Patricia Modad, MD, PA

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

ME 103310 Issued in FL

Legal business name

PATRICIA MODAD, MD, PA

Practice address

50 Leanni Way
Suites A3 & A4
Palm Coast, FL 32137-4751

Phone

(386) 447-6831

Fax

(386) 447-6834

NPI assigned

Apr 18, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Patricia Isabel Modad, MDNPI 1104847466

Title

President

Phone

(386) 447-6831

Specialties & licenses 1

Addresses

Other names 1

• Palm Coast OB GYN Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3144/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Patricia Isabel Modad, M.D., F.A.C.O.G.

  • Obstetrics & Gynecology Physician
  • Palm Coast, FL
  • NPI 1104847466
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323129600000",
    "number": "1942590401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LEANNI WAY",
            "address_2": "SUITES A3 & A4",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321374751",
            "telephone_number": "386-447-6831",
            "fax_number": "386-447-6834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 LEANNI WAY",
            "address_2": "SUITES A3 & A4",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321374751",
            "telephone_number": "386-447-6831",
            "fax_number": "386-447-6834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICIA MODAD, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-18",
        "last_updated": "2011-12-06",
        "status": "A",
        "authorized_official_last_name": "MODAD",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "ISABEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-447-6831",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME 103310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palm Coast OB GYN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Raymond Michael Parkhurst, DC
• Kimberly Parnami
• Alta Parsons
• Michael John Parsons, MD
• Patricia McEwen Ma CCC-SLP LLC
• PB Healthcare SVCS II LLC
• PB Healthcare SVCS, Inc
• Pco Operations, LP
• Peaceful Home Alf LLC
• David Pearson, D.C.

• Obstetrics & Gynecology Physician in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.