Skip to main content
UniHealth

Doctor search

Karen Michelle Phan Wai, MD

Ophthalmology · Stanford

NPI 1073017208

Medicare standing
Clear
Enrolled, allowed to bill and order, not excluded
Plans that list them
20
4 carriers
Offices
3

Offices

3 locations · Stanford Health Care · University Healthcare Alliance · County of Santa Clara

Looking this up.

Hospitals listed: Stanford Health Care. That is not proof they admit you there this week.

Plans that list them

20 plans · 4 carriers

A missing listing does not mean out of network. Directories change, and a listing does not cover every office. Call Dr. Wai’s office to confirm they take your plan. Ask about the office you use, its medical group, referrals and appointments.

20 of 20 plans

Plans whose provider directory lists this clinician
Alignment Health BreathEasy (HMO C-SNP)Alignment Health PlanListedOct 3, 2026
Alignment Health Clarity (HMO C-SNP)Alignment Health PlanListedOct 3, 2026
Alignment Health Harmony (HMO)Alignment Health PlanListedOct 3, 2026
Alignment Health Heart & Diabetes (HMO C-SNP)Alignment Health PlanListedOct 3, 2026
Alignment Health Heart & Diabetes CalPlus (HMO C-SNP)Alignment Health PlanListedOct 3, 2026
Alignment Health Heart & Diabetes Care (HMO C-SNP)Alignment Health PlanListedSep 28, 2026
Alignment Health Heart & Diabetes Choice (HMO C-SNP)Alignment Health PlanListedSep 28, 2026
Alignment Health Honor+ Plan (HMO)Alignment Health PlanListedOct 3, 2026
Alignment Health My Choice CalCare (HMO)Alignment Health PlanListedOct 3, 2026
Alignment Health Silicon (HMO C-SNP)Alignment Health PlanListedOct 3, 2026
Alignment Health Sutter Advantage +More (HMO)Alignment Health PlanListedOct 3, 2026
Alignment Health smartHMO (HMO)Alignment Health PlanListedOct 3, 2026
Alignment Health the ONE (HMO)Alignment Health PlanListedOct 3, 2026
Anthem Full Dual Advantage Aligned (HMO D-SNP)Anthem Blue CrossListedOct 3, 2026
Anthem Medicare Advantage (HMO-POS)Anthem Blue CrossListedOct 3, 2026
SCAN Balance (HMO C-SNP)SCAN Health PlanListedOct 3, 2026
SCAN Classic (HMO)SCAN Health PlanListedOct 3, 2026
SCAN MyChoice (HMO)SCAN Health PlanListedOct 3, 2026
SCAN Strive (HMO C-SNP)SCAN Health PlanListedOct 3, 2026
DualConnect (HMO D-SNP)Santa Clara Family Health PlanListedSep 1, 2026

California Medical Board record

Licence A176636 · Current

Licensed to practise in California · since 2022 · expires 2028-05-31 · Case Western Reserve University School of Medicine.

No disciplinary actions, convictions, malpractice judgments or citations in this record.

Hospitals they work in

1 hospital

These rate the hospital, not this clinician. Most measures at most hospitals are no different from the national rate.

  • Stanford Health CareStanford, CAAcute Care Hospital · Voluntary non-profit - Private · Has an emergency departmentPart of Stanford Health Care, which runs 3 hospitalsHome of Stanford Cancer Institute, a National Cancer Institute designated comprehensive cancer centrePatients rate it 4 of 5 · 83% would definitely recommend it
    Overall rating: 5 of 5 starsWorse than the national rate — Perioperative pulmonary embolism or deep vein thrombosis rate: 5.31 (4.24 to 6.37) · 8,661 cases, Jul 2022 – Jun 2024Worse than the national rate — Rate of inpatient admissions for patients receiving outpatient chemotherapy: 14.1 (12.7 to 15.7) · 2,191 cases, Jan 2024 – Dec 2024Better than the national rate — Postoperative respiratory failure rate: 4.08 (1.95 to 6.21) · 5,296 cases, Jul 2022 – Jun 2024Better than the national rate — Catheter Associated Urinary Tract Infections (ICU + select Wards): 0.317, Oct 2024 – Sep 2025Better than the national rate — Clostridium Difficile (C.Diff): 0.446, Oct 2024 – Sep 2025Better than the national rate — SSI - Colon Surgery: 0.241, Oct 2024 – Sep 2025Better than the national rate — Ratio of unplanned hospital visits after hospital outpatient surgery: 0.7 (0.6 to 0.9) · 3,348 cases, Jan 2024 – Dec 2024
See every measure and the patient survey for Stanford Health Care

Behind the star rating — Deaths: 5 better, 3 the same, 0 worse of 8 measures. Safety: 3 better, 5 the same, 0 worse of 8 measures. Readmissions: 2 better, 5 the same, 4 worse of 11 measures. The star rating is worked out from an earlier period than the measures below, so the two can disagree.

Every scored measure at Stanford Health Care
Perioperative pulmonary embolism or deep vein thrombosis rateComplications and deaths5.31 (4.24 to 6.37) · 8,661 casesWorseJul 2022 – Jun 2024
Rate of inpatient admissions for patients receiving outpatient chemotherapyUnplanned return visits14.1 (12.7 to 15.7) · 2,191 casesWorseJan 2024 – Dec 2024
Postoperative respiratory failure rateComplications and deaths4.08 (1.95 to 6.21) · 5,296 casesBetterJul 2022 – Jun 2024
Catheter Associated Urinary Tract Infections (ICU + select Wards)Infections0.317BetterOct 2024 – Sep 2025
Clostridium Difficile (C.Diff)Infections0.446BetterOct 2024 – Sep 2025
SSI - Colon SurgeryInfections0.241BetterOct 2024 – Sep 2025
Ratio of unplanned hospital visits after hospital outpatient surgeryUnplanned return visits0.7 (0.6 to 0.9) · 3,348 casesBetterJan 2024 – Dec 2024
Abdominopelvic accidental puncture or laceration rateComplications and deaths1.06 (0.45 to 1.67) · 5,374 casesNo differentJul 2022 – Jun 2024
CMS Medicare PSI 90: Patient safety and adverse events compositeComplications and deaths0.86 (0.72 to 1)No differentJul 2022 – Jun 2024
Death rate among surgical inpatients with serious treatable complicationsComplications and deaths166.09 (137.88 to 194.3) · 470 casesNo differentJul 2022 – Jun 2024
Death rate for CABG surgery patientsComplications and deaths1.1 · 192 casesNoneJul 2022 – Jun 2025
Death rate for COPD patientsComplications and deaths6.4 · 146 casesNoneJul 2022 – Jun 2025
Death rate for heart attack patientsComplications and deaths9.7 · 253 casesNoneJul 2022 – Jun 2025
Death rate for heart failure patientsComplications and deaths6.3 · 880 casesNoneJul 2022 – Jun 2025
Death rate for pneumonia patientsComplications and deaths10.3 · 935 casesNoneJul 2022 – Jun 2025
Death rate for stroke patientsComplications and deaths8.7 · 501 casesNoneJul 2023 – Jun 2025
Hybrid Hospital-Wide All-Cause Risk Standardized Mortality RateComplications and deaths2.1 · 7,730 casesNoneJul 2024 – Jun 2025
Iatrogenic pneumothorax rateComplications and deaths0.13 (0 to 0.27) · 20,799 casesNo differentJul 2022 – Jun 2024
In-hospital fall-associated fracture rateComplications and deaths0.28 (0.14 to 0.43) · 23,182 casesNo differentJul 2022 – Jun 2024
Postoperative acute kidney injury requiring dialysis rateComplications and deaths0.94 (0.2 to 1.68) · 5,694 casesNo differentJul 2022 – Jun 2024
Postoperative hemorrhage or hematoma rateComplications and deaths2.36 (1.54 to 3.19) · 7,846 casesNo differentJul 2022 – Jun 2024
Postoperative sepsis rateComplications and deaths5.2 (3.76 to 6.64) · 5,603 casesNo differentJul 2022 – Jun 2024
Postoperative wound dehiscence rateComplications and deaths1.38 (0.23 to 2.53) · 2,211 casesNo differentJul 2022 – Jun 2024
Pressure ulcer rateComplications and deaths0.52 (0.21 to 0.83) · 19,915 casesNo differentJul 2022 – Jun 2024
Rate of complications for hip/knee replacement patientsComplications and deaths3.6 · 416 casesNoneApr 2023 – Mar 2025
Central Line Associated Bloodstream Infection (ICU + select Wards)Infections0.869No differentOct 2024 – Sep 2025
MRSA BacteremiaInfections0.857No differentOct 2024 – Sep 2025
SSI - Abdominal HysterectomyInfections0.368No differentOct 2024 – Sep 2025
Acute Myocardial Infarction (AMI) 30-Day Readmission RateUnplanned return visits16.2 · 247 casesNoneJul 2023 – Jun 2025
Heart failure (HF) 30-Day Readmission RateUnplanned return visits20.5 · 1,021 casesNoneJul 2023 – Jun 2025
Hospital return days for heart attack patientsUnplanned return visits47.8 · 258 casesNoneJul 2022 – Jun 2025
Hospital return days for heart failure patientsUnplanned return visits-1.6 · 990 casesNoneJul 2022 – Jun 2025
Hospital return days for pneumonia patientsUnplanned return visits20.8 · 976 casesNoneJul 2022 – Jun 2025
Pneumonia (PN) 30-Day Readmission RateUnplanned return visits16.5 · 959 casesNoneJul 2023 – Jun 2025
Rate of emergency department (ED) visits for patients receiving outpatient chemotherapyUnplanned return visits5.2 (4.4 to 6.2) · 2,191 casesNo differentJan 2024 – Dec 2024
Rate of readmission after hip/knee replacementUnplanned return visits5.1 · 425 casesNoneJul 2023 – Jun 2025
Rate of readmission for CABGUnplanned return visits9.6 · 158 casesNoneJul 2023 – Jun 2025
Rate of readmission for chronic obstructive pulmonary disease (COPD) patientsUnplanned return visits19.6 · 183 casesNoneJul 2023 – Jun 2025
Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)Unplanned return visits12.7 (10.4 to 15.4) · 4,578 casesNo differentJan 2022 – Dec 2024

What patients said (6,810 patients answered, 25% of those asked)

Patient survey stars by topic at Stanford Health Care
Cleanliness4
Nurse communication4
Doctor communication4
Communication about medicines3
Discharge information4
Overall hospital rating4
Quietness2
Recommend hospital5
Share of patients giving the best answer at Stanford Health Care
Room was "always" clean75%
Nurses "always" communicated well82%
Doctors "always" communicated well81%
Staff "always" explained63%
Yes, staff "did" give patients this information89%
Yes, staff "did" give patients information about help after discharge89%
Doctors "always" explained things so they could understand76%
Doctors "always" listened carefully80%
Doctors "always" treated them with courtesy and respect87%
Patients who gave a rating of "9" or "10" (high)79%
Staff "always" explained new medications76%
Nurses "always" explained things so they could understand77%
Nurses "always" listened carefully79%
Nurses "always" treated them with courtesy and respect88%
"Always" quiet at night53%
"YES", patients would definitely recommend the hospital83%
Staff "always" explained possible side effects50%
Yes, staff "did" give patients information about possible symptoms90%

Original Medicare doctor bills

$74,359

Medicare paid this office $74,359 for 318 people.

This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.

Largest Original Medicare bills
New patient visit (45+ min)138$18,237$132
Return visit (30+ min)133$18,179$102
Imaging of retina254$9,173$28
Injection of drug into eye36$6,941$104
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's217$3,543$15
See all 8 services
Every Original Medicare service billed
New patient visit (45+ min)138$18,237$132
Return visit (30+ min)133$18,179$102
Imaging of retina254$9,173$28
Injection of drug into eye36$6,941$104
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's217$3,543$15
Short return visit (20+ min)29$1,551$52
Removal of eye fluid (vitreous) between lens and retina11$1,307$119
Exam of visual field with extended testing11$396$36

Procedures Medicare counted

Procedure volume Medicare published
Cataract surgery1-10None

Who their Medicare patients are

318 Original Medicare patients in 2024. Average age 74 · Under 65 8% · 85 and older 13% · Women 59% · Also on Medicaid 31% · Health risk score 1.42. Above the middle of the specialty; the typical ophthalmology clinician is at 1.16.

Conditions among them: High blood pressure 75% · Diabetes 49% · Coronary heart disease 26% · Chronic kidney disease 24% · Depression 20% · Cancer 17% · Heart failure 14% · Atrial fibrillation 14% · COPD 9% · Dementia 9% · Stroke 8%.

The office billed $584,520, Medicare allowed $94,629 and paid $74,359; for 1,103 services of 30 kinds.

Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.

Year by year

Original Medicare by year
20243181,103741.42$584,520$74,359
2023115172741.59$251,918$13,672
20223749771.79$58,917$3,803

Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.

See the services billed each year

2023: 3 services

Original Medicare services billed in 2023
Short return visit (20+ min)64$4,019$54
Removal of membrane of retina with removal of internal limiting membrane of retina14$2,434$174
Imaging of retina33$770$22

2022: 1 service

Original Medicare services billed in 2022
Short return visit (20+ min)16$897$56

Medicaid work

$2,784 in 2024

Medicaid paid $2,784 for 104 billed services this clinician did in 2024, up to 33 people in a month for one service.

Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.

Largest Medicaid services in 2024
Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [OCT]), posterior segment, with interpretation and report, unilateral or bilateral; retina64$1,292
Return visit (30+ min)12$748
New patient visit (45+ min)16$724
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established)12$21
Medicaid work by year
2024104433$2,784

Drugs they prescribed that Part D paid

$6,191

Pharmacies billed $6,191 in 2024.

This is pharmacy cost, not the office bill, and not what patients paid.

Opioids were 0% of their Part D prescriptions (0 of 124) in 2024. At or below the middle of the specialty; the typical ophthalmology clinician is at 0%.

88 generic and fewer than 11 brand-name prescriptions · $6,191 in drug cost.

Part D prescriptions only. The opioid rate is opioid prescriptions as a share of all this clinician's Part D prescriptions; surgeons and pain specialists run higher than others, so it is shown against the same specialty.

Largest Part D drug costs
Azelastine16$1,236$77
Prednisolone Acetate26$894$34
Ketorolac Tromethamine14$389$28
Dorzolamide-Timolol13$178$14
Erythromycin13$117$9

Year by year

Part D prescribing by year
2024124580% (0)None$6,191
20232161030% (0)32%$21,060
2022175900% (0)33%$18,008
2021184820% (0)43%$16,569
202010958None23%$3,051
20199058None24%$4,993
20184318NoneNone$2,426

Part D prescriptions only. A drug prescribed to fewer than 11 people in a year is hidden.

See the drugs prescribed each year

2023: 7 drugs

Part D drugs prescribed in 2023
Restasis14$10,579$756
Prednisolone Acetate47$1,736$37
Azelastine16$1,253$78
Ketorolac Tromethamine21$422$20
Erythromycin24$408$17
Dorzolamide-Timolol12$347$29
Olopatadine11$341$31

2022: 7 drugs

Part D drugs prescribed in 2022
Prednisolone Acetate25$1,058$42
Azelastine12$914$76
Moxifloxacin20$717$36
Ketorolac Tromethamine16$595$37
Latanoprost16$593$37
Dorzolamide-Timolol11$437$40
Erythromycin24$310$13

2021: 4 drugs

Part D drugs prescribed in 2021
Prednisolone Acetate50$1,836$37
Moxifloxacin34$1,520$45
Ketorolac Tromethamine30$511$17
Dorzolamide11$428$39

2020: 3 drugs

Part D drugs prescribed in 2020
Prednisolone Acetate16$589$37
Erythromycin29$423$15
Ketorolac Tromethamine14$218$16

2019: 1 drug

Part D drugs prescribed in 2019
Erythromycin21$310$15

Money from drug and device companies

$5,567 in 2025

Industry payments by year
2025717$3,465$5,567
2024813$1,313$3,138
202378None$859
2022615None$2,566
202111None$60

Paid work is consulting, speaking, honoraria and royalties, as opposed to meals and travel.

A payment is not proof that care is biased.

Payments by company
Genentech USAVabysmo$5,032
8 payments
  • Travel for Vabysmo · 2025-10-16 · $965
  • Travel for Vabysmo · 2025-10-16 · $224
  • Meals for Vabysmo · 2025-10-16 · $286
  • Consulting for Vabysmo · 2025-10-16 · $3,465
  • Meals for Vabysmo · 2025-10-16 · $15
  • Meals for Susvimo · 2025-08-14 · $32
  • Meals for Vabysmo · 2025-04-07 · $15
  • Meals for Vabysmo · 2025-01-06 · $31
Astellas Pharma Global DevelopmentIzervay$193
2 payments
  • Meals for Izervay · 2025-08-02 · $33
  • Meals for Izervay · 2025-06-17 · $160
Regeneron PharmaceuticalsEylea Hd$155
2 payments
  • Meals for Eylea Hd · 2025-11-11 · $81
  • Meals for Eylea Hd · 2025-03-19 · $74
Astellas Pharma USIzervay$69
1 payment
  • Meals for Izervay · 2025-11-12 · $69
ANI PharmaceuticalsPurified Cortrophin Gel$50
2 payments
  • Meals for Yutiq · 2025-05-19 · $19
  • Meals for Purified Cortrophin Gel · 2025-02-14 · $31
GenentechVabysmo$42
1 payment
  • Meals for Vabysmo · 2025-05-14 · $42
See all 17 published payments
Every published payment
Astellas Pharma USMeals · 2025-11-12Izervay$69
Regeneron PharmaceuticalsMeals · 2025-11-11Eylea Hd$81
Genentech USATravel · 2025-10-16Vabysmo$965
Genentech USATravel · 2025-10-16Vabysmo$224
Genentech USAMeals · 2025-10-16Vabysmo$286
Genentech USAConsulting · 2025-10-16Vabysmo$3,465
Genentech USAMeals · 2025-10-16Vabysmo$15
Genentech USAMeals · 2025-08-14Susvimo$32
Astellas Pharma Global DevelopmentMeals · 2025-08-02Izervay$33
Regeneron Healthcare SolutionsMeals · 2025-07-10Eylea Hd$27
Astellas Pharma Global DevelopmentMeals · 2025-06-17Izervay$160
ANI PharmaceuticalsMeals · 2025-05-19Yutiq$19
GenentechMeals · 2025-05-14Vabysmo$42
Genentech USAMeals · 2025-04-07Vabysmo$15
Regeneron PharmaceuticalsMeals · 2025-03-19Eylea Hd$74
ANI PharmaceuticalsMeals · 2025-02-14Purified Cortrophin Gel$31
Genentech USAMeals · 2025-01-06Vabysmo$31
See earlier years (2024, 2023, 2022, 2021)

2024: $3,138

Payments by company in 2024
AbbvieOzurdex$1,358
2 payments
  • Consulting · 2024-04-03 · $1,313
  • Meals for Ozurdex · 2024-01-26 · $45
Regeneron PharmaceuticalsNone$700
1 payment
  • Grant · 2024-05-13 · $700
Astellas Pharma USIzervay$451
4 payments
  • Meals for Izervay · 2024-11-04 · $33
  • Meals for Izervay · 2024-06-25 · $131
  • Meals for Izervay · 2024-04-22 · $150
  • Meals for Izervay · 2024-03-05 · $137
AmgenTepezza$217
2 payments
  • Meals for Tepezza · 2024-11-19 · $70
  • Meals for Tepezza · 2024-11-19 · $147
Regeneron Healthcare SolutionsEylea Hd$127
1 payment
  • Meals for Eylea Hd · 2024-06-08 · $127
ANI PharmaceuticalsPurified Cortrophin Gel$127
1 payment
  • Meals for Purified Cortrophin Gel · 2024-11-22 · $127
Alimera SciencesYutiq$114
1 payment
  • Meals for Yutiq · 2024-01-09 · $114
Astellas Pharma Global DevelopmentIzervay$44
1 payment
  • Meals for Izervay · 2024-10-19 · $44

2023: $859

Payments by company in 2023
GlaukosIstent Infinite Trabecular Micro-Bypass System Model Is3$172
2 payments
  • Meals for Istent Infinite Trabecular Micro-Bypass System Model Is3 · 2023-12-06 · $86
  • Meals for Is3-Istent Infinitetrabecular Micro-Bypass System Model Is3 · 2023-12-06 · $86
Astellas Pharma USNone$149
1 payment
  • Meals · 2023-08-02 · $149
BiogenNone$128
1 payment
  • Meals · 2023-01-25 · $128
Regeneron PharmaceuticalsEylea$127
1 payment
  • Meals for Eylea · 2023-08-23 · $127
Regeneron Healthcare SolutionsEylea Hd$119
1 payment
  • Meals for Eylea Hd · 2023-10-12 · $119
Alimera SciencesIluvien$84
1 payment
  • Meals for Iluvien · 2023-05-31 · $84
Bausch & Lomb AmericasStellaris$80
1 payment
  • Meals for Stellaris · 2023-08-06 · $80

2022: $2,566

Payments by company in 2022
Alcon VisionNone$1,556
4 payments
  • Travel · 2022-10-28 · $692
  • Meals · 2022-10-28 · $256
  • Travel · 2022-10-28 · $155
  • Travel · 2022-10-28 · $454
GlaukosIstent Inject W$343
5 payments
  • Meals for Istent Inject W · 2022-12-12 · $86
  • Meals for Istent Inject W · 2022-05-16 · $18
  • Meals for Istent Inject W · 2022-04-27 · $107
  • Meals for Istent Inject W · 2022-03-15 · $109
  • Meals for Istent Inject W · 2022-03-15 · $22
Apellis PharmaceuticalsNone$246
2 payments
  • Meals · 2022-11-14 · $118
  • Meals · 2022-09-14 · $128
AbbvieOzurdex$220
2 payments
  • Meals for Ozurdex · 2022-12-07 · $95
  • Meals for Ozurdex · 2022-08-16 · $124
Alimera SciencesIluvien$107
1 payment
  • Meals for Iluvien · 2022-10-25 · $107
GenentechVabysmo$94
1 payment
  • Meals for Vabysmo · 2022-12-13 · $94

2021: $60

Payments by company in 2021
Alcon VisionNone$60
1 payment
  • Meals · 2021-05-23 · $60

Professional record

NPI
1073017208
Licence
CA A176636California A176636: Current · expires 2028-05-31
Group
Stanford Health Care · University Healthcare Alliance · County of Santa Clara
Gender
Female
More record details
Sole proprietor
No
Taxonomy
Federal specialty code 207W00000X (207W00000X)
Mailing address
300 Pasteur Dr, Stanford, CA, 94305
NPI first listed
2018-03-21
NPI last updated
2025-03-17
NPI record certified
2025-03-17

This is when the NPI record was last certified, not a medical board exam.