Individual provider Active NPI

Sejal Priyalkumar Modi

  • Physical Therapist
  • Edison, NJ
National Provider Identifier
1669981643
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
041718-1 Issued in NY
Practice address
323 Horizon Dr
Edison, NJ 08817-5750
Phone
(405) 778-0474
NPI assigned
Sep 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 041718-1 NY Primary

Addresses

Primary practice location

323 Horizon Dr
Edison, NJ 08817-5750

Mailing address

323 Horizon Dr
Edison, NJ 08817-5750
Phone (405) 778-0474

Other practice location 1

460 Grand St
New York, NY 10002-4058
Phone (405) 778-0474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231116000247 NJ Practitioner - Physical Therapist in Private Practice 6608223474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prime Care Physical Therapy LLCGroup PAC ID 7214356443, 2 clinicians

Practice addresses (Care Compare)

109 White Oak LN
Suite 54
Old Bridge, NJ 08857-1981
Phone (708) 663-9200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041718-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Care Physical Therapy LLC CurrentSince Oct 3, 2023 Accepting new patients

Locations

109 White Oak Ln
Ste 54
Old Bridge, NJ 08857
Phone (708) 663-9200

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1506038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1669981643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 HORIZON DR",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088175750",
            "telephone_number": "405-778-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 HORIZON DR",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088175750",
            "telephone_number": "405-778-0474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "460 Grand St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100024058",
            "country_code": "US",
            "telephone_number": "405-778-0474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MODI",
        "first_name": "SEJAL",
        "middle_name": "PRIYALKUMAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-22",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "041718-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.