Active NPI
Vijay Modur, MD
- Clinical Pathology Physician
- Acton, MA
National Provider Identifier
1821551979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Pathology Physician
- License
- 2010013501
- Practice address
- 3 Squirrel Hill Rd
Acton, MA 01720-2017 - Phone
- (610) 409-8366
- NPI assigned
- Apr 6, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Pathology Physician | 207ZC0006X | 2010013501 | MO | Primary |
Addresses
Primary practice location
3 Squirrel Hill Rd
Acton, MA 01720-2017
Mailing address
50 Binney St
Cambridge, MA 02142-1512
Phone (508) 308-6173
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010013501 | MO | MD | Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554508800000",
"number": "1821551979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 BINNEY ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021421512",
"telephone_number": "508-308-6173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 SQUIRREL HILL RD",
"city": "ACTON",
"state": "MA",
"postal_code": "017202017",
"telephone_number": "610-409-8366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MODUR",
"first_name": "VIJAY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-06",
"last_updated": "2019-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "207ZC0006X",
"taxonomy_group": "",
"desc": "Pathology, Clinical Pathology",
"state": "MO",
"license": "2010013501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Acton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.