Active NPI
Kathan Modi, APN
- Family Nurse Practitioner
- Edison, NJ
National Provider Identifier
1710537634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 26NJ00959800
- Practice address
- 138 Winthrop Rd
Edison, NJ 08817-3834 - Phone
- (848) 248-0214
- NPI assigned
- Sep 12, 2019
- 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 |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 26NJ00959800 | NJ | |
| Family Nurse Practitioner | 363LF0000X | 26NJ00959800 | NJ | Primary |
Addresses
Primary practice location
138 Winthrop Rd
Edison, NJ 08817-3834
Mailing address
138 Winthrop Rd
Edison, NJ 08817-3834
Phone (848) 248-0214
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ, CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Rutgers New Jersey Medical School, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
14 -20 Prospect St
East Orange, NJ 07017-2238
Phone (973) 672-2025
152 Campmeeting Rd
Bolton, CT 06043-7528
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ00959800 | NJ | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Villagehealth DM LLC | Current | Accepting new patients |
Locations
2000 16th St
Fl 8
Denver, CO 80202
2000 16th St
Denver, CO 80202
Phone (253) 733-4500
14-20 Prospect St
East Orange, NJ 07017
Phone (720) 631-1142
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
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": "1568246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568246400000",
"number": "1710537634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "138 WINTHROP RD",
"city": "EDISON",
"state": "NJ",
"postal_code": "088173834",
"telephone_number": "848-248-0214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "138 WINTHROP RD",
"city": "EDISON",
"state": "NJ",
"postal_code": "088173834",
"telephone_number": "848-248-0214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MODI",
"first_name": "KATHAN",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-12",
"last_updated": "2019-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "NJ",
"license": "26NJ00959800",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NJ",
"license": "26NJ00959800",
"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 Sep 12, 2019; 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.