Praveen Kumar Modi, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

PM069773 Issued in MI

Practice address

990 W Ann Arbor TRL
Suite 102
Plymouth, MI 48170-6204

Phone

(734) 414-1088

Fax

(734) 414-1095

NPI assigned

Apr 18, 2006

Sex

Male

Sole proprietor

Yes

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 MI

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

Specialty

Internal Medicine

Education

Wayne State University School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health at Home- Southeast Michigan Home health agency, Livonia, MI, CCN 237069
• Residential Home Health Home health agency, Troy, MI, CCN 237459
• Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156
• St Joe Mercy Hospital System Livonia Hospital, Livonia, MI, CCN 230002
• Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029
• University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046
• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: praveen.modi@pmmp.eclinicaldirectplus.com
• Direct secure messaging: pmodi817342@direct.hfhs.org
• Direct secure messaging: pmodi1056272@direct.hfhs.org
• FHIR API: https://fhir4.healow.com/fhir/r4/EGIFCA/Endpoint/EGIFCA

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.

• Praveen Modi, MD, PC

  • Internal Medicine Physician
  • West Bloomfield, MI
  • NPI 1255528527
  Medicare reassignment NPD Authorized official
• Select Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Glenview, IL
  • NPI 1346368248
  Care Compare group
• Midwest Physician Services PC

  • Nurse Practitioner
  • Toledo, OH
  • NPI 1215945878

  Internal Medicine

  NPD (past)

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

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation
• Regents of the University of Michigan

  • General Acute Care Hospital
  • Ann Arbor, MI
  • NPI 1003878539
  Care Compare affiliation
• Residential Home Health, LLC

  • Home Health Agency
  • Troy, MI
  • NPI 1992768550
  Care Compare affiliation
• St Joseph Mercy Hospital

  • General Acute Care Hospital
  • Ypsilanti, MI
  • NPI 1780658443
  Care Compare affiliation
• St Joseph Mercy Hospital-SMHC

  • General Acute Care Hospital
  • Pontiac, MI
  • NPI 1053356352
  Care Compare affiliation
• St Mary Mercy Hospital

  • General Acute Care Hospital
  • Livonia, MI
  • NPI 1790706901
  Care Compare affiliation
• Trinity Home Health Services

  • Home Health Agency
  • Livonia, MI
  • NPI 1508823774
  Care Compare affiliation

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425340800000",
    "number": "1144285669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 W ANN ARBOR TRL",
            "address_2": "SUITE 102",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706204",
            "telephone_number": "734-414-1088",
            "fax_number": "734-414-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 W ANN ARBOR TRL",
            "address_2": "SUITE 102",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706204",
            "telephone_number": "734-414-1088",
            "fax_number": "734-414-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODI",
        "first_name": "PRAVEEN",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2015-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "PM069773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alaysa Mixon
• MJM Counseling PLLC
• Mkaye Counseling, PLLC
• MMS Counseling Services
• Kristin E Moccia
• Danielle Modlin
• Dayna Modrzynski
• Lesley Moffat, B.S.
• Anthony Moffitt, LLMSW
• Fatimah Luay Mohammed-Ali

• Internal Medicine Physician in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.