Sabena Juzer Modi-Masood, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601006961 Issued in MI

Practice address

102 Paul Mellon CT Suite 102
Waldorf, MD 20602-2788

Phone

(301) 645-7414

Fax

(301) 645-7997

NPI assigned

Aug 6, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ashvin J. Patel, M.D. PA

  • Internal Medicine Physician
  • Waldorf, MD
  • NPI 1306140462
  NPD (past)

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

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522800000000",
    "number": "1619386471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 RAMBLEWOOD DR",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488237396",
            "telephone_number": "517-332-1200",
            "fax_number": "517-351-7122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PAUL MELLON CT SUITE 102",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022788",
            "telephone_number": "301-645-7414",
            "fax_number": "301-645-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODI-MASOOD",
        "first_name": "SABENA",
        "middle_name": "JUZER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-06",
        "last_updated": "2018-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0005435",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Belinda J Miranda, PT
• Sanjeeb K Mishra, M.D.
• Dolly Misra, MD
• Scheherazad Mistry, LGPC
• Akaash Hari Mittal, MD
• Anar Ashwinbhai Modi, MD
• Moez L Pirmohamed, MD, LLC
• Nicole Renee Moffett, O.D.
• Mohamed and Rehana Hussain MD, PA
• Mohamed and Rehana Hussain MD, PA

• Physician Assistant in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.