Dimple Modi, MD

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

068678 Issued in GA

Practice address

550 Redmond Rd NW
Rome, GA 30165-1416

Phone

(762) 235-3200

Fax

(706) 233-8503

NPI assigned

Jun 21, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Ophthalmology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Richard Carlin MD PCGroup PAC ID 4183693641, 10 clinicians

Harbin Clinic LLCGroup PAC ID 0446154231, 238 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.23 of 100Reported as group

Quality

65.74

Promoting interoperability

100

Improvement activities

40

Cost

78.37

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dmodi3005149@carolinashealthcaresystem.direct-ci.com

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.

• Harbin Clinic, LLC

  • Multi-Specialty Clinic/Center
  • Rome, GA
  • NPI 1679599088
  Medicare reassignment Care Compare group NPD
• Richard Carlin MD PC

  • Specialist
  • Snellville, GA
  • NPI 1538364815
  Medicare reassignment Care Compare group NPD
• Harbin Clinic, LLC

  • Ambulatory Surgical Clinic/Center
  • Rome, GA
  • NPI 1447385158
  NPD
• Harbin Clinic, LLC

  • Ambulatory Surgical Clinic/Center
  • Cartersville, GA
  • NPI 1467016055
  NPD

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1205032844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 TECHNOLOGY PKWY NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651369",
            "telephone_number": "762-235-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 REDMOND RD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651416",
            "telephone_number": "762-235-3200",
            "fax_number": "706-233-8503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2377 Lenora Church Rd",
            "address_purpose": "LOCATION",
            "city": "Snellville",
            "state": "GA",
            "postal_code": "300783232",
            "country_code": "US",
            "telephone_number": "770-979-2020",
            "fax_number": "770-978-3321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MODI",
        "first_name": "DIMPLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "068678",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "GA",
            "license": "068678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dimple.modi.1@1498.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "550 Redmond Rd NW",
            "city": "Rome",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301651416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael K Mitchell
• Victoria C Mitchell, MOT
• Lindsay Moates, NP
• Mobile Med LLC
• Elizabeth Grace Mobley
• Alejandra Molinar, BS
• Jonathon Richard Molnar, MD
• Edwin Clark Montague, D.O.
• Elizabeth Teel Montague
• Rebecca Jordan Montero, M.S.

• Retina Specialist (Ophthalmology) Physician in Rome, GA
• Providers in Rome, GA by specialty
• Retina Specialist (Ophthalmology) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.