Poonam Modha, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD12839 Issued in RI

Practice address

455 Toll Gate Rd
Psychiatry Liaison Clinic
Warwick, RI 02886

Phone

(401) 737-7010

NPI assigned

Feb 1, 2007

Sex

Female

Sole proprietor

No

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 RI, MA2 enrollments

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 2

Specialty

Psychiatry

Education

University of Massachusetts Medical School, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Affinity Physicians LLC.Group PAC ID 0244413391, 723 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kent County Memorial Hospital Hospital, Warwick, RI, CCN 410009

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Affinity Physicians LLC.

  • Internal Medicine Physician
  • Warwick, RI
  • NPI 1184944662

  Psychiatry

  Medicare reassignment Care Compare group NPD
• The McLean Hospital Corporation

  dba McLean Professional Practice Group

  • Psychiatry Physician
  • Belmont, MA
  • NPI 1114979580
  Medicare reassignment NPD
• Affinity Physicians LLC

  • Anesthesiology Physician
  • Providence, RI
  • NPI 1053038471
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kent County Memorial Hospital

  dba Kent County Hospital Rehab Unit

  • Rehabilitation Hospital Unit
  • Warwick, RI
  • NPI 1023017944
  Care Compare affiliation
• Kent County Memorial Hospital

  • General Acute Care Hospital
  • Warwick, RI
  • NPI 1386643294
  Care Compare affiliation

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1679611842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "address_2": "PRC AND CREDENTIALING",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759",
            "telephone_number": "401-273-0641",
            "fax_number": "401-273-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "address_2": "PSYCHIATRY LIAISON CLINIC",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "02886",
            "telephone_number": "401-737-7010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "345 Blackstone Blvd",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029064800",
            "country_code": "US",
            "telephone_number": "401-455-6571",
            "fax_number": "401-455-6293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MODHA",
        "first_name": "POONAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "RI",
            "license": "MD12839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Thomas Mitchell, FNP-C
• Matthew Bryant Mitchell, DPT
• Stephanie Lynn Mitchell, LMHC
• Mji Inc
• Lia Marie Moceri
• Nadeem Hashim Mohammed, MD
• Rose A Molina, LICSW
• Cassidy F Molinare
• Shyla Mae Mollo, LCSW
• Momentum Inc.

• Psychiatry Physician in Warwick, RI
• Providers in Warwick, RI by specialty
• Psychiatry Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; 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.

Verify at the official NPI Registry.