Lyle Terrence Modlin, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

00631 Issued in MD

Practice address

43 Old Solomons Island Rd
Suite 102
Annapolis, MD 21401-3850

Phone

(410) 263-3100

Fax

(410) 263-7380

NPI assigned

Jul 31, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Temple University School of Podiatric Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Potomac Podiatry PLLC

  • Foot & Ankle Surgery Podiatrist
  • Crofton, MD
  • NPI 1972171411
  NPD
• Potomac Podiatry PLLC

  • Foot & Ankle Surgery Podiatrist
  • Woodbridge, VA
  • NPI 1184731549
  NPD

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398124800000",
    "number": "1851307045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 OLD SOLOMONS ISLAND RD",
            "address_2": "SUITE 102",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013850",
            "telephone_number": "410-263-3100",
            "fax_number": "410-263-7380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 OLD SOLOMONS ISLAND RD",
            "address_2": "SUITE 102",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013850",
            "telephone_number": "410-263-3100",
            "fax_number": "410-263-7380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODLIN",
        "first_name": "LYLE",
        "middle_name": "TERRENCE",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2014-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MD",
            "license": "00631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "463068800",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4081901",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ilana Mittman
• MKM Home Care, LLC
• Modern Dermatology of Maryland, LLC
• Jitendrakumar Rajnikant Modi, M.D.
• Kim Modica
• Milan Pankaj Mody, P.A.
• Jeannine Mogavero Theoret, M.D.
• Cyndra Renee Mogayzel, M.D.
• John C Moghtader, M.D.
• Zayed Mohiyuddin, M.B.,B.S.

• Foot & Ankle Surgery Podiatrist in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Foot & Ankle Surgery Podiatrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.