Paul Modesto, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY2368 Issued in FL

Practice address

22456 Ensenada Way
Boca Raton, FL 33433-4627

Phone

(561) 213-8865

NPI assigned

Feb 20, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1629113568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 N FEDERAL HWY",
            "address_2": "SUITE 270",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334874910",
            "telephone_number": "561-241-6628",
            "fax_number": "561-241-8651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22456 ENSENADA WAY",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334334627",
            "telephone_number": "561-213-8865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODESTO",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2024-07-12",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY2368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mobilehelp, LLC
• Mobility City Holdings Inc
• Sabrina Mock, PTA
• Modern Care Collective, LLC
• Modern Medicine Inc
• Elizabeth Eloise Moffett, LMHC
• Mogell Dental Associates
• Kenneth A Mogell, D.M.D.
• Maryam Moghareh, MD
• Mehrnoush Mohammadpour, PHARMD

• Clinical Psychologist in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.

Verify at the official NPI Registry.