NPIMap

Individual provider Active NPI

Karen A Hulbert, MD

  • Family Medicine Physician
  • Princeton, WI
National Provider Identifier
1679524409
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
45973 Issued in WI
Practice address
502 W Water St
Princeton, WI 54968-9141
Phone
(920) 295-6432
Fax
(920) 295-4833
NPI assigned
May 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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 45973 WI Primary

Addresses

Primary practice location

502 W Water St
Princeton, WI 54968-9141

Mailing address

1155 N Mayfair Rd
Plank Road Clinic
Milwaukee, WI 53226-3462
Phone (414) 955-5990

Other practice location 1

1155 N Mayfair Rd
Plank Road Clinic
Milwaukee, WI 53226-3462
Phone (414) 955-5990

Other identifiers 2

IdentifierTypeStateIssuer
1679524409MedicaidWI
006906261LOtherHUMANA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20090814000371 WI Practitioner - Family Practice 7416001128 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

502 W Water St
Princeton, WI 54968-9141
Phone (920) 295-6432

Hospital & facility affiliations

  • Thedacare at Home Home health agency, Appleton, WI, CCN 527010
  • Thedacare at Home Hospice, Appleton, WI, CCN 521504
  • Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045
  • Thedacare Medical Center - Berlin Inc Hospital, Berlin, WI, CCN 521355
  • Thedacare Medical Center - Wild Rose Hospital, Wild Rose, WI, CCN 521303
  • Thedacare Regional Medical Center - Appleton Inc Hospital, Appleton, WI, CCN 520160

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45973WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated Family Medicine CurrentSince Jan 1, 2021 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jun 1, 2013 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jun 1, 2013 Accepting new patients
The Medical College of Wisconsin, Inc. Family Medicine CurrentSince Jul 1, 2009 Accepting new patients
Thedacare Medical Center - Berlin, Inc. Past Accepting new patients

Locations

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

1405 Mill St
New London, WI 54961
Phone (920) 531-2000

1320 Wisconsin Ave
Racine, WI 53403
Phone (262) 687-2222

N2934 State Road 22
Wautoma, WI 54982
Phone (920) 787-4613

840 N 87th St
Wauwatosa, WI 53226
Phone (414) 805-5540

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

Interoperability endpoints

  • Direct secure messaging: khulbert298023@direct.thedacare.org

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1679524409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 N MAYFAIR RD",
            "address_2": "PLANK ROAD CLINIC",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263462",
            "telephone_number": "414-955-5990",
            "fax_number": "414-955-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 W WATER ST",
            "city": "PRINCETON",
            "state": "WI",
            "postal_code": "549689141",
            "telephone_number": "920-295-6432",
            "fax_number": "920-295-4833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1155 N Mayfair Rd",
            "address_2": "PLANK ROAD CLINIC",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263462",
            "country_code": "US",
            "telephone_number": "414-955-5990",
            "fax_number": "414-955-6282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HULBERT",
        "first_name": "KAREN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "45973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679524409",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "006906261L",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, WI

Sources for this page

Verify at the official NPI Registry.