NPIMap

Individual provider Active NPI

Dixitkumar N Modi, MD

  • Family Medicine Physician
  • Cocoa Beach, FL
National Provider Identifier
1124238506
Registry record updated Jan 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME133520 Issued in FL
Practice address
4350 N Atlantic Ave
Cocoa Beach, FL 32931-3656
Phone
(334) 327-9530
NPI assigned
May 23, 2007
Last updated
Jan 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME133520 FL Primary

Addresses

Primary practice location

4350 N Atlantic Ave
Cocoa Beach, FL 32931-3656

Mailing address

4350 N Atlantic Ave Ste 1
Cocoa Beach, FL 32931-3656
Phone (321) 613-5352

Other identifiers 2

IdentifierTypeStateIssuer
023052500MedicaidFL
ME133520OtherFLMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20171220002904 FL Practitioner - Family PracticePractitioner - General PracticePractitioner - Preventive Medicine 9436203387 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Preventive Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
My Vital View LLCGroup PAC ID 8921434697, 4 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

2194 Hwy A1A
Suite 107
Indian Harbour Beach, FL 32937-4955
Phone 32176563170

4350 N Atlantic Ave
Cocoa Beach, FL 32931-3603
Phone (321) 613-5352

4350 N Atlantic Ave
Cocoa Beach, FL 32931-3656

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME133520FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
My Vital View, LLC CurrentSince Mar 1, 2022 Accepting new patients
Dixitkumar N Modi MD PA Family Medicine CurrentSince Jul 26, 2019 Accepting new patients

Locations

4350 N Atlantic Ave
Cocoa Beach, FL 32931
Phone (321) 202-3323

4350 N Atlantic Ave
Ste 1
Cocoa Beach, FL 32931

2194 Highway A1A
Ste 107
Indian Harbour Beach, FL 32937
Phone (321) 241-4551

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: dixitkumar.modi@modi.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/DAGJBD/Endpoint/DAGJBD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609632000000",
    "number": "1124238506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 N ATLANTIC AVE STE 1",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329313656",
            "telephone_number": "321-613-5352",
            "fax_number": "321-613-5356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 N ATLANTIC AVE",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329313656",
            "telephone_number": "334-327-9530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODI",
        "first_name": "DIXITKUMAR",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2021-01-03",
        "certification_date": "2021-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME133520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023052500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME133520",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cocoa Beach, FL

Sources for this page

Verify at the official NPI Registry.