Active NPI
Michelle Sarah Modaff, D.D.S.
- General Practice Dentistry
- Avon Park, FL
National Provider Identifier
1497768295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- HAD 33
- Practice address
- 950 County Road 17a W
Avon Park, FL 33825-2164 - Phone
- (863) 452-3000
- NPI assigned
- Aug 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | HAD 33 | FL | Primary |
Addresses
Primary practice location
950 County Road 17a W
Avon Park, FL 33825-2164
Mailing address
47 5TH St NW
Winter Haven, FL 33881-4672
Phone (863) 268-7850
Other names 1
- Dr. Michelle Sarah Trifu
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151103001646 | FL | Order and Referring Only - Dentist | 0547570533 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HAD 33 | FL | MD | General Practice Dentistry |
Practice roles (8 of 9)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Florida Health Care, Inc. | General Practice | Past | Accepting new patients |
| Central Florida Health Care Inc | General Practice | Past | Accepting new patients |
| Central Florida Health Care, Inc. | Past | Accepting new patients | |
| Central Florida Health Care, Inc. | Past | Accepting new patients | |
| Central Florida Health Care, Inc | Past | Accepting new patients | |
| Central Florida Health Care, Inc. | General Practice | Past | Accepting new patients |
| Central Florida Health Care, Inc. | Past | Accepting new patients | |
| Central Florida Health Care, Inc | General Practice | Past | Accepting new patients |
Networks
- Freedom Health HMO Network
Interoperability endpoints
- michelle.modaff.1@12125.direct.athenahealth.com
Organizations & group practices 8
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.
-
- Federally Qualified Health Center (FQHC)
- Winter Haven, FL
- NPI 1467752998
General Practice
-
- Federally Qualified Health Center (FQHC)
- Bartow, FL
- NPI 1407615826
-
- Federally Qualified Health Center (FQHC)
- Avon Park, FL
- NPI 1831232669
General Practice
-
- Federally Qualified Health Center (FQHC)
- Dundee, FL
- NPI 1063408813
-
- Federally Qualified Health Center (FQHC)
- Avon Park, FL
- NPI 1063409290
General Practice
-
- Federally Qualified Health Center (FQHC)
- Lakeland, FL
- NPI 1386835064
-
- Multi-Specialty Clinic/Center
- Dundee, FL
- NPI 1720247588
-
- Federally Qualified Health Center (FQHC)
- Wauchula, FL
- NPI 1790116911
General Practice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555027200000",
"number": "1497768295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 5TH ST NW",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338814672",
"telephone_number": "863-268-7850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 COUNTY ROAD 17A W",
"city": "AVON PARK",
"state": "FL",
"postal_code": "338252164",
"telephone_number": "863-452-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MODAFF",
"first_name": "MICHELLE",
"middle_name": "SARAH",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-14",
"last_updated": "2019-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "HAD 33",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MICHELLE",
"last_name": "TRIFU",
"middle_name": "SARAH",
"prefix": "DR.",
"credential": "D.D.S.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Avon Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.