Maya Modzelewska, M.D.

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

MD181084 Issued in OR

Practice address

1100 22ND St SE
Salem, OR 97302-6558

Phone

(585) 275-3274

Fax

(585) 442-2949

NPI assigned

Apr 4, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR, HI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physical Medicine and RehabilitationAlso: Pain Management

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Salem Pain and Spine Specialists PCGroup PAC ID 3072780089, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Home Care Services Home health agency, Kaneohe, HI, CCN 127017
• Adventist Health Castle Hospital, Kailua, HI, CCN 120006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Salem Pain and Spine Specialists PC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Salem, OR
  • NPI 1124316567
  Medicare reassignment Care Compare group NPD
• Improving Function

  dba Malama Pain, Spine and Joint Medicine

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Kailua, HI
  • NPI 1184319253
  Medicare reassignment NPD Authorized official
• Big Island Pain Center Inc.

  • Interventional Pain Medicine Physician
  • Hilo, HI
  • NPI 1255683785
  Medicare reassignment NPD
• S&G Labs Hawaii LLC

  • Clinical Medical Laboratory
  • Kailua Kona, HI
  • NPI 1477925188
  NPD (past)

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

• Castle Medical Center

  • General Acute Care Hospital
  • Kailua, HI
  • NPI 1316937691
  Care Compare affiliation
• Western Health Resources

  dba Adventist Health Home Care Services

  • Home Health Agency
  • Kaneohe, HI
  • NPI 1093147886
  Care Compare affiliation

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1790074490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 22ND ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973026558",
            "telephone_number": "503-971-6771",
            "fax_number": "503-385-8421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 22ND ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973026558",
            "telephone_number": "585-275-3274",
            "fax_number": "585-442-2949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "970 N Kalaheo Ave Ste A109",
            "address_purpose": "LOCATION",
            "city": "Kailua",
            "state": "HI",
            "postal_code": "967341868",
            "country_code": "US",
            "telephone_number": "808-501-2235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MODZELEWSKA",
        "first_name": "MAYA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-04",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OR",
            "license": "MD181084",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "OR",
            "license": "MD181084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "maya.modzelewska.p80@direct.wvp.nextgenshare.com",
            "affiliation": "Y",
            "affiliationName": "Salem Pain and Spine Specialists PC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1100 22nd St SE",
            "city": "Salem",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973026558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Salem, OR
• Providers in Salem, OR by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.