Shobana Raghuram Modur

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

1493 Cambridge St.
Cambridge Hospital
Cambridge, MA 02139

Phone

(617) 665-1185

NPI assigned

Aug 17, 2018

Sex

Female

Sole proprietor

No

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 MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• The McLean Hospital Corporation

  • Psychiatry Physician
  • Belmont, MA
  • NPI 1114979580
  Medicare reassignment NPD

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1114407350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1493 CAMBRIDGE ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021391099",
            "telephone_number": "617-665-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1493 CAMBRIDGE ST.",
            "address_2": "CAMBRIDGE HOSPITAL",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "02139",
            "telephone_number": "617-665-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODUR",
        "first_name": "SHOBANA",
        "middle_name": "RAGHURAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-17",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mahmoud Ahmed Moawad Elnaa, M.D.
• Mobile-Med Work Health Solutions, Inc.
• Andrew P Modest, M.D.
• Leslie A Modlin, M.D.
• Jennifer Modliszewski
• Brigitte Moeller, MSW, LICSW
• Rafaela Mogauro, DONA
• Justine Jessa Mohaddess-Westmoreland, PSYD
• Jose M Molinar, M.D.
• Eliza Molinsek, LCSW

• Social Worker in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.