Pratibha Modi, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301043398 Issued in MI

Practice address

16800 W 12 Mile Rd
Ste 205
Southfield, MI 48076-2108

Phone

(248) 559-0900

Fax

(248) 559-0011

NPI assigned

Oct 27, 2005

Last updated

Oct 22, 2020By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: pmodi27551@direct.beaumont.edu

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.

• Southfield Internists PC

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1760573075
  Authorized official Same address or phone

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1184614349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16800 W 12 MILE RD",
            "address_2": "STE 205",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762108",
            "telephone_number": "248-559-0900",
            "fax_number": "248-559-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16800 W 12 MILE RD",
            "address_2": "STE 205",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762108",
            "telephone_number": "248-559-0900",
            "fax_number": "248-559-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODI",
        "first_name": "PRATIBHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-27",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301043398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmodi27551@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "16800 W 12 Mile Rd",
            "address_2": "Ste 205",
            "city": "Southfield",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480762108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mobility Home Health Care Inc
• Pamela Ann Mobley
• Modern Home Health Care Inc.
• Modern Medical Equipments Inc
• Katelynn Modert
• Suchi R Modi, RPT
• Keira Modreske
• Yogesh Mody, MD
• Lisa Modzel
• Amanda Mogielski

• Internal Medicine Physician in Southfield, MI
• Providers in Southfield, 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 Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.