Individual provider Active NPI

Kokila Mody, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Staten Island, NY
National Provider Identifier
1104894146
Registry record updated May 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
113624 Issued in NY
Practice address
1 Edgewater Plaza
1St FL. Lab
Staten Island, NY 10305
Phone
(718) 226-4130
Fax
(718) 226-4185
NPI assigned
Mar 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1136241 NY
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 113624 NY Primary

Addresses

Primary practice location

1 Edgewater Plaza
1St FL. Lab
Staten Island, NY 10305

Mailing address

1 Edgewater St
6TH FL. Payer Relations
Staten Island, NY 10305-4900
Phone (718) 226-1008

Other identifiers 1

IdentifierTypeStateIssuer
220016392OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20071114000314 NY Practitioner - Pathology 7911095658 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1965
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (212) 434-6980

Hospital & facility affiliations

  • Staten Island University Hospital Hospital, Staten Island, NY, CCN 330160

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1136241NYMDSpecialist
113624NYMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Apr 1, 2019 Accepting new patients
Physicians of University Hospital, PC CurrentSince Dec 1, 2009 Accepting new patients
Physicians of University Hospital, PC CurrentSince Dec 1, 2009 Accepting new patients
Seaview Pathology PC Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

300 Community Dr
Plandome, NY 11030

1 Edgewater St
Fl Lab
Staten Island, NY 10305
Phone (718) 226-4130

1 Edgewater St
Staten Island, NY 10305
Phone (718) 226-1008

242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458

1 Edgewater St
Fl 6
Staten Island, NY 10305
Phone (718) 226-1047

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

401 Seaview Ave
Lowr
Staten Island, NY 10305
Phone (718) 226-6186

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Organizations & group practices 4

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 1

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210204800000",
    "number": "1104894146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EDGEWATER ST",
            "address_2": "6TH FL. PAYER RELATIONS",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054900",
            "telephone_number": "718-226-1008",
            "fax_number": "718-226-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EDGEWATER PLAZA",
            "address_2": "1ST FL. LAB",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10305",
            "telephone_number": "718-226-4130",
            "fax_number": "718-226-4185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODY",
        "first_name": "KOKILA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2008-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1136241",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "113624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "220016392",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.