SANDRA FLEMING M.D.
NPI 1972595171
Obstetrics & Gynecology - Gynecology in Wellesley, MA
NPI Status: Active since August 16, 2005
Contact Information
386 WASHINGTON ST STE 2
WELLESLEY, MA
ZIP 02481
Phone: (617) 326-3232
Fax: (781) 329-6479
- Individual
- Female
- Obstetrics & Gynecology
- Gynecology
- Accepts Insurance
- Opted-Out Medicare
- Medicare Quality Reporting
About SANDRA FLEMING
This page provides the complete NPI Profile along with additional information for Sandra Fleming, a women's health care provider established in Wellesley, Massachusetts with a medical specialization in Obstetrics & Gynecology, focusing in gynecology . The healthcare provider is registered in the NPI registry with number 1972595171 assigned on August 2005. The practitioner's primary taxonomy code is 207VG0400X with license number 220999 (MA). The provider is registered as an individual and her NPI record was last updated 7 years ago.
- NPI
- 1972595171
- Provider Name
- SANDRA FLEMING M.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 386 WASHINGTON ST STE 2 WELLESLEY, MA 02481
- Location Phone
- (617) 326-3232
- Location Fax
- (781) 329-6479
- Mailing Address
- 1 LYONS ST DEDHAM, MA 02026
- Mailing Phone
- (781) 329-1400
- Mailing Fax
- (781) 329-6479
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-16-2005
- Last Update Date
- 04-02-2019
- Code Navigator
Women's health care providers like Sandra Fleming treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Sandra Fleming opted out of Medicare effective on 04-01-2023 until 04-01-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Obstetrics & Gynecology Gynecology
- Taxonomy Code
- 207VG0400X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 220999
- License State
- MA
- Taxonomy Description
- A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Access Blue New England HMO 6000/20%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7500/30%/10000 Value - HMO
- Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
- Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 3000/0%/7500 RxD - HMO
- Anthem Gold Access Blue New England HMO 500/30%/9000 - HMO
- Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
- Anthem Silver Access Blue New England HMO 2500/30%/10000 Value - HMO
- Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/10000 - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/9000 - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/9000 RxD - HMO
- Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/20%/8500 - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2066921 | MEDICAID (05) | MA |
Medicare Participation & PECOS Enrollment Status
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 04-01-2023
Opt-Out End Date: 04-01-2027
Eligible to Order and Refer? No
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Established patient office or other outpatient visit, 30-39 minutes
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.
This service was performed 27 times for 14 patientsMIPS Quality Measures
The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Breast Cancer Screening | 91% | 354 |
| Cervical Cancer Screening | 95% | 805 |
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 50% | 875 |
| Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented | 77% | 1016 |
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 72% | 767 |
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 73% | 767 |
Reviews for SANDRA FLEMING M.D.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1972595171, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 59 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1972595171, enumerated as an "individual" on August 16, 2005.
The provider is located at 386 WASHINGTON ST STE 2 WELLESLEY, MA 02481 and the phone number is (617) 326-3232.
Obstetrics & Gynecology with taxonomy code 207VG0400X and a focus in Gynecology.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Medicare and. Please consult your insurance carrier or call the provider to verify.
