1. Home
  2. Directory
  3. Massachusetts
  4. Winchester
  5. Internal Medicine
  6. NPI Profile

SANJAY R HEGDE MD
NPI 1881756179
Internal Medicine - Gastroenterology in Winchester, MA

Active since December 14, 2006PECOS EnrolledAccepts Medicare Assignment
75.09/100
CMS Quality Rating
955 MAIN ST, SUITE 206, WINCHESTER, MA 01890(781) 729-5855(781) 721-5891 Get Directions Write a Review

NPPES record last updated: September 9, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Sanjay R Hegde Md NPPES

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

SANJAY R HEGDE MD (NPI 1881756179) is an individual gastroenterology provider in Winchester, Massachusetts, licensed in Massachusetts (247933) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS, is affiliated with Winchester Hospital, and is a graduate of Tufts University School Of Medicine (2001).

NPPES Registry Identity

NPI1881756179
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameSANJAY R HEGDECredential: MD
Location Address955 MAIN ST, SUITE 206Winchester, MA 01890-1961
Mailing Address955 Main St Ste 206Winchester, MA 01890-4302 · (781) 729-5855 · Fax (781) 721-5891
Phone(781) 729-5855
Fax(781) 721-5891
Sole ProprietorNo
Medical School CMSTufts University School Of MedicineGraduated 2001
Enumeration DateDecember 14, 2006
Last NPPES UpdateSeptember 9, 2016
✔ NPI 1881756179 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Licenses✔ Licensed in MA · 247933✔ Licensed in PA · MT183245✔ Licensed in MD · D69588
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
955 MAIN ST, Winchester, MA 01890
Open in Google Maps ↗

Other Identifiers 5

OtherS062-0364MD · Blue Cross/blue Shield - Regional
Medicaid418373800MD
Medicare PINP00797658MD
Medicare PIN165452Y1PMD
Other954004-01 & 02MD · Blue Cross/blue Shield

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

Sanjay R Hegde 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 ID8628149861
PECOS Enrollment IDI20110924000003
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 9

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.
202 services154 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
94 services92 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
88 services85 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.
70 services49 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
69 services68 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
60 services60 patients

Hospital Affiliations CMS Care Compare 2

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

Winchester Hospital

Acute Care Hospitals · Winchester, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220105
Location41 Highland AvenueWinchester, MA 01890 · Middlesex County
Emergency services Birthing friendly

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 01890 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
$144.11 typical visit price
range $63.72 – $189.86
Typical copayment $36.02 (range $15.93 – $47.46)
Most-billed visit code 99204
Established Patient
$111.18 typical visit price
range $21.07 – $155.29
Typical copayment $27.79 (range $5.26 – $38.82)
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.

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.

75.09/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality68.93
Promoting Interoperability78
Improvement Activities40
Cost66.38

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.

DR. JOSEPH P O'DONNELL D.M.D.
Dentist (Pediatric Dentistry)
955 MAIN ST
WINCHESTER, MA 01890
Middlesex County (781) 729-1900
ROBERT J OBRIEN JR, MD AND ASSOCIATES PC
Specialist
955 MAIN ST, SUITE G6
WINCHESTER, MA 01890
Middlesex County (781) 729-4878
LINDSAY ROSE MCGOVERN PA-C
Physician Assistant (Medical)
955 MAIN ST
WINCHESTER, MA 01890
Middlesex County (781) 729-4878
DR. GERALDINE C GARCIA-ROGERS D.M.D.
Dentist (Pediatric Dentistry)
955 MAIN ST
WINCHESTER, MA 01890
Middlesex County (781) 729-1900
MIDDLESEX SURGICAL ASSOCIATES INC
Specialist
955 MAIN ST, SUITE G2A
WINCHESTER, MA 01890
Middlesex County (781) 729-2020
DR. LAURA CHRISTINA VITALE M.D.
Pediatrics
955 MAIN ST, STE 103
WINCHESTER, MA 01890
Middlesex County (617) 359-5052
ALEXANDRIA MCGOVERN PA-C
Physician Assistant
955 MAIN ST
WINCHESTER, MA 01890
Middlesex County (781) 888-5791
EDWARD A RYAN MD
Ophthalmology
955 MAIN ST, STE 108
WINCHESTER, MA 01890
Middlesex County (787) 721-0447

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 Sanjay Hegde's NPI number?

The NPI number for Sanjay Hegde is 1881756179. It was assigned to this individual provider in the NPPES registry on December 14, 2006.

Where is Sanjay Hegde located?

Sanjay Hegde practices at 955 Main St Suite 206, Winchester, MA 01890. The listed phone number is (781) 729-5855.

What is Sanjay Hegde's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Sanjay Hegde enrolled in Medicare?

Yes. Sanjay Hegde 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.

Is Sanjay Hegde affiliated with any hospitals?

According to CMS data, Sanjay Hegde is affiliated with Winchester Hospital and Lahey Hospital & Medical Center, Burlington.

When was this NPI record last updated?

The NPPES record for Sanjay Hegde was last updated on September 9, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.