual" on December 28, 2005
The provider is located at 1850 W Arlington Blvd Greenville, Nc 27834 and the phone number is (252) 413-6202
The provider's speciality is Family Medicine with taxonomy code 207Q00000X
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 $83.9 with an average copayment of $20.97 for new patient appointments. Established patients should expect a typical charge of $95.94 and an average copayment of 23.98. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on December 28, 2005. 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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