NPIMap

Individual provider Active NPI

Brinda G Modh

  • Internal Medicine Physician
  • Melbourne, FL
National Provider Identifier
1851739304
Registry record updated Jun 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME116384 Issued in FL
Practice address
8041 Spyglass Hill Rd Ste 102
Melbourne, FL 32940-8559
Phone
(321) 255-4003
Fax
(321) 255-2728
NPI assigned
Jun 6, 2013
Last updated
Jun 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME116384 NY
Internal Medicine Physician 207R00000X ME116384 FL Primary

Addresses

Primary practice location

8041 Spyglass Hill Rd Ste 102
Melbourne, FL 32940-8559

Mailing address

PO Box 361095
Melbourne, FL 32936-1095
Phone (321) 255-4003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130920000056 FL Practitioner - Internal Medicine 3779727300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
H2 Rehabilitation Services of Florida LLCGroup PAC ID 3971411851, shared by 10 NPIs, 257 clinicians
Medical Associates of Brevard LLCGroup PAC ID 4486558012, 75 clinicians

Practice addresses (Care Compare)

3680 N Wickham Rd
Suite B
Melbourne, FL 32935-2327
Phone (321) 255-5500

8041 Spyglass Hill Rd
Suite 102
Melbourne, FL 32940-8559
Phone (321) 255-4003

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME116384NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Brevard LLC CurrentSince Dec 1, 2014 Accepting new patients

Locations

1305 Hickory St
Melbourne, FL 32901
Phone (321) 255-1500

1341 Medical Park Dr
Ste 101A
Melbourne, FL 32901
Phone (321) 733-2711

8041 Spyglass Hill Rd
Ste 102
Viera, FL 32940
Phone (321) 255-4003

Interoperability endpoints

  • Direct secure messaging: bmodh71749@epicdirect.hf.org
  • Direct secure messaging: brindamodh@mab.medentdirect.com

Organizations & group practices 1

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.

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591315200000",
    "number": "1851739304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 361095",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329361095",
            "telephone_number": "321-255-4003",
            "fax_number": "321-255-2728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8041 SPYGLASS HILL RD STE 102",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408559",
            "telephone_number": "321-255-4003",
            "fax_number": "321-255-2728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODH",
        "first_name": "BRINDA",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-06",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "ME116384",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME116384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.