Dixitkumar N Modi MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DIXITKUMAR N MODI MD PA

Practice address

4350 N Atlantic Ave
Cocoa Beach, FL 32931-3656

Phone

(334) 327-9530

NPI assigned

Aug 20, 2019

Reactivated

Feb 23, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Dixitkumar Navinchandra Modi, MDNPI 1124238506

Title

Owner

Phone

(334) 327-9530

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Dixitkumar N Modi, MD

  • Family Medicine Physician
  • Cocoa Beach, FL
  • NPI 1124238506
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708646400000",
    "number": "1962059493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 TRASONA DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407670",
            "telephone_number": "321-613-5352",
            "fax_number": "321-613-5356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 N ATLANTIC AVE",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329313656",
            "telephone_number": "334-327-9530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIXITKUMAR N MODI MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-20",
        "last_updated": "2024-02-23",
        "certification_date": "2020-10-11",
        "deactivation_date": "2024-02-20",
        "reactivation_date": "2024-02-23",
        "status": "A",
        "authorized_official_last_name": "MODI",
        "authorized_official_first_name": "DIXITKUMAR",
        "authorized_official_middle_name": "NAVINCHANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-327-9530",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104790300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME133520",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Ray Devins, D.D.S.
• Javier Diaz Blanco, MD
• Beth Ann Dickerson, APRN
• Dignified Care L.L.C.
• Laura Ann Dijerome, RN, CNP
• Natalia Dougher
• Kimberly Dozier-Thornton, MD
• Dr. Alex Davis - Assessment and Consulting PLLC
• Dr. Betsy Leveritt, D.O.,
• Tejash Dungarani, M.D.

• Family Medicine Physician in Cocoa Beach, FL
• Providers in Cocoa Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.