3500 Main Street Suite 201
Springfield MA 01199
Medical School: Albert Einstein College Of Medicine Of Yeshiva University - 1974
Accepts Medicare: Yes
Participates In eRX: No
Participates In PQRS: Yes
Participates In EHR: Yes
License #: 46941
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Awards & Recognitions
Dr. Laura Feldman is associated with these group practices
|HCPCS Code||Description||Average Price||Average Price
Allowed By Medicare
|HCPCS Code:36561||Description:Insert tunneled cv cath||Average Price:$2,379.00||Average Price Allowed
|HCPCS Code:37224||Description:Fem/popl revas w/tla||Average Price:$1,089.00||Average Price Allowed
|HCPCS Code:36558||Description:Insert tunneled cv cath||Average Price:$608.00||Average Price Allowed
|HCPCS Code:36147||Description:Access av dial grft for eval||Average Price:$408.00||Average Price Allowed
|HCPCS Code:36569||Description:Insert picc cath||Average Price:$203.00||Average Price Allowed
|HCPCS Code:75989||Description:Abscess drainage under x-ray||Average Price:$128.00||Average Price Allowed
|HCPCS Code:75625||Description:Contrast x-ray exam of aorta||Average Price:$126.00||Average Price Allowed
|HCPCS Code:75710||Description:Artery x-rays arm/leg||Average Price:$123.00||Average Price Allowed
|HCPCS Code:77001||Description:Fluoroguide for vein device||Average Price:$42.00||Average Price Allowed
HCPCS Code Definitions
- Introduction of needle and/or catheter, arteriovenous shunt created for dialysis (graft/fistula); initial access with complete radiological evaluation of dialysis access, including fluoroscopy, image documentation and report (includes access of shunt, injection[s] of contrast, and all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava)
- Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; age 5 years or older
- Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older
- Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump; age 5 years or older
- Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal angioplasty
- Aortography, abdominal, by serialography, radiological supervision and interpretation
- Angiography, extremity, unilateral, radiological supervision and interpretation
- Fluoroscopic guidance for central venous access device placement, replacement (catheter only or complete), or removal (includes fluoroscopic guidance for vascular access and catheter manipulation, any necessary contrast injections through access site or catheter with related venography radiologic supervision and interpretation, and radiographic documentation of final catheter position) (List separately in addition to code for primary procedure)
- Radiological guidance (ie, fluoroscopy, ultrasound, or computed tomography), for percutaneous drainage (eg, abscess, specimen collection), with placement of catheter, radiological supervision and interpretation
Medical Malpractice Cases
Medical Board Sanctions
*These referrals represent the top 10 that Dr. Feldman has made to other doctors
Health risk of air pollution on people living with major chronic diseases: a Canadian population-based study. - BMJ open
The objective of this study was to use health administrative and environmental data to quantify the effects of ambient air pollution on health service use among those with chronic diseases. We hypothesised that health service use would be higher among those with more exposure to air pollution as measured by the Air Quality Health Index (AQHI).Health administrative data was used to quantify health service use at the primary (physician office visits) and secondary (emergency department visits, hospitalisations) level of care in Ontario, Canada.We included individuals who resided in Ontario, Canada, from 2003 to 2010, who were ever diagnosed with one of 11 major chronic diseases.Rate ratios (RR) from Poisson regression models were used to estimate the short-term impact of incremental unit increases in AQHI, nitrogen dioxide (NO2; 10â€…ppb), fine particulate matter (PM2.5; 10â€…Âµg/m(3)) and ozone (O3; 10â€…ppb) on health services use among individuals with each disease. We adjusted for age, sex, day of the week, temperature, season, year, socioeconomic status and region of residence.Increases in outpatient visits ranged from 1% to 5% for every unit increase in the 10-point AQHI scale, corresponding to an increase of about 15â€…000 outpatient visits on a day with poor versus good air quality. The greatest increases in outpatient visits were for individuals with non-lung cancers (AQHI:RR=1.05; NO2:RR=1.14; p<0.0001) and COPD (AQHI:RR=1.05; NO2:RR=1.12; p<0.0001) and in hospitalisations, for individuals with diabetes (AQHI:RR=1.04; NO2:RR=1.07; p<0.0001) and COPD (AQHI:RR=1.03; NO2:RR=1.09; p<1.001). The impact remained 2â€…days after peak AQHI levels.Among individuals with chronic diseases, health service use increased with higher levels of exposure to air pollution, as measured by the AQHI. Future research would do well to measure the utility of targeted air quality advisories based on the AQHI to reduce associated health service use.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Quality of asthma care under different primary care models in Canada: a population-based study. - BMC family practice
Previous research has shown variations in quality of care and patient outcomes under different primary care models. The objective of this study was to use previously validated, evidence-based performance indicators to measure quality of asthma care over time and to compare quality of care between different primary care models.Data were obtained for years 2006 to 2010 from the Ontario Asthma Surveillance Information System, which uses health administrative databases to track individuals with asthma living in the province of Ontario, Canada. Individuals with asthma (n=1,813,922) were divided into groups based on the practice model of their primary care provider (i.e., fee-for-service, blended fee-for-service, blended capitation). Quality of asthma care was measured using six validated, evidence-based asthma care performance indicators.All of the asthma performance indicators improved over time within each of the primary care models. Compared to the traditional fee-for-service model, the blended fee-for-service and blended capitation models had higher use of spirometry for asthma diagnosis and monitoring, higher rates of inhaled corticosteroid prescription, and lower outpatient claims. Emergency department visits were lowest in the blended fee-for-service group.Quality of asthma care improved over time within each of the primary care models. However, the amount by which they improved differed between the models. The newer primary care models (i.e., blended fee-for-service, blended capitation) appear to provide better quality of asthma care compared to the traditional fee-for-service model.
Chronic disease prevalence in women and air pollution--A 30-year longitudinal cohort study. - Environment international
Air pollution, such as fine particulate matter (PM2.5), can increase risk of adverse health events among people with heart disease, diabetes, asthma and chronic obstructive pulmonary disease (COPD) by aggravating these conditions. Identifying the influence of PM2.5 on prevalence of these conditions may help target interventions to reduce disease morbidity among high-risk populations.The objective of this study is to measure the association of exposure of PM2.5 with prevalence risk of various chronic diseases among a longitudinal cohort of women.Women from Ontario who enrolled in the Canadian National Breast Screening Study (CNBSS) from 1980 to 1985 (n = 29,549) were linked to provincial health administrative data from April 1, 1992 to March 31, 2013 to determine the prevalence of major chronic disease and conditions (heart disease, diabetes, asthma, COPD, acute myocardial infarction, angina, stroke and cancers). Exposure to PM2.5 was measured using satellite data collected from January 1, 1998 to December 31, 2006 and assigned to resident postal-code at time of entry into study. Poisson regression models were used to describe the relationship between exposure to ambient PM2.5 and chronic disease prevalence. Prevalence rate ratios (PRs) were estimated while adjusting for potential confounders: baseline age, smoking, BMI, marital status, education and occupation. Separate models were run for each chronic disease and condition.Congestive heart failure (PR = 1.31, 95% CI: 1.13, 1.51), diabetes (PR = 1.28, 95% CI: 1.16, 1.41), ischemic heart disease (PR = 1.22, 95% CI: 1.14, 1.30), and stroke (PR = 1.21, 95% CI: 1.09, 1.35) showed over a 20% increase in PRs per 10 Î¼g/m(3) increase in PM2.5 after adjusting for risk factors. Risks were elevated in smokers and those with BMI greater than 30.This study estimated significant elevated prevalent rate ratios per unit increase in PM2.5 in nine of the ten chronic diseases studied.Copyright Â© 2015 Elsevier Ltd. All rights reserved.
Potassium phosphite increases tolerance to UV-B in potato. - Plant physiology and biochemistry : PPB / SociÃ©tÃ© franÃ§aise de physiologie vÃ©gÃ©tale
The use of biocompatible chemical compounds that enhance plant disease resistance through Induced Resistance (IR) is an innovative strategy to improve the yield and quality of crops. Phosphites (Phi), inorganic salts of phosphorous acid, are environment friendly, and have been described to induce disease control. Phi, similar to other plant inductors, are thought to be effective against different types of biotic and abiotic stress, and it is assumed that the underlying signaling pathways probably overlap and interact. The signaling pathways triggered by UV-B radiation, for instance, are known to crosstalk with other signaling routes that respond that biotic stress. In the present work, the effect of potassium phosphite (KPhi) pre-treatment on UV-B stress tolerance was evaluated in potato leaves. Plants were treated with KPhi and, after 3 days, exposed to 2 h/day of UV-B (1.5 Watt m(-2)) for 0, 3 and 6 days. KPhi pre-treatment had a beneficial effect on two photosynthetic parameters, specifically chlorophyll content and expression of the psbA gene. Oxidative stress caused by UV-B was also prevented by KPhi. A decrease in the accumulation of hydrogen peroxide (H2O2) in leaves and an increase in guaiacol peroxidase (POD) and superoxide dismutase (SOD) activities were also observed. In addition, the expression levels of a gene involved in flavonoid synthesis increased in UV-B-stressed plants only when pre-treated with KPhi. Finally, accumulation of glucanases and chitinases was induced by UV-B stress and markedly potentiated by KPhi pre-treatment. Altogether, this is the first report that shows a contribution of KPhi in UV-B stress tolerance in potato plants.Copyright Â© 2015 Elsevier Masson SAS. All rights reserved.
Asthma deaths in a large provincial health system. A 10-year population-based study. - Annals of the American Thoracic Society
Individuals with asthma are more likely to die from chronic conditions than the general population. Measuring only mortality with asthma listed as the primary cause of death may lead to an underestimation of total asthma mortality.To examine mortality patterns in the asthma population over 10 years, including asthma as the primary cause of death (asthma-specific mortality) and asthma as a secondary, contributing cause of death (asthma-contributing mortality).Health administrative data from Ontario, Canada were used to identify mortality rates and cause of death in subjects 0 to 99 years of age. Mortality rates were calculated in the asthma and general population from 1999 to 2008. Total asthma mortality was estimated by adding rates of asthma-specific and asthma-contributing mortality for years 2003 to 2008.Asthma-specific mortality rates per 100,000 asthma population decreased by 54.4% from 13.6 in 1999 to 6.2 in 2008. In 2008, the asthma population had higher all-cause mortality compared with the general population (rate ratio, 1.3), asthma-specific mortality rates were 60% higher among those in the lowest compared with highest socioeconomic status, and total asthma mortality was fourfold higher than asthma-specific mortality alone (21.6 vs. 5.4 per 100,000).All-cause mortality rates have decreased substantially over the past decade. Compared with the general population, the asthma population has higher all-cause mortality and is more likely to die from comorbid conditions. Total asthma mortality was fourfold higher than asthma-specific mortality, highlighting the importance of comprehensive measurement approaches that include asthma-specific and asthma-contributing mortality.
Smoking initiation among young adults in the United States and Canada, 1998-2010: a systematic review. - Preventing chronic disease
Young adults have the highest smoking rate of any age group in the United States and Canada, and recent data indicate that they often initiate smoking as young adults. The objective of this study was to systematically review peer-reviewed articles on cigarette smoking initiation and effective prevention efforts among young adults.We searched 5 databases for research articles published in English between 1998 and 2010 on smoking initiation among young adults (aged 18-25) living in the United States or Canada. We extracted the following data from each study selected: the measure of initiation used, age range of initiation, age range of study population, data source, target population, sampling method, and sample size. We summarized the primary findings of each study according to 3 research questions and categories of data (eg, sociodemographic) that emerged during the data extraction process.Of 1,072 identified studies, we found 27 articles that met our search criteria, but several included a larger age range of initiation (eg, 18-30, 18-36) than we initially intended to include. Disparities in young adult smoking initiation existed according to sex, race, and educational attainment. The use of alcohol and illegal drugs was associated with smoking initiation. The risk of smoking initiation among young adults increased under the following circumstances: exposure to smoking, boredom or stress while serving in the military, attending tobacco-sponsored social events while in college, and exposure to social norms and perceptions that encourage smoking. Effective prevention efforts include exposure to counter-marketing, denormalization campaigns, taxation, and the presence of smoke-free policies.Much remains to be learned about young adult smoking initiation, particularly among young adults in the straight-to-work population. Dissimilar measures of smoking initiation limit our knowledge about smoking initiation among young adults. We recommend developing a standardized measure of initiation that indicates progression to regular established smoking.
The Annual September Peak in Asthma Exacerbation Rates: Still a Reality? - Annals of the American Thoracic Society
Recent research suggests that the asthma epidemic observed in the 1980s and 1990s has stabilized. Changing trends in asthma may have an impact on the well-reported global phenomenon of the "asthma September peak". The 38th week of the year has been identified as the peak time for asthma exacerbations among children.The purpose of this study was to examine the longitudinal trend of the September peak, and to see if it changed over time, differed by age groups or varied across different geographical regions.Monthly rates of asthma emergency department (ED) and physician visits were calculated using data from 2003-2013 provided by the Ontario Asthma Surveillance Information System (OASIS)-a population-based surveillance system with over 2 million individuals with asthma. Age-specific rates were calculated using the prevalent asthma population - asthma individuals with â‰¥ 1 health service claim for asthma in the respective year - as the denominator. Rates were stratified by age group and region of residence. Spatial relationships within the province were tested to examine if the September peak was more prominent in certain regions of Ontario.The highest September peak in ED visits was observed in 2005 for children aged 0-4 and 5-9 years (18.35 and 8.11 per 1000 asthma prevalence). The rate of asthma ED visits in all children was consistently highest in September; however, the "spike" became marginally less severe over time. Since 2005, there has been a 51.7% decrease in the September ED visit rate for all age groups. Monthly physician visits for all age groups usually peaked in October, roughly 4 weeks following the peak in ED. Analysis by residence showed that rates throughout Ontario were higher in September than other months, suggesting that the spike was widespread rather than localized.While the magnitude of the September peak has decreased over time, the asthma ED visit rate remains significantly higher in September. Physician visits are also highest in the fall. These findings stress the importance of empowering children and families to maintain good asthma control throughout the year including handwashing to minimize respiratory viral infections in September.
Estimating Toronto's health services use for the 2015 Pan American and Parapan American Games. - Perspectives in public health
Ambient air temperature may exacerbate the burden of chronic diseases on Ontario's healthcare system during mass gathering events. This study aimed to estimate the impact of increasing temperature in July and August on health services use for chronic conditions in Ontario's Golden Horseshoe region during the 2015 Pan American and Parapan American Games, using environmental and health administrative data from previous years.Negative binomial regression was used to calculate incidence risk ratios for same-day health services use (hospitalisations, emergency department visits, physician office visits) for all causes, asthma, asthma-related conditions, diabetes and hypertension associated with unit increases in daily maximum temperature from 1 May to 31 August in 2008-2010. Sensitivity analysis was performed to estimate the added burden of an increased population size, in order to model an influx of visitors during the Games.In July and August, on days with daily maximum temperatures of 35Â°C compared to 25Â°C, we estimated seeing 7,827 more physician office visits for all causes in Ontario's Golden Horseshoe region. The estimated relative increase in physician office visits for diabetes due to temperature alone was 8.4%. With an estimated 10% increase in population, the increase in physician office visits for all causes tripled to an estimated 23,590.Temperature was identified as a potential contributor to greater health services use during the Games, particularly for those living with diabetes. These results highlight the importance of strategic delivery of health services during mass gathering events, and suggest a role for educating at-risk individuals on prevention behaviours, particularly on very hot days.Â© Royal Society for Public Health 2015.
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