Individual provider Active NPI

Robert J Modes, DO

  • Emergency Medicine Physician
  • Pontiac, MI
National Provider Identifier
1588289003
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101026330 Issued in MI
Practice address
50 N Perry St
Pontiac, MI 48342-2217
Phone
(248) 338-5392
NPI assigned
Jun 10, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101026330 MI Primary

Addresses

Primary practice location

50 N Perry St
Pontiac, MI 48342-2217

Mailing address

50 N Perry St
Pontiac, MI 48342-2217
Phone (248) 338-5392

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230522002577 MI Practitioner - Emergency Medicine 1951726090 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Hospital GroupGroup PAC ID 2365968351, 366 clinicians

Practice addresses (Care Compare)

1100 S Van Dyke Rd
Bad Axe, MI 48413-9615
Phone (989) 269-9521

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101026330MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Degara App, PLLC Emergency Medicine CurrentSince May 16, 2023 Accepting new patients
McLaren Hospital Group Emergency Medicine CurrentSince Jun 9, 2025 Accepting new patients

Locations

1100 S Van Dyke Rd
Bad Axe, MI 48413
Phone (989) 269-9521

5701 Bow Pointe Dr
Ste 300
Clarkston, MI 48346
Phone (248) 379-4246

2420 Owen Rd
Ste A
Fenton, MI 48430
Phone (810) 496-2460

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

Organizations & group practices 2

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 1

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": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1588289003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N PERRY ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422217",
            "telephone_number": "248-338-5392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N PERRY ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422217",
            "telephone_number": "248-338-5392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODES",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-10",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101026330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.