Active NPI
Kalpit Rajesh Modi, MD
- Emergency Medicine Physician
- Worcester, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 1018202
- Practice address
- 55 Lake Ave N
Worcester, MA 01655-0002 - Phone
- (508) 421-1400
- Fax
- (508) 421-1490
- NPI assigned
- Jun 21, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 1018202 | MA | Primary |
| Emergency Medicine Physician | 207P00000X | MT223864 | PA |
Addresses
Primary practice location
55 Lake Ave N
Worcester, MA 01655-0002
Mailing address
PO Box 415348
Boston, MA 02241-5348
Other practice location 1
5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (484) 622-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- University of Minnesota Medical School, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000
Hospital & facility affiliations
- Umass Memorial Healthalliance Hospitals
- Umass Memorial Medical Center/University Campus
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1018202 | MA | MD | Emergency Medicine Physician |
| MT223864 | PA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Umass Memorial Medical Group Inc | Emergency Medicine | Current | Accepting new patients |
| Umass Memorial Medical Group, Inc. | Current | Accepting new patients |
Locations
55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862
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.
-
- Internal Medicine Physician
- Worcester, MA
- NPI 1760445373
Emergency Medicine
-
- Urgent Care Clinic/Center
- Oxford, MA
- NPI 1982381018
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Leominster, MA
- NPI 1013995133
-
- Psychiatric Hospital Unit
- Clinton, MA
- NPI 1285171934
-
- General Acute Care Hospital
- Worcester, MA
- NPI 1831151455
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712016000000",
"number": "1659940112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 415348",
"city": "BOSTON",
"state": "MA",
"postal_code": "022415348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 LAKE AVE N",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016550002",
"telephone_number": "508-421-1400",
"fax_number": "508-421-1490"
}
],
"practiceLocations": [
{
"address_1": "5501 Old York Rd",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191413018",
"country_code": "US",
"telephone_number": "484-622-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MODI",
"first_name": "KALPIT",
"middle_name": "RAJESH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-21",
"last_updated": "2024-04-02",
"certification_date": "2024-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MA",
"license": "1018202",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "PA",
"license": "MT223864",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.