Nilesh K Modi

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ14984700 Issued in NJ

Practice address

651 High St
Burlington, NJ 08016-2737

Phone

(609) 386-0775

NPI assigned

Jan 19, 2023

Last updated

Nov 25, 2024By the provider in NPPES

Sex

Male

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

Enrolled in NJ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Jersey Family Medical Centers, IncGroup PAC ID 0547170763, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southern Jersey Family Medical Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Hammonton, NJ
  • NPI 1568473973
  Medicare reassignment Care Compare group NPD
• Southern Jersey Family Medical Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pemberton, NJ
  • NPI 1205951019
  NPD
• Southern Jersey Family Medical Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Burlington City, NJ
  • NPI 1265557326
  NPD (past)

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

{
    "created_epoch": "1674086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1700591153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1309",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080536309",
            "telephone_number": "609-567-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 HIGH ST",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "080162737",
            "telephone_number": "609-386-0775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Pemberton Browns Mills Rd",
            "address_purpose": "LOCATION",
            "city": "Pemberton",
            "state": "NJ",
            "postal_code": "080681537",
            "country_code": "US",
            "telephone_number": "609-894-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MODI",
        "first_name": "NILESH",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-19",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NJ",
            "license": "26NR18978700",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ14984700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pria Milledge, LPN
• Anissa Miller, CNA
• Mindful Living Therapy and Counseling
• Mindfully Healing Mental and Behavioral Wellness Services
• Beth A Mitchell, MSW, LCSW
• Bibi Mohamed, LPN
• Jacqueline M Moloney
• Denise Mongiello, LPN
• Deborah Ann Montebeelo, LPN
• Jennie Marie Mooney, OTR

• Family Nurse Practitioner in Burlington, NJ
• Providers in Burlington, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.

Verify at the official NPI Registry.