Angela Russell Modi, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9112371 Issued in FL

Practice address

5 Tampa General Cir Ste 410
Tampa, FL 33606-3578

Phone

(813) 844-7473

Fax

(813) 844-1966

NPI assigned

Aug 7, 2014

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: amodi166790@direct.tgh.org
• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Old Dominion Anesthesia LLC

  • Anesthesiology Physician
  • Charlottesville, VA
  • NPI 1902248677
  NPD (past)

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

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1326457920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1289",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336011289",
            "telephone_number": "813-844-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 TAMPA GENERAL CIR STE 410",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063578",
            "telephone_number": "813-844-7473",
            "fax_number": "813-844-1966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODI",
        "first_name": "ANGELA",
        "middle_name": "RUSSELL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-07",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.005098",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9112371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natsuko Moden, PA-C
• Modern Life Counseling LLC
• Kristen Modesitt, LCSW
• Ami Sonia Modh, D.O.
• Ashok K Modh, M.D.
• Jalpa Modi, PHARMD, RPH
• Susan Snyder Modi, ARNP
• Jeffrey Victor Moffett, DMD
• Moffitt Cancer Center & Research Institute
• Joseph Kevin Moffitt, MD

• Physician Assistant in Tampa, FL
• Providers in Tampa, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.