NPIMap

Individual provider Active NPI

Sachin Surendra Mody, MD

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1730106444
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2006-01714 Issued in NC
Practice address
8930 Blakeney Professional Dr
Charlotte, NC 28277-6660
Phone
(704) 667-3500
NPI assigned
Jul 17, 2006
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2006-01714 NC Primary

Addresses

Primary practice location

8930 Blakeney Professional Dr
Charlotte, NC 28277-6660

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address smody128894@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070409000492 NC Practitioner - Family Practice 7214932482 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, shared by 56 NPIs, 2,324 clinicians
Lifesource of North CarolinaGroup PAC ID 7416132428, 172 clinicians

Practice addresses (Care Compare)

1928 Hwy 84
Weddington, NC 28104-9513
Phone (704) 841-2175

3205 Randall Pkwy
Suite 105
Wilmington, NC 28403-2565
Phone (910) 742-9243

8930 Blakeney Professional Dr
Charlotte, NC 28277-6660
Phone (704) 667-3500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2006-01714NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Feb 25, 2008 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Arboretum Urgent Care Center Family Medicine CurrentSince Jun 23, 2012 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Family Medicine CurrentSince Feb 25, 2008 Accepting new patients
Lifesource Prime Inc Family Medicine CurrentSince Aug 4, 2024 Accepting new patients
Lifesource Prime Inc Family Medicine CurrentSince Aug 4, 2024 Accepting new patients
Carolinas Physicians Network Inc Family Medicine CurrentSince Apr 11, 2012 Accepting new patients
Lifesource of North Carolina CurrentSince Jun 15, 2022 Accepting new patients
Lifesource of North Carolina Family Medicine CurrentSince Jun 15, 2022 Accepting new patients
Union Urgent Care LLC Family Medicine Past Accepting new patients
McLoughlin Family Practice Group Family Medicine Past Accepting new patients
Carolinas Physicians Network Inc Family Medicine Past Accepting new patients
Union Urgent Care LLC Family Medicine Past Accepting new patients
Carolinas Physicians Network Inc. Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

231 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 304-6400

8930 Blakeney Professional Dr
Charlotte, NC 28277
Phone (704) 667-3500

2407 Plantation Center Dr
Matthews, NC 28105
Phone (704) 448-9819

4429 W Highway 27
Vale, NC 28168
Phone (704) 748-2245

3205 Randall Pkwy
Ste 105
Wilmington, NC 28403
Phone (910) 338-2880

Interoperability endpoints

  • Direct secure messaging: smody128894@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1730106444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8930 BLAKENEY PROFESSIONAL DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282776660",
            "telephone_number": "704-667-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODY",
        "first_name": "SACHIN",
        "middle_name": "SURENDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2024-07-15",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2006-01714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smody128894@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "8930 Blakeney Professional Dr",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282776660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.