Alexandra Modell, L.AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

948-55 Issued in WI

Practice address

5225 N Ironwood Rd Ste 102
Glendale, WI 53217-4909

Phone

(414) 491-2084

NPI assigned

Jan 30, 2020

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

Other identifiers 2

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1063043875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 N IRONWOOD RD STE 102",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 N IRONWOOD RD STE 102",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174909",
            "telephone_number": "414-491-2084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODELL",
        "first_name": "ALEXANDRA",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-30",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WI",
            "license": "948-55",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEITHER MEDICARE OR MEDICAID, AS ACUPUNCTURE IS NOT COVERED",
            "identifier": "NONE",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACUPUNCTURE IS NOT COVERED CURRENTLY UNDER MEDICARE AND MEDICADE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "amodellwellness@gmail.com",
            "affiliation": "N",
            "address_1": "5225 N Ironwood Rd Ste 102",
            "city": "Glendale",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532174909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "amodellwellness@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Secure professional email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5225 N Ironwood Rd Ste 102",
            "city": "Glendale",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532174909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Glendale, WI
• Acupuncturist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.