NPIMap

Individual provider Active NPI

Karen Jill C Iccarelli, M.D.

  • Family Medicine Physician
  • Williamsport, MD
National Provider Identifier
1508894023
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0052136 Issued in MD
Practice address
16605 Kendle Rd
Williamsport, MD 21795-1614
Phone
(301) 223-1241
Fax
(301) 223-1240
NPI assigned
Jun 30, 2006
Last updated
Oct 16, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0052136 MD Primary

Addresses

Primary practice location

16605 Kendle Rd
Williamsport, MD 21795-1614

Mailing address

16605 Kendle Rd
Williamsport, MD 21795-1614
Phone (301) 223-1241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070728000121 MD Practitioner - Family Practice 0345341764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Pittsburgh School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Meritus Medical Center IncGroup PAC ID 7113811795, shared by 8 NPIs, 730 clinicians

Practice addresses (Care Compare)

11110 Medical Campus Rd
Hagerstown, MD 21742-6700

16605 Kendle Rd
Williamsport, MD 21795-1614
Phone (301) 223-1241

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.95 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
83.16

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions12
Skin biopsy12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0052136MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Karen Jill Ciccarelli, M.D. PC Family Medicine CurrentSince Jul 1, 2007 Accepting new patients
Washington County Emergency Medicine Physicians, LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Meritus Medical Laboratory LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21601/brand/1/csg/1/fhir/r4
  • Direct secure messaging: karen.jill.ciccarelli.1@21601.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1508894023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16605 KENDLE RD",
            "city": "WILLIAMSPORT",
            "state": "MD",
            "postal_code": "217951614",
            "telephone_number": "301-223-1241",
            "fax_number": "301-223-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16605 KENDLE RD",
            "city": "WILLIAMSPORT",
            "state": "MD",
            "postal_code": "217951614",
            "telephone_number": "301-223-1241",
            "fax_number": "301-223-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "C ICCARELLI",
        "first_name": "KAREN",
        "middle_name": "JILL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0052136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsport, MD

Sources for this page

Verify at the official NPI Registry.