Darryk James Modracek, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA00313 Issued in RI

Practice address

593 Eddy St
Rhode Island Hospital. Dept of Cardiac Surgery (Ctic)
Providence, RI 02903-4923

Phone

(401) 444-5150

NPI assigned

May 9, 2007

Sex

Male

Sole proprietor

Yes

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

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

Physician Assistant

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rhode Island HospitalGroup PAC ID 8921900044, 430 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rhode Island Hospital Hospital, Providence, RI, CCN 410007
• The Miriam Hospital Hospital, Providence, RI, CCN 410012

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dmodracek9748@brownhealth.medalliesdirect.net

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.

• Rhode Island Hospital

  • Multi-Specialty Clinic/Center
  • Providence, RI
  • NPI 1154537520
  Medicare reassignment Care Compare group NPD
• Lifespan Physician Group, Inc.

  • General Practice Physician
  • Providence, RI
  • NPI 1407116643
  Medicare reassignment NPD
• Lifespan Corporation

  • Children's Rehabilitation Hospital
  • Providence, RI
  • NPI 1790221232
  NPD
• Lifespan Physician Group, Inc.

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678

  Physician Assistant

  NPD
• Rhode Island Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1972768174
  NPD

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

• Rhode Island Hospital

  • Ambulance
  • Providence, RI
  • NPI 1053552299

  Hospital

  Care Compare affiliation
• Rhode Island Hospital

  • Clinic/Center
  • Providence, RI
  • NPI 1154663383

  Hospital

  Care Compare affiliation
• Rhode Island Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1588659528
  Care Compare affiliation
• Rhode Island Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1972768174
  Care Compare affiliation
• The Miriam Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1487649430
  Care Compare affiliation

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394755200000",
    "number": "1780898932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 DR BRALEY RD",
            "city": "ROCHESTER",
            "state": "MA",
            "postal_code": "027701900",
            "telephone_number": "508-858-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "RHODE ISLAND HOSPITAL. DEPT OF CARDIAC SURGERY (CTIC)",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODRACEK",
        "first_name": "DARRYK",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2014-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA00313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Mittner, LICSW
• Danielle F Miyagishima, M.D., PH.D.
• Areum Mo, RPH
• Bijan Moazezi
• Amy Modracek, RD
• Christopher Mogilski
• Fnu Mohammad Hazique
• Yasmeen Olivia Mohammad
• Krisztina Moldovan
• Martina Molina

• Physician Assistant in Providence, RI
• Providers in Providence, RI by specialty
• Physician Assistant in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2014; 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.