Active NPI
John Gregory Modrall, MD
- Vascular Surgery Physician
- Dallas, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- K6159
- Practice address
- 5323 Harry Hines Blvd
Dallas, TX 75390-7208 - Phone
- (214) 645-0538
- Fax
- (214) 645-0546
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | K6159 | TX | |
| Vascular Surgery Physician | 2086S0129X | K6159 | TX | Primary |
| Vascular Surgery Physician | 2086S0129X | E-7074 | AR |
Addresses
Primary practice location
5323 Harry Hines Blvd
Dallas, TX 75390-7208
Mailing address
PO Box 845347
Dallas, TX 75284-5347
Phone (214) 645-0545
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8D1525 | Other | TX | MEDICARE |
| 106174903 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- University of Colorado School of Medicine, Denver, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5201 Harry Hines Blvd
Dallas, TX 75235-7708
Phone (214) 590-5582
5201 Harry Hines VLVD
Dallas, TX 75235-7708
Phone (214) 590-5582
6201 Harry Hines Blvd
Dallas, TX 75235-5202
Phone (817) 987-3955
6202 Harry Hines Blvd
Dallas, TX 75235-5202
Phone (469) 488-7000
Hospital & facility affiliations
- Ut of Texas Southwestern University Hospital - William P. Clements Jr.
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.87 of 100
- Quality
- 70.15
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.75
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| K6159 | TX | MD | Surgery Physician |
| E-7074 | AR | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Texas Southwestern Medical Center at Dallas | Current | Accepting new patients | |
| The University of Texas Southwestern Medical Center at Dallas | Current | Accepting new patients | |
| University of Texas Southwestern Medical Center at Dallas | Vascular Surgery | Current | Accepting new patients |
Locations
5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396
3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591
5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390
Interoperability endpoints
- greg.modrall@direct.swmed.us
Organizations & group practices 3
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.
-
- Anesthesiology Physician
- Dallas, TX
- NPI 1942270566
-
- Clinical Medical Laboratory
- Dallas, TX
- NPI 1396832713
-
- Vascular Surgery Physician
- Dallas, TX
- NPI 1134173966
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Dallas, TX
- NPI 1285798918
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445212800000",
"number": "1457435398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 845347",
"city": "DALLAS",
"state": "TX",
"postal_code": "752845347",
"telephone_number": "214-645-0545",
"fax_number": "214-645-0546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5323 HARRY HINES BLVD",
"city": "DALLAS",
"state": "TX",
"postal_code": "753907208",
"telephone_number": "214-645-0538",
"fax_number": "214-645-0546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MODRALL",
"first_name": "JOHN",
"middle_name": "GREGORY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2015-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TX",
"license": "K6159",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "TX",
"license": "K6159",
"primary": true
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "AR",
"license": "E-7074",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "8D1525",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "106174903",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; 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.