DR. SONAL N. PANDYA M.D.
NPI 1023059631
Plastic Surgery in Burlington, MA

Q: What is Sonal Pandya's NPI number?

The NPI number for Sonal Pandya is 1023059631. It was assigned to this individual provider in the NPPES registry on June 8, 2006.

Q: What is Sonal Pandya's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Q: When was this NPI record last updated?

The NPPES record for Sonal Pandya was last updated on November 29, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 08, 2006PECOS EnrolledAccepts Medicare Assignment

91.41/100

CMS Quality Rating

41 MALL RD, BURLINGTON, MA 01805(781) 744-5100(781) 744-5215 Get Directions Write a Review

NPPES record last updated: November 29, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Sonal N. Pandya M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SONAL N. PANDYA M.D. (NPI 1023059631) is an individual plastic surgery provider in Burlington, Massachusetts, licensed in Massachusetts (156048) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS, is affiliated with Lahey Hospital & Medical Center, Burlington, and is a graduate of Other (1992).

NPPES Registry Identity

NPI1023059631

Entity TypeIndividualFemale

Primary Taxonomy208200000X

Provider Legal NameDR. SONAL N. PANDYACredential: M.D.

Location Address41 MALL RDBurlington, MA 01805-0001

Mailing Address41 Mall RdBurlington, MA 01805-0001 · (781) 744-5100 · Fax (781) 744-5215

Phone(781) 744-5100

Fax(781) 744-5215

Sole ProprietorNo

Medical School CMSOtherGraduated 1992

Enumeration DateJune 8, 2006

Last NPPES UpdateNovember 29, 2010

✔ NPI 1023059631 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208200000X

License✔ Licensed in MA · 156048

Definition

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

41 MALL RD, Burlington, MA 01805

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Other Identifiers 3

Medicare PINA3378501MA

Medicare UPINH58724MA

Medicaid110007668AMA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Sonal N. Pandya M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7618987405

PECOS Enrollment IDI20100506000663

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

31 services31 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

31 services22 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

20 services20 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

20 services18 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lahey Hospital & Medical Center, Burlington

Acute Care Hospitals · Burlington, MA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220171

Location41 & 45 Mall RoadBurlington, MA 01803 · Middlesex County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01805 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$97.64 typical visit price

range $63.72 – $189.86

Typical copayment $24.41 (range $15.93 – $47.46)

Most-billed visit code 99203

Established Patient

$78.84 typical visit price

range $21.07 – $155.29

Typical copayment $19.71 (range $5.26 – $38.82)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

91.41/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

76.87

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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