Sumul Modi, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

2019-01143 Issued in NC

Practice address

5500 Executive Center Dr Ste 206
Charlotte, NC 28212-8864

Phone

(984) 777-9940

Fax

(877) 794-5929

NPI assigned

Aug 13, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2025 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sumul.modi@org78.direct.charmhealth.com

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

• Axon Medical Group PC

  • Neurology Physician
  • Raleigh, NC
  • NPI 1164397253
  NPD Authorized official
• Axon Medical Group PC

  • Radiology Clinic/Center
  • Raleigh, NC
  • NPI 1750256855
  NPD Authorized official

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701475200000",
    "number": "1033466776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 EXECUTIVE CENTER DR STE 206",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128864",
            "telephone_number": "984-777-9940",
            "fax_number": "877-794-5929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 EXECUTIVE CENTER DR STE 206",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128864",
            "telephone_number": "984-777-9940",
            "fax_number": "877-794-5929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODI",
        "first_name": "SUMUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-13",
        "last_updated": "2023-12-02",
        "certification_date": "2023-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2019-01143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sumul.modi@org78.direct.charmhealth.com",
            "affiliation": "N",
            "endpointDescription": "Celeste Brain Health - Neurology Clinic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5500 Executive Center Dr Ste 206",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282128864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Modern Vue Health and Wellness
• Modern Wellness Psychiatric & Family Health PLLC
• Angela M Moderow, PT
• Dhwani Modha, PA-C
• Ankita Modi, MD
• Leposava Lepa Modie, LCSW
• Modlin & Londry DDS PA
• Modlin & Londry II DDS PLLC
• Modlin & Londry X DDS PLLC
• Modlin & Londry XI DDS PLLC

• Neurology Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Neurology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.