DR. JESSE SANDOVAL (D.O.) – Phlebology Physician, NPI 1972552271
Phlebology Physician
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. JESSE SANDOVAL (D.O.)
1199 Shoreline Ln
#310
Boise, ID 837026813
Phone: (208) 333-1472
Fax: (208) 333-7757
Type: Location
247 N Fireweed St Ste A
Soldotna, AK 996697593
Phone: (907) 262-8597
Type: Location
PO BOX 7130
BOISE, ID 837071130
Phone: (208) 333-1472
Fax: (208) 333-7757
Type: Mailing
245 N BINKLEY ST STE 101
SOLDOTNA, AK 996697500
Phone: (907) 714-4111
Fax: (907) 262-5191
Type: Location
Idaho Lottery Building, 1199, West Shoreline Lane, Downtown, Boise, Ada County, Idaho, 83702, United States
#310
BOISE, ID 837026813
Phone: (208) 333-1472
Fax: (208) 333-7757
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-11-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160407002168 | I | Internal Medicine | AK | TBD |
| I20191105001067 | I | Internal Medicine | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 173 | 138 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 115 | 97 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 83 | 72 | $0 |
Insurance plans in this area (ZIP 83702)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| INTERNAL MEDICINE | ID | 93971 | Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers | 15 | 14 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TX | |
| Physician Assistant | DC | |
| Family Practice | ID | |
| Registered Dietitian Or Nutrition Professional | AK | |
| Family Practice | AK | |
| Emergency Medicine | PA | |
| - | AK | |
| Physical Therapist In Private Practice | AK | |
| P S Y C H I A T R Y | LA | |
| Physical Therapist In Private Practice | AK |
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