Individual provider Active NPI

Michael R Sandfort, MD

  • Colon & Rectal Surgery Physician
  • New Bedford, MA
National Provider Identifier
1841228707
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
58007 Issued in MA
Practice address
101 Page St
New Bedford, MA 02740-3464
Phone
(508) 973-5130
Fax
(508) 973-5135
NPI assigned
Jun 29, 2006
Last updated
Apr 27, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 58007 MA
Colon & Rectal Surgery Physician 208C00000X 58007 MA Primary

Addresses

Primary practice location

101 Page St
New Bedford, MA 02740-3464

Mailing address

200 Mill Rd
Fairhaven, MA 02719-5252
Phone (508) 973-2000

Other identifiers 15

IdentifierTypeStateIssuer
0027845OtherNHP
1202178003OtherCIGNA FOR REFERRALS
201129OtherBLUE CHIP
J06317OtherMASS BS
000334OtherSWH
020013712OtherRAILROAD MED
J06317OtherMABLUE CROSS BLUE SHIELD
1401000OtherUHC
3020860MedicaidMA
8226OtherHPHC
058007OtherTUFTS
000000021262OtherBMC
3428634OtherAETNA
B20915202OtherMACIGNA
MS07821MedicaidRI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address msandfort19888@direct.southcoast.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110203000200 MA Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 0941259196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

363 Highland Ave
Fall River, MA 02720-3703
Phone (508) 973-5919

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue2019
Removal of skin lesions55
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
58007MAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. Surgery CurrentSince Nov 6, 2018 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Nov 6, 2018 Accepting new patients

Locations

363 Highland Ave
Fall River, MA 02720
Phone (508) 679-7052

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

101 Page St
New Bedford, MA 02740
Phone (508) 961-5425

2444 E Main Rd
Portsmouth, RI 02871
Phone (401) 683-4817

Interoperability endpoints

  • Direct secure messaging: msandfort19888@direct.southcoast.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1841228707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195252",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PAGE ST",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027403464",
            "telephone_number": "508-973-5130",
            "fax_number": "508-973-5135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDFORT",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "58007",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "MA",
            "license": "58007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "0027845",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA FOR REFERRALS",
            "identifier": "1202178003",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "201129",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASS BS",
            "identifier": "J06317",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SWH",
            "identifier": "000334",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MED",
            "identifier": "020013712",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "J06317",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "1401000",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3020860",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "8226",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "058007",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC",
            "identifier": "000000021262",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3428634",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "B20915202",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MS07821",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msandfort19888@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "101 Page St",
            "city": "New Bedford",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027403464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Bedford, MA

Sources for this page

Verify at the official NPI Registry.