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SANDRA LYNN CUMMINS LCSW
NPI 1386164408
Social Worker - Clinical in Missoula, MT

Active since June 20, 2017PECOS EnrolledAccepts Medicare Assignment
85.43/100
CMS Quality Rating
500 W BROADWAY ST, MISSOULA, MT 59802(406) 327-3046(406) 327-3385 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 21, 2022, Jun 20, 2017 (2 updates tracked since 2017).

About Sandra Lynn Cummins Lcsw NPPES

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

SANDRA LYNN CUMMINS LCSW (NPI 1386164408) is an individual clinical provider in Missoula, Montana, licensed in Montana (20702) and active in the NPI registry since June 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2010).

NPPES Registry Identity

NPI1386164408
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameSANDRA LYNN CUMMINSCredential: LCSW
Location Address500 W BROADWAY STMissoula, MT 59802-4008
Mailing Address500 W Broadway StMissoula, MT 59802-4008 · (406) 327-3046 · Fax (406) 327-3385
Phone(406) 327-3046
Fax(406) 327-3385
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateJune 20, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1386164408 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in MT · 20702
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
500 W BROADWAY ST, Missoula, MT 59802
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Mountain Health CO-OP, PacificSource Health Plans.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Sandra Lynn Cummins Lcsw 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 ID8921372657
PECOS Enrollment IDI20170919004265
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.

Medicare Billing Reassignment

Medicare enrollment records show Sandra Cummins reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Providence Health & Services Mt
Same address
Endocrinology, Diabetes & Metabolism
500 W BROADWAY ST STE 210
Missoula, MT 59802
  • Reassigned Medicare billing, Montana enrollment
  • 325 clinicians in this Medicare group
NPI 1235370065 (406) 329-5736

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 59802 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
$0.00 typical visit price
range $56.81 – $172.26
Typical copayment $0.00 (range $14.20 – $43.06)
Most-billed visit code NA
Established Patient
$70.82 typical visit price
range $18.24 – $140.32
Typical copayment $17.70 (range $4.56 – $35.08)
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.

85.43/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality85.98
Promoting Interoperability100
Improvement Activities40
Cost65.45

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.

SIMONE MUSCO MD
Internal Medicine (Clinical Cardiac Electrophysiology)
500 W BROADWAY ST, STE 320
MISSOULA, MT 59802
Missoula County (406) 329-5615
PROVIDENCE HEALTH & SERVICES MT
General Acute Care Hospital
500 W BROADWAY ST
MISSOULA, MT 59802
Missoula County (406) 543-7271
JAMIE BELKOWSKI PHARMACIST
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
500 W BROADWAY ST
MISSOULA, MT 59802
Missoula County (406) 543-7271
DR. DESIREE NICOLE OWSLEY PHARMD
Pharmacist (Pharmacotherapy)
500 W BROADWAY ST
MISSOULA, MT 59802
Missoula County (406) 327-1650
JEANNIE H SWAIN PHARMD
Pharmacist (Pharmacotherapy)
500 W BROADWAY ST
MISSOULA, MT 59802
Missoula County (406) 329-5721
HEATHER HIGHTOWER NP
Nurse Practitioner (Family)
500 W BROADWAY ST
MISSOULA, MT 59802
Missoula County (406) 728-2539
MR. CURTIS G WICKRE MD
Internal Medicine (Nephrology)
500 W BROADWAY ST, 4TH FLOOR
MISSOULA, MT 59802
Missoula County (406) 327-1900
DR. TRAVIS OWEN ABICHT MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
500 W BROADWAY ST
MISSOULA, MT 59802
Missoula County (406) 329-5615

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 Cummins's NPI number?

The NPI number for Sandra Cummins is 1386164408. It was assigned to this individual provider in the NPPES registry on June 20, 2017.

Where is Sandra Cummins located?

Sandra Cummins practices at 500 W Broadway St, Missoula, MT 59802. The listed phone number is (406) 327-3046.

What is Sandra Cummins's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Sandra Cummins enrolled in Medicare?

Yes. Sandra Cummins 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.

Which organization bills Medicare for Sandra Cummins's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sandra Cummins reassigns Medicare benefits to Providence Health & Services Mt (Missoula, MT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sandra Cummins's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sandra Cummins accept?

Health plans from Blue Cross and Blue Shield of Montana, Mountain Health CO-OP and PacificSource Health Plans list Sandra Cummins 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.

When was this NPI record last updated?

The NPPES record for Sandra Cummins was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.