Karen Birmingham, M.D.
NPI 1851483010 · Plastic Surgery Physician · Marmora, NJ
Enrolled with Medicare as Practitioner - Plastic and Reconstructive Surgery · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Karen Birmingham, M.D. is a Plastic Surgery Physician provider in Marmora, NJ (NPI 1851483010).
Provider details
- NPI number
- 1851483010
- Entity type
- Individual
- Primary specialty
- Plastic Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- Yes
- License
- 25MA07419800 (NJ)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
19 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
34 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Established Patient Office Or Other Outpatient Visit With Low Level OD Decision Making, If Using Time, 20 Minutes Or More99213 | 22 | $96 |
| Initial Hospital Care With Moderate Level of Medical Decision Making, If Using Time, at Least 75 Minutes99223 | 12 | $179 |
Typical Medicare-allowed amounts for these services range $96–$179 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-09-28
- Last updated
- 2010-12-03
Frequently asked questions
- What is Karen Birmingham's NPI number?
- Karen Birmingham's National Provider Identifier (NPI) is 1851483010, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Karen Birmingham's specialty?
- Karen Birmingham is listed in the NPPES registry with a primary specialty of Plastic Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Karen Birmingham located?
- Karen Birmingham's practice location on file with NPPES is 110 Roosevelt Blvd, Marmora, NJ 08223-1403.
- What is Karen Birmingham's phone number?
- The practice phone number listed in the NPPES registry for Karen Birmingham is (609) 390-2404.
- Does Karen Birmingham accept Medicare?
- Karen Birmingham is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Karen Birmingham's NPI active?
- Yes — Karen Birmingham's NPI (1851483010) is active in the NPPES registry as of the last update on 2010-12-03.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.