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SANDRA L. WORRELL MD
NPI 1285841775
Family Medicine in West Burlington, IA

Active since May 16, 2007PECOS EnrolledAccepts Medicare Assignment
1225 S GEAR AVE STE 159, WEST BURLINGTON, IA 52655(319) 768-1570 Get Directions Write a Review

NPPES record last updated: November 24, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 24, 2025, May 25, 2021 (2 updates tracked since 2021).

About Sandra L. Worrell Md NPPES

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

SANDRA L. WORRELL MD (NPI 1285841775) is an individual family medicine provider in West Burlington, Iowa, licensed in Iowa (MD49175) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS, is affiliated with Southeast Iowa Regional Medical Center, and is a graduate of Other (2005).

NPPES Registry Identity

NPI1285841775
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameSANDRA L. WORRELLCredential: MD
Location Address1225 S GEAR AVE STE 159West Burlington, IA 52655-1686
Mailing Address1225 S Gear Ave Ste 159West Burlington, IA 52655-1686 · (319) 768-1570
Phone(319) 768-1570
Sole ProprietorNo
Medical School CMSOtherGraduated 2005
Enumeration DateMay 16, 2007
Last NPPES UpdateNovember 24, 20252 updates tracked since enumeration
NPPES CertifiedNovember 24, 2025
✔ NPI 1285841775 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in IA · MD49175✔ Licensed in TX · N1497
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License 125049837 (IL)
1225 S GEAR AVE STE 159, West Burlington, IA 52655
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and more.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

Sandra L. Worrell Md 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 ID8325103310
PECOS Enrollment IDI20220713003431
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 10

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.

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.
682 services347 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
228 services228 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.
97 services81 patients
Transitional care management services for problem of at least moderate complexity 99495
Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.
41 services33 patients
Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402
An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.
27 services27 patients
Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination G0405
An Electrocardiogram (ECG) with 12 leads is a routine test to check your heart's activity. It's done during your initial preventive physical exam. The test involves attaching 12 leads or sensors to your body to record electrical signals from your heart. This helps identify any heart problems.
25 services25 patients

Hospital Affiliations CMS Care Compare 2

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

Southeast Iowa Regional Medical Center

Acute Care Hospitals · West Burlington, IA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number160057
Location1221 South Gear AvenueWest Burlington, IA 52655 · Des Moines County
Emergency services Birthing friendly

University Of Iowa Hospital & Clinics

Acute Care Hospitals · Iowa City, IA
3/5 CMS rating
OwnershipGovernment - State
CMS Certification Number160058
Location200 Hawkins DriveIowa City, IA 52242 · Johnson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 52655 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
$81.84 typical visit price
range $52.96 – $161.40
Typical copayment $20.46 (range $13.24 – $40.35)
Most-billed visit code 99203
Established Patient
$94.05 typical visit price
range $16.91 – $131.98
Typical copayment $23.51 (range $4.22 – $32.99)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
2 suppliers15 claims15 services$209.93 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

SARAH KOTTENSTETTE MD
Family Medicine
1225 S GEAR AVE STE 159
WEST BURLINGTON, IA 52655
Des Moines County (319) 768-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sandra Worrell's NPI number?

The NPI number for Sandra Worrell is 1285841775. It was assigned to this individual provider in the NPPES registry on May 16, 2007.

Where is Sandra Worrell located?

Sandra Worrell practices at 1225 S Gear Ave Ste 159, West Burlington, IA 52655. The listed phone number is (319) 768-1570.

What is Sandra Worrell's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Sandra Worrell enrolled in Medicare?

Yes. Sandra Worrell is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Sandra Worrell accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan and 1 other insurer list Sandra Worrell as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Sandra Worrell affiliated with any hospitals?

According to CMS data, Sandra Worrell is affiliated with Southeast Iowa Regional Medical Center and University Of Iowa Hospital & Clinics.

When was this NPI record last updated?

The NPPES record for Sandra Worrell was last updated on November 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.