Mamta Devshi Modhwadia, M.D

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A113990 Issued in CA

Practice address

3853 Rosecrans Street
San Diego, CA 92110-3960

Phone

(619) 692-8232

Fax

(619) 542-4060

NPI assigned

Feb 14, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Neighborhood Healthcare

  • Federally Qualified Health Center (FQHC)
  • Escondido, CA
  • NPI 1598703647
  Medicare reassignment NPD
• Senior Medical Associates, Inc.

  • Geriatric Medicine (Internal Medicine) Physician
  • San Diego, CA
  • NPI 1629253505
  Medicare reassignment NPD
• Neighborhood Healthcare

  • Federally Qualified Health Center (FQHC)
  • Beaumont, CA
  • NPI 1629601653
  NPD
• Banner -- University Medical Center Phoenix Campus Behavioral Health

  • Adult Mental Health Clinic/Center
  • Phoenix, AZ
  • NPI 1235182262
  NPD (past)

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1043353667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3853 ROSECRANS STREET",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3853 ROSECRANS STREET",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103960",
            "telephone_number": "619-692-8232",
            "fax_number": "619-542-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODHWADIA",
        "first_name": "MAMTA",
        "middle_name": "DEVSHI",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A113990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Modern Meridians
• Modern Therapies LLC
• Modernhealth Holdings Inc
• Lucia Modesti, M.D.
• Modesto Radiological Medical Group, Inc
• James G Modir, M.D.
• Royya Fatima Modir, M.D.
• Kaeli Modrzejewski
• Bhavesh Surendra Mody, D.O.
• Sheila Mody, MD

• Psychiatry Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.