Individual provider Active NPI

Shrey Modi, M.D.

  • Colon & Rectal Surgery Physician
  • Bettendorf, IA
National Provider Identifier
1336671593
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
MD-51537 Issued in IA
Practice address
4500 Utica Ridge Rd # Surgery
Bettendorf, IA 52722-1626
Phone
(563) 742-5300
NPI assigned
Mar 28, 2017
Last updated
Jun 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X MD-51537 IA Primary
Colon & Rectal Surgery Physician 208C00000X 036.165921 IL
Colon & Rectal Surgery Physician 208C00000X 2026013958 MO

Addresses

Primary practice location

4500 Utica Ridge Rd # Surgery
Bettendorf, IA 52722-1626

Mailing address

4480 Utica Ridge Rd Ste 1124
Bettendorf, IA 52722-1644

Other practice location 1

3801 S National Ave Ste 130
Springfield, MO 65807-6162
Phone (417) 730-7160

Other practice location 2

1001 E Primrose St
Springfield, MO 65807-5155
Phone (417) 875-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, IL, MO3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20230824003653 IA Practitioner - General SurgeryPractitioner - Colorectal Surgery (Proctology) 8628456795 Reassigns benefits to 1 organization
I20230906000890 IL Practitioner - General SurgeryPractitioner - Colorectal Surgery (Proctology) 8628456795 Reassigns benefits to 1 organization
I20260608001874 MO Practitioner - Colorectal Surgery (Proctology) 8628456795

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Colorectal Surgery (Proctology)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4480 Utica Ridge Rd
Suite 1124
Bettendorf, IA 52722-1644
Phone (563) 742-5300

600 John Deere Rd
Suite 301
Moline, IL 61265-6812
Phone (309) 779-4850

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy14
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-51537IAMDColon & Rectal Surgery Physician
036.165921ILMDColon & Rectal Surgery Physician
2026013958MOMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation CurrentSince Sep 11, 2023 Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 1124
Bettendorf, IA 52722
Phone (563) 742-5300

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

4500 Utica Ridge Rd
Bettendorf, IA 52722
Phone (563) 742-2724

1776 Westlakes Pkwy
Ste 400
West Des Moines, IA 50266
Phone (515) 241-6161

600 N College Ave
Ste 120
Geneseo, IL 61254
Phone (309) 944-5342

600 John Deere Rd
Ste 301
Moline, IL 61265
Phone (309) 779-4400

Interoperability endpoints

  • Direct secure messaging: smodi991195@direct.unitypoint.org

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1336671593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4480 UTICA RIDGE RD STE 1124",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 UTICA RIDGE RD # SURGERY",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221626",
            "telephone_number": "563-742-5300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3801 S National Ave Ste 130",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658076162",
            "country_code": "US",
            "telephone_number": "417-730-7160",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 E Primrose St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658075155",
            "country_code": "US",
            "telephone_number": "417-875-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MODI",
        "first_name": "SHREY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-28",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "IA",
            "license": "MD-51537",
            "primary": true
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "IL",
            "license": "036.165921",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "MO",
            "license": "2026013958",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

Verify at the official NPI Registry.