NPIMap

Individual provider Active NPI

Ronak S Modi, M.D.

  • Gastroenterology Physician
  • Fountain Hill, PA
National Provider Identifier
1417283219
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD454591 Issued in PA
Practice address
701 Ostrum St
Suite 201
Fountain Hill, PA 18015-1155
Phone
(484) 526-6545
Fax
(484) 526-6546
NPI assigned
Oct 29, 2009
Last updated
Nov 17, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD454591 PA Primary

Addresses

Primary practice location

701 Ostrum St
Suite 201
Fountain Hill, PA 18015-1155

Mailing address

701 Ostrum St
Suite 201
Fountain Hill, PA 18015-1155
Phone (484) 526-6545

Other identifiers 1

IdentifierTypeStateIssuer
103016310MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150605000364 PA Practitioner - Gastroenterology 5991026718 Reassigns benefits to 2 organizations
I20171220000983 NJ Practitioner - Gastroenterology 5991026718 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

701 Ostrum St
Suite 201
Fountain Hill, PA 18015-1152
Phone (484) 526-6545

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy58
Upper gastrointestinal (GI) endoscopy for acid reflux139

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD454591PAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Warren Physician Group, PC CurrentSince Nov 1, 2017 Accepting new patients
Drexel University CurrentSince Jul 13, 2015 Accepting new patients
St. Luke's Warren Physician Group, PC Current Accepting new patients
St. Luke's Warren Physician Group, PC CurrentSince Nov 1, 2017 Accepting new patients
St. Luke's Physician Group, Inc. Current Accepting new patients
St Luke's Physician Group Inc CurrentSince Dec 1, 2016 Accepting new patients
Drexel University Current Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Dec 1, 2016 Accepting new patients
St. Luke's Physician Group, Inc. Past Accepting new patients

Locations

185 Roseberry St
Bldg 2ND
Phillipsburg, NJ 08865
Phone (908) 847-2619

279 State Route 31 S
Washington, NJ 07882
Phone (908) 689-2201

2200 St Lukes Blvd
Ste 230
Easton, PA 18045
Phone (484) 503-2500

701 Ostrum St
Ste 201
Fountain Hill, PA 18015
Phone (610) 868-1014

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

1427 Vine St
Fl 2
Philadelphia, PA 19102
Phone (215) 762-2530

1427 Vine St
Fl 8
Philadelphia, PA 19102
Phone (215) 762-6660

1601 Cherry St
Ste 11511
Philadelphia, PA 19102

Interoperability endpoints

  • Direct secure messaging: ronak.modi@slpg.direct-sluhn.org

Organizations & group practices 9

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 10

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": "1256774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1417283219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 OSTRUM ST",
            "address_2": "SUITE 201",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180151155",
            "telephone_number": "484-526-6545",
            "fax_number": "484-526-6546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 OSTRUM ST",
            "address_2": "SUITE 201",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180151155",
            "telephone_number": "484-526-6545",
            "fax_number": "484-526-6546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODI",
        "first_name": "RONAK",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-29",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD454591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103016310",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Hill, PA

Sources for this page

Verify at the official NPI Registry.