DR. KAREN COTTINGHAM MD
NPI 1629112974
Internal Medicine in Houston, TX
NPI Status: Active since February 19, 2007
Contact Information
1213 HERMANN DR
SUITE 620
HOUSTON, TX
ZIP 77004
Phone: (713) 524-0957
- Individual
- Female
- Internal Medicine
- PECOS Enrolled
- Opted-Out Medicare
About KAREN COTTINGHAM
This page provides the complete NPI Profile along with additional information for Karen Cottingham, an internist established in Houston, Texas with a medical specialization in Internal Medicine. The healthcare provider is registered in the NPI registry with number 1629112974 assigned on February 2007. The practitioner's primary taxonomy code is 207R00000X with license number G4934 (TX). The provider is registered as an individual and her NPI record was last updated 18 years ago.
- NPI
- 1629112974
- Provider Name
- DR. KAREN COTTINGHAM MD
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1213 HERMANN DR SUITE 620 HOUSTON, TX 77004
- Location Phone
- (713) 524-0957
- Mailing Address
- 1213 HERMANN DR SUITE 620 HOUSTON, TX 77004
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 02-19-2007
- Last Update Date
- 07-11-2007
- Code Navigator
An internist like Karen Cottingham 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.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Karen Cottingham opted out of Medicare effective on 01-01-2013 until 01-01-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
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
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- G4934
- License State
- TX
- 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.
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 | 207RX0202X | Allopathic & Osteopathic Physicians | Internal Medicine | G4934 (TX) |
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 |
|---|---|---|---|
| B21990 | MEDICARE UPIN (02) | TX |
Medicare Participation & PECOS Enrollment Status
Karen Cottingham 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
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 01-01-2013
Opt-Out End Date: 01-01-2027
Eligible to Order and Refer? 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 77004 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $134.06
- Minimum New Patient Price $58.24
- Maximum New Patient Price $176.98
- Average New Patient Copayment $33.51
- Minimum New Patient Copayment $14.56
- Maximum New Patient Copayment $44.24
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $102.71
- Minimum Established Patient Price $18.6
- Maximum Established Patient Price $143.93
- Average Established Patient Copayment $25.67
- Minimum Established Patient Copayment $4.65
- Maximum Established Patient Copayment $35.98
* 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.
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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 | 1 | 1 | 2 | 9 | 7 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 4 | 9 | 2 | 1 | 4 | 9 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 4 + 9 + 2 + 1 + 4 + 9 + 1 + 4 + 24 = 66 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 66 = 4 | 4 | ||||||||
The NPI number 1629112974 is valid because the calculated check digit 4 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 |
|---|---|---|---|
| 1104824408 | CATHERINE L KARMEL MD Individual | Obstetrics & Gynecology | 1213 HERMANN DR STE 630 HOUSTON, TX 77004 (713) 520-9580 |
| 1841288362 | DR. TONY S MCCLUNG MD Individual | Urology | 1213 HERMANN DR SUITE 520 HOUSTON, TX 77004 (713) 528-3444 |
| 1386626695 | KENNETH L TOPPELL M.D. Individual | Internal Medicine (Pulmonary Disease) | 1213 HERMANN DR SUITE 570 HOUSTON, TX 77004 (713) 524-3900 |
| 1407807886 | DR. GASTON LHEBRARD CASILLAS M.D. Individual | Surgery | 1213 HERMANN DR SUITE 460 HOUSTON, TX 77004 (713) 807-0505 |
| 1043251044 | DR. THINH Q VO MD Individual | Internal Medicine (Pulmonary Disease) | 1213 HERMANN DR 570 HOUSTON, TX 77004 (713) 524-3900 |
| 1013925221 | DR. BENNETT L PEARSON DDS Individual | Dentist (General Practice) | 1213 HERMANN DR #275 HOUSTON, TX 77004 (713) 529-3069 |
| 1750399184 | MARYAM TAGHADOSI M.D. Individual | Pediatrics | 1213 HERMANN DR SUITE 770 HOUSTON, TX 77004 (713) 807-8921 |
| 1316053093 | DR. IRWIN S NOVAK MD Individual | Specialist | 1213 HERMANN DR SUITE 745 HOUSTON, TX 77004 (713) 630-0228 |
| 1659489573 | DR. HECTOR DELCASTILLO JR. MD Individual | Obstetrics & Gynecology | 1213 HERMANN DR STE 220 HOUSTON, TX 77004 (713) 526-4787 |
| 1245330174 | MOHAMED SABBAHI PH.D, PT, ECS Individual | Physical Therapist (Electrophysiology, Clinical) | 1213 HERMANN DR SUITE 255 HOUSTON, TX 77004 (713) 522-6004 |
| 1891884052 | DR. JOHN DUNCAN SMITH JR. DDS Individual | Dentist (Oral and Maxillofacial Surgery) | 1213 HERMANN DR STE 250 HOUSTON, TX 77004 (713) 942-8188 |
| 1861546558 | DR. DONALD GEORGE GARDNER DDS Individual | Dentist (Oral and Maxillofacial Surgery) | 1213 HERMANN DR SUITE 380 HOUSTON, TX 77004 (713) 524-8341 |
| 1558416370 | AM-TEX REHAB SERVICES INC Organization | Physical Therapist (Electrophysiology, Clinical) | 1213 HERMANN DR SUITE 255 HOUSTON, TX 77004 (713) 522-6004 |
| 1649326620 | DR. MELBA KAREN ADAMS DDS Individual | Dentist (Periodontics) | 1213 HERMANN DR SUITE 265 HOUSTON, TX 77004 (713) 523-0502 |
| 1457486227 | ROBERT W. FAYLE, M.D., P.A. Organization | Psychiatry & Neurology (Neurology) | 1213 HERMANN DR SUITE #715 HOUSTON, TX 77004 (713) 529-1914 |
| 1174730196 | SAMIR N TUMA, MD, PA Organization | Internal Medicine (Nephrology) | 1213 HERMANN DR SUITE 700 HOUSTON, TX 77004 (713) 526-5105 |
| 1346446929 | IRWIN S NOVAK MD PA Organization | Psychiatry & Neurology (Neurology) | 1213 HERMANN DR SUITE #745 HOUSTON, TX 77004 (713) 630-0228 |
| 1649466517 | COLO PROCTOLOGY ASSOCIATES PA Organization | Colon & Rectal Surgery | 1213 HERMANN DR STE 530 HOUSTON, TX 77004 (713) 523-2121 |
| 1902095995 | NINAN T. MATHEW, M.D., P.A. Organization | Specialist | 1213 HERMANN DR SUITE 820 HOUSTON, TX 77004 (713) 528-1916 |
| 1407045032 | MELANIE MENCER, M.D., P.A. Organization | Family Medicine | 1213 HERMANN DR SUITE 430 HOUSTON, TX 77004 (713) 522-1221 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1629112974, enumerated in the NPI registry as an "individual" on February 19, 2007
The provider is located at 1213 Hermann Dr Suite 620 Houston, Tx 77004 and the phone number is (713) 524-0957
The provider's speciality is Internal Medicine with taxonomy code 207R00000X
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 $134.06 with an average copayment of $33.51 for new patient appointments. Established patients should expect a typical charge of $102.71 and an average copayment of 25.67. Please review your insurance plan or contact the provider directly to determine your specific costs.
No, the provider signed an affidavit on January 01, 2013 to opt-out of the Medicare program. The provider is excluded from the Medicare program until January 01, 2027.
This NPI record was last updated on February 19, 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.