Viraj Indravadan Modi, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

55017 Issued in CT

Practice address

Uconn Medical Group
263 Farmington Avenue
Farmington, CT 06030-0001

Phone

(860) 679-4477

Fax

(860) 679-4474

NPI assigned

Mar 19, 2011

Last updated

Sep 29, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1154425288
  Medicare reassignment NPD
• The Hospital of Central Connecticut at New Britain General and Bradley

  dba The Hospital of Central Connecticut

  • Hospitalist Physician
  • New Britain, CT
  • NPI 1063461481

  Internal Medicine

  Medicare reassignment NPD
• University of Connecticut Health Center

  dba University Physicians

  • General Practice Physician
  • Farmington, CT
  • NPI 1720083769

  Internal Medicine

  Medicare reassignment NPD
• Midstate Medical Center

  • Psychiatric Hospital Unit
  • Meriden, CT
  • NPI 1316022718
  NPD
• The Hospital of Central Connecticut at New Britain General and Bradley

  dba The Hospital of Central Connecticut

  • Psychiatric Hospital Unit
  • New Britain, CT
  • NPI 1992867006
  NPD
• University of Connecticut Health Center

  dba University Physicians

  • Durable Medical Equipment & Medical Supplies
  • Farmington, CT
  • NPI 1104809375
  NPD
• University of Connecticut Health Center

  • Clinical Medical Laboratory
  • Farmington, CT
  • NPI 1427031293
  NPD (past)

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

{
    "created_epoch": "1300492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1811296684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UCONN MEDICAL GROUP",
            "address_2": "263 FARMINGTON AVENUE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060300001",
            "telephone_number": "860-679-4477",
            "fax_number": "860-679-4474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UCONN MEDICAL GROUP",
            "address_2": "263 FARMINGTON AVENUE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060300001",
            "telephone_number": "860-679-4477",
            "fax_number": "860-679-4474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODI",
        "first_name": "VIRAJ",
        "middle_name": "INDRAVADAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-19",
        "last_updated": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS12190",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "55017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "14V1L",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012203500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vmodi10899@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "Uconn Medical Group",
            "address_2": "263 Farmington Avenue",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060300001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mitra Kabakoff D.D.D., PLLC
• Ashita Mittal, DO
• Sanjay Mittal, M.D.
• MLT Wellness, LLC
• Niala Moallem, MD
• Laura Moehringer, LCSW
• Amir Mohammad, M.D., MPH
• Shivani Mohan, MD
• Ibrahim Mohsin, MD
• Emilie Mojica, O.D.

• Internal Medicine Physician in Farmington, CT
• Providers in Farmington, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.