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ANTHONY B SANDOVAL MD
NPI 1528062346
Internal Medicine - Cardiovascular Disease in Los Alamos, NM

Active since June 09, 2005PECOS EnrolledAccepts Medicare Assignment
85.18/100
CMS Quality Rating
4967 TRINITY DR, LOS ALAMOS, NM 87544(505) 699-0202(505) 662-4712 Get Directions Write a Review

NPPES record last updated: April 14, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 19, 2023, Jul 18, 2023, Jan 31, 2019 (3 updates tracked since 2019).

About Anthony B Sandoval Md NPPES

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

ANTHONY B SANDOVAL MD (NPI 1528062346) is an individual cardiovascular disease provider in Los Alamos, New Mexico, licensed in New Mexico (84-112) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, is affiliated with Unm Hospital, and is a graduate of Other (1982).

NPPES Registry Identity

NPI1528062346
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameANTHONY B SANDOVALCredential: MD
Location Address4967 TRINITY DRLos Alamos, NM 87544-3009
Mailing Address800 Bradbury Dr Se Ste 116Albuquerque, NM 87106-4310 · (505) 272-1476 · Fax (505) 662-7122
Phone(505) 699-0202
Fax(505) 662-4712
Sole ProprietorYes
Medical School CMSOtherGraduated 1982
Enumeration DateJune 9, 2005
Last NPPES UpdateApril 14, 20253 updates tracked since enumeration
NPPES CertifiedApril 14, 2025
✔ NPI 1528062346 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License✔ Licensed in NM · 84-112
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
4967 TRINITY DR, Los Alamos, NM 87544
Open in Google Maps ↗

Other Identifiers 1

Medicaid39461NM

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Superior HealthPlan, Ambetter of Oklahoma.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

Anthony B Sandoval 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 ID7113091653
PECOS Enrollment IDI20080801000255
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 8

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.
66 services59 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
65 services60 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
62 services26 patients
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
59 services59 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.
47 services40 patients
Programming of dual lead pacemaker system 93280
Programming of a dual lead pacemaker system is a procedure to adjust your heart's pacemaker settings. This process involves a small device, called a programmer, that communicates with your pacemaker to ensure it's working optimally for your heart's needs.
28 services22 patients

Hospital Affiliations CMS Care Compare

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

Unm Hospital

Acute Care Hospitals · Albuquerque, NM
2/5 CMS rating
OwnershipGovernment - State
CMS Certification Number320001
Location2211 Lomas Boulevard NEAlbuquerque, NM 87106 · Bernalillo County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87544 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
$126.21 typical visit price
range $54.26 – $166.80
Typical copayment $31.55 (range $13.56 – $41.70)
Most-billed visit code 99204
Established Patient
$68.00 typical visit price
range $17.00 – $135.35
Typical copayment $17.00 (range $4.25 – $33.83)
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.

85.18/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81
Promoting Interoperability100
Improvement Activities40
Cost57.08

Reported Quality Measures

Coronary Artery Disease (CAD): Antiplatelet Therapy
Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease (CAD) seen within a 12 month period who were prescribed aspirin or clopidogrel
96%165 patients4/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%530 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
84%170 patients4/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
32%111 patients2/55-star benchmark: 98%
Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet
Percentage of patients 18 years of age and older who were diagnosed with acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous coronary interventions (PCI) in the 12 months prior to the measurement period, or who had an active…
95%127 patients4/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
90%120 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
16%127 patients1/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
36%398 patients2/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
89%87 patients4/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
74%127 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
43%127 patients3/55-star benchmark: 79%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$75.41 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Anthony Sandoval's NPI number?

The NPI number for Anthony Sandoval is 1528062346. It was assigned to this individual provider in the NPPES registry on June 9, 2005.

Where is Anthony Sandoval located?

Anthony Sandoval practices at 4967 Trinity Dr, Los Alamos, NM 87544. The listed phone number is (505) 699-0202.

What is Anthony Sandoval's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Anthony Sandoval enrolled in Medicare?

Yes. Anthony Sandoval 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 Anthony Sandoval accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Superior HealthPlan and Ambetter of Oklahoma list Anthony Sandoval 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 Anthony Sandoval affiliated with any hospitals?

According to CMS data, Anthony Sandoval is affiliated with Unm Hospital.

When was this NPI record last updated?

The NPPES record for Anthony Sandoval was last updated on April 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.