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PROVIDER PROFILE · NPI 1336146281

Karen Kovalow-St. JohnM.D.

RheumatologySan Luis Obispo, CAI
CROSS-REFERENCE

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OIG/SAM exclusion screening, sanctions history
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REFERRAL NETWORK

Where Karen Kovalow-St. John's patients come from & go

Directional shared-patient flow from Medicare claims — who sends patients to this provider (inbound) and where this provider's patients go next (outbound). 20 inbound referrers · 50 outbound destinations.

Receives referrals from
Inbound — who sends patients here
PhysicianPatientsVisits
PORTER HOSPITAL LLC3601,498
EDDY, NATALIE63197
Jeffrey Huth
Diagnostic Radiology · Valparaiso, IN
4067
Esther Lee
Diagnostic Radiology · Valparaiso, IN
3252
INDIANA UNIVERSITY HEALTH LA PORTE HOSPITAL INC2782
Thomas Kay
Orthopedic Surgery · Chesterton, IN
2756
Vivek Mishra
Diagnostic Radiology · Laporte, IN
2331
James Forde
Diagnostic Radiology · Valparaiso, IN
2135
Omar Barakat
Diagnostic Radiology · Valparaiso, IN
2143
Sandeep Sehgal
Cardiology · Valparaiso, IN
2068
Keith Atassi
Cardiology · Valparaiso, IN
1951
SILBERMAN, RICHARD1950
Refers patients to
Outbound — where patients go next
PhysicianPatientsVisits
PORTER HOSPITAL LLC256948
ST MARY MEDICAL CENTER INC83252
EDDY, NATALIE47101
FRANCISCAN HEALTH MICHIGAN CITY43178
Jeffrey Huth
Diagnostic Radiology · Valparaiso, IN
3451
Esther Lee
Diagnostic Radiology · Valparaiso, IN
3268
Alverno Laboratories, Llc
Clinical Laboratory · Hammond, IN
3070
Quest Diagnostics Llc Il
Clinical Laboratory · Wood Dale, IL
2964
Divyesh Patel
Diagnostic Radiology · Valparaiso, IN
2860
James Forde
Diagnostic Radiology · Valparaiso, IN
2658
FRANCISCAN HEALTH CROWN POINT2649
Keith Atassi
Cardiology · Valparaiso, IN
2572
Source: CMS Physician Shared Patient Patterns (30-day window, Medicare FFS). Direction = a beneficiary seen by the first provider, then the second, within 30 days; a proxy for referral, not a documented referral. Pairs with fewer than 11 shared beneficiaries are suppressed.
MEDICARE UTILIZATION · PART B · 2024
Total beneficiaries
1,083
Unique beneficiaries
—
Total services
107,382
Distinct HCPCS
17
Medicare payment
$1.4M
Peer benchmark
Q1
Q2
Q3
Q4
Q5
Total Medicare services vs. 530 Rheumatology providers in CA — top quintile (cohort median 1,833).
PRESCRIBING · PART D · 2024
Total Rx claims
1,320
Beneficiaries
—
Total drug cost
$889K
Distinct drugs
22
Brand share
19.1%
Top prescribed drugs
Hydroxychloroquine Sulfate279 claims
Prednisone218 claims
Celecoxib127 claims
Alendronate Sodium123 claims
Meloxicam120 claims
QUALITY · MIPS · 2024
Final MIPS score
84.0
Quality
70.7
Cost
68.5
Improvement activities
40.0
Promoting interop.
100.0
Payment adjustment
0.38%
Group
INDUSTRY PAYMENTS · OPEN PAYMENTS · 2024
Total received
$3K
Payment records
165
By payment type
Food and Beverage$3K