Karen Jill C Iccarelli, M.D.

Individual provider Active NPI Family Medicine Physician · Williamsport, MD

NPI 1508894023 · NPPES record last updated Oct 16, 2012

Key facts

NPI
1508894023
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
D0052136 (MD)
Practice address
16605 Kendle Rd
Williamsport, MD 21795-1614
Phone
(301) 223-1241
Fax
(301) 223-1240
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 12

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

Hospital & facility affiliations 5

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

Medicare Care Compare profile

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 Inc (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

  • Home Call Home health agency · Frederick, MD · CCN 217040
  • Meritus Medical Center, Inc Home health agency · Hagerstown, MD · CCN 217085
  • Hospice of Washington County, Inc Hospice · Hagerstown, MD · CCN 211511
  • Meritus Medical Center Hospital · Hagerstown, MD · CCN 210001
  • Berkeley Medical Center Hospital · Martinsburg, WV · CCN 510008

Merit-based Incentive Payment System (MIPS)

Final score
94.95 of 100 (individual)
Quality
100
Improvement activities
40
Cost
83.16

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions12
Skin biopsy12

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0052136MDMDFamily Medicine Physician

Practice roles

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

Specialties & licenses

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

Addresses

Primary practice location

16605 Kendle Rd
Williamsport, MD 21795-1614

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
401020500MedicaidMD

Other providers in Williamsport, MD

All providers in Williamsport, MD · Family Medicine Physician in Maryland

Sources for this page

Verify at the official NPI Registry.