Active NPI
Modivera Medical PC
- Family Medicine Physician
- Venetia, PA
National Provider Identifier
1700748910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- MODIVERA MEDICAL PC
- Practice address
- 553 Church Hill Rd
Venetia, PA 15367-1144 - Phone
- (412) 965-5341
- Fax
- (412) 965-5341
- NPI assigned
- Nov 25, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Amy Hancock
- Title
- Ceo
- Phone
- (412) 965-5341
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
553 Church Hill Rd
Venetia, PA 15367-1144
Mailing address
553 Church Hill Rd
Venetia, PA 15367-1144
Phone (412) 965-5341
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1764028800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1764028800000",
"number": "1700748910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "553 CHURCH HILL RD",
"city": "VENETIA",
"state": "PA",
"postal_code": "153671144",
"telephone_number": "412-965-5341",
"fax_number": "412-965-5341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "553 CHURCH HILL RD",
"city": "VENETIA",
"state": "PA",
"postal_code": "153671144",
"telephone_number": "412-965-5341",
"fax_number": "412-965-5341"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MODIVERA MEDICAL PC",
"organizational_subpart": "NO",
"enumeration_date": "2025-11-25",
"last_updated": "2025-11-25",
"certification_date": "2025-11-25",
"status": "A",
"authorized_official_last_name": "HANCOCK",
"authorized_official_first_name": "AMY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "412-965-5341"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Venetia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.