Suraj Modi

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME146061 Issued in FL

Practice address

455 W Warren Ave
Longwood, FL 32750-4038

Phone

(407) 262-2220

Fax

(407) 834-5011

NPI assigned

May 10, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, TX2 enrollments

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 2

Specialty

Psychiatry

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Brave Health Inc.Group PAC ID 8123458981, 112 clinicians

Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Orlando Health Hospital, Orlando, FL, CCN 100006

Merit-based Incentive Payment System (MIPS)

Final score

79.91 of 100Reported as group

Quality

61.18

Promoting interoperability

100

Improvement activities

40

Cost

71.86

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smodi363741@orlandohealth.medalliesdirect.net
• Direct secure messaging: smodi216429@direct.shands.ufl.edu

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.

• Brave Health Inc.

  • Community/Behavioral Health Agency
  • Miami, FL
  • NPI 1821588674
  Medicare reassignment Care Compare group NPD
• Orlando Health Medical Group Inc

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1669429577
  Medicare reassignment Care Compare group NPD
• Ibis Healthcare Inc

  dba Gracepoint

  • Community/Behavioral Health Agency
  • Tampa, FL
  • NPI 1346224011
  Medicare reassignment NPD
• Brave Health Medical Group PA

  • Community/Behavioral Health Agency
  • Miami, FL
  • NPI 1225669161

  TX

  Medicare reassignment
• Ibis Healthcare Inc

  dba Gracepoint

  • Federally Qualified Health Center (FQHC)
  • Tampa, FL
  • NPI 1922777218
  NPD
• Orlando Health Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Winter Park, FL
  • NPI 1265019541
  NPD
• Orlando Health, Inc.

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1184709057
  NPD

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

• Orlando Health, Inc.

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1184709057
  Care Compare affiliation

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

{
    "created_epoch": "1494374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1144756305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 W WARREN AVE",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504038",
            "telephone_number": "407-262-2220",
            "fax_number": "407-834-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 W WARREN AVE",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504038",
            "telephone_number": "407-262-2220",
            "fax_number": "407-834-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODI",
        "first_name": "SURAJ",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-10",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME146061",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Hope Mitchell
• Tamela Mae Mitchell
• Imran Hassan Miyanji, DPT
• Jerome Mobley
• Modern Psychiatry, PA
• Robert B. Molpus, MD
• Brittany Montalvo
• Donny Moon, L.M.T.
• Katherine Morales, MSW
• Michael Morales

• Psychiatry Physician in Longwood, FL
• Providers in Longwood, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.