Modini Chintha Liyanage, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301074724 Issued in MI

Practice address

1203 S Wayne Rd
Westland, MI 48186-4362

Phone

(734) 729-5780

Fax

(734) 729-7730

NPI assigned

Sep 22, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Enrolled in MI

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

Family Practice

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sciometrix LLCGroup PAC ID 7618367087, 58 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Corewell Health Wayne Hospital Hospital, Wayne, MI, CCN 230142
• Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020
• St Joe Mercy Hospital System Livonia Hospital, Livonia, MI, CCN 230002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FIGBDD/Endpoint/FIGBDD

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.

• Modini Liyanage PLLC

  • Family Medicine Physician
  • Westland, MI
  • NPI 1588353593
  Medicare reassignment NPD Authorized official
• Sciometrix LLC

  • General Practice Physician
  • Royal Oak, MI
  • NPI 1619649894
  Medicare reassignment Care Compare group NPD
• Wayne Medical Center PLLC

  • Family Medicine Physician
  • Westland, MI
  • NPI 1134661143
  NPD Authorized official
• Sciometrix Inc

  • General Practice Physician
  • Staten Island, NY
  • NPI 1457065591
  NPD
• American Indian Health and Family Services of Southeastern Mi Inc

  • Federally Qualified Health Center (FQHC)
  • Detroit, MI
  • NPI 1366552804

  Family Medicine

  NPD (past)

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

• Oakwood Healthcare Inc

  • Community Health Clinic/Center
  • Dearborn, MI
  • NPI 1790414670

  Hospital

  Care Compare affiliation
• Oakwood Healthcare, Inc.

  • General Acute Care Hospital
  • Wayne, MI
  • NPI 1295785285
  Care Compare affiliation
• Oakwood Healthcare, Inc.

  • General Acute Care Hospital
  • Dearborn, MI
  • NPI 1740230119
  Care Compare affiliation
• St Mary Mercy Hospital

  • General Acute Care Hospital
  • Livonia, MI
  • NPI 1790706901
  Care Compare affiliation

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297987200000",
    "number": "1457450413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 S WAYNE RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481864362",
            "telephone_number": "734-729-5780",
            "fax_number": "734-729-7730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 S WAYNE RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481864362",
            "telephone_number": "734-729-5780",
            "fax_number": "734-729-7730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIYANAGE",
        "first_name": "MODINI",
        "middle_name": "CHINTHA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2011-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301074724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDWEST HEALTH PLAN",
            "identifier": "023685",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCE NUMBER",
            "identifier": "4301074724",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CHOICES PPO PIN",
            "identifier": "139077",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP PIN",
            "identifier": "H98425",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPE HEALTH PLAN PIN",
            "identifier": "00000009780A",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GROUP PIN",
            "identifier": "700H221880",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES PIN",
            "identifier": "139077",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PIN",
            "identifier": "2725155",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "7589557",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4626563",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Katherine Welk Litow, M.D.
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• Sabrina Lividini
• Alexandra Ljubic, LMSW
• Bernard S Lofman, D.O.
• Judith G Lolas, LMSW ACSW
• Louis C. Tegtmeyer, D.O. P.C.
• Jaavaid Love

• Family Medicine Physician in Westland, MI
• Providers in Westland, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2011; 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.