NPIMap

Individual provider Active NPI

Ippolito Modica, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • New York, NY
National Provider Identifier
1083897409
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
60-246899 Issued in NY
Practice address
1000 10TH Ave
New York, NY 10019-1147
Phone
(917) 697-9419
Fax
(212) 523-5435
NPI assigned
Dec 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 60-246899 NY Primary

Addresses

Primary practice location

1000 10TH Ave
New York, NY 10019-1147

Mailing address

1000 10TH Ave
New York, NY 10019-1147
Phone (917) 697-9419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080416000391 NY Practitioner - Pathology 1557449584 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians
Gastrointestinal Care of Long Island PLLCGroup PAC ID 7517042211, 175 clinicians

Practice addresses (Care Compare)

1 Gustave L Levy PL
New York, NY 10029-6504
Phone (212) 241-8014

401 N Middletown Rd
Suite 273
Pearl River, NY 10965-1298
Phone (845) 557-7112

Hospital & facility affiliations

  • Mount Sinai West Hospital, New York, NY, CCN 330046
  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024
  • Mount Sinai Beth Israel Hospital, New York, NY, CCN 330169

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
60-246899NYMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastrointestinal Care of Long Island PLLC CurrentSince Jan 1, 2025 Accepting new patients
Ghassan Philip Sayegh DO PLLC CurrentSince Jul 27, 2024 Accepting new patients
Fpa Hospital Based Anatomic Pathology & Clinical Pathology CurrentSince Jan 1, 2016 Accepting new patients
Amboy Medical Practice PC CurrentSince Oct 1, 2024 Accepting new patients
Fpa Hospital Based Anatomic Pathology & Clinical Pathology Current Accepting new patients
Amboy Medical Practice PC CurrentSince Oct 1, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai Anatomic Pathology & Clinical Pathology CurrentSince Apr 1, 2023 Accepting new patients
Fpa Hospital Based CurrentSince Jan 1, 2016 Accepting new patients
Fpa Hospital Based Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Apr 1, 2023 Accepting new patients
Singular Anesthesia Services, PLLC PastSince Jul 27, 2024 Accepting new patients

Locations

1375 Washington Ave
Ste 101
Albany, NY 12206
Phone (518) 438-4483

187 Veterans Blvd
Massapequa, NY 11758
Phone (516) 795-5523

310 E 14th St
New York, NY 10003
Phone (212) 979-4000

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1468 Madison Ave
New York, NY 10029
Phone (212) 241-0440

5 E 98th St
Fl 6
New York, NY 10029
Phone (212) 241-2221

974 Route 45
Ste 2000
Pomona, NY 10970
Phone (845) 354-3700

355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

615 Yonkers Ave
Yonkers, NY 10704

970 N Broadway
Ste 307
Yonkers, NY 10701
Phone (914) 627-0206

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 11

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196985600000",
    "number": "1083897409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 10TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191147",
            "telephone_number": "917-697-9419",
            "fax_number": "212-523-5435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 10TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191147",
            "telephone_number": "917-697-9419",
            "fax_number": "212-523-5435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODICA",
        "first_name": "IPPOLITO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-07",
        "last_updated": "2007-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "60-246899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.