NPIMap

Individual provider Active NPI

Jignesh M Modi, MD

  • Vascular & Interventional Radiology Physician
  • New City, NY
National Provider Identifier
1508062167
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
25455 Issued in OK
Practice address
18 Squadron Blvd
New City, NY 10956-5210
Phone
(845) 634-9729
NPI assigned
Jun 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 25455 OK Primary

Addresses

Primary practice location

18 Squadron Blvd
New City, NY 10956-5210

Mailing address

18 Squadron Blvd
New City, NY 10956-5210
Phone (845) 634-9729

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130815000209 CT Practitioner - Diagnostic Radiology 3375621063 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2001
Medicare assignment
May accept Medicare assignment
Group practices
Diagnostic Imaging Services of CT LLCGroup PAC ID 3577465111, 18 clinicians
Midstate Radiology Associates LLCGroup PAC ID 4880593565, 89 clinicians
Starling Physicians, PLLCGroup PAC ID 7517863749, 276 clinicians
Meriden Imaging Center IncGroup PAC ID 4385683556, 56 clinicians

Practice addresses (Care Compare)

1 Towne Park PLZ
Norwich, CT 06360-2247
Phone (203) 949-2700

100 Grand St
New Britain, CT 06052-2016
Phone (203) 949-2700

375 Willard Ave
Newington, CT 06111-2300
Phone (860) 258-3480

863 N Main St Ext
Wallingford, CT 06492-2434

Hospital & facility affiliations

  • William W Backus Hospital Hospital, Norwich, CT, CCN 070024
  • Midstate Medical Center Hospital, Meriden, CT, CCN 070017
  • The Hospital of Central Connecticut Hospital, New Britain, CT, CCN 070035
  • Windham Community Memorial Hospital Hospital, Willimantic, CT, CCN 070021
  • Griffin Hospital Hospital, Derby, CT, CCN 070031

Merit-based Incentive Payment System (MIPS)

Final score
86.02 of 100Reported as group
Quality
82.26
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.37 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25455OKMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Imaging Services of CT, LLC Vascular & Interventional Radiology CurrentSince Jul 18, 2016 Accepting new patients
Midstate Radiology Associates, LLC Vascular & Interventional Radiology CurrentSince Jul 18, 2016 Accepting new patients
Starling Physicians, PLLC CurrentSince Oct 1, 2024 Accepting new patients
Meriden Imaging Center, Inc. Vascular & Interventional Radiology CurrentSince Jul 18, 2016 Accepting new patients
Starling Physicians PLLC CurrentSince Oct 1, 2024 Accepting new patients
North Country Drug Inc. PastSince Nov 29, 2014 Accepting new patients

Locations

100 Simsbury Rd
Avon, CT 06001
Phone (860) 659-8830

680 S Main St
Cheshire, CT 06410
Phone (203) 272-3595

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

375 Willard Ave
Newington, CT 06111
Phone (860) 666-5252

1 Towne Park Plz
Norwich, CT 06360
Phone (860) 886-1433

201 N Mountain Rd
Plainville, CT 06062
Phone (860) 224-5416

863 N Main Street Ext
Wallingford, CT 06492

101 N Plains Rd
Wallingford, CT 06492
Phone (203) 265-0018

Organizations & group practices 6

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.

Hospital & facility affiliations 9

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": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429747200000",
    "number": "1508062167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 SQUADRON BLVD",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109565210",
            "telephone_number": "845-634-9729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 SQUADRON BLVD",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109565210",
            "telephone_number": "845-634-9729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODI",
        "first_name": "JIGNESH",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-21",
        "last_updated": "2015-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "OK",
            "license": "25455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New City, NY

Sources for this page

Verify at the official NPI Registry.