Individual provider Active NPI

Pooja G Mody, D.O

  • Surgery Physician
  • Las Vegas, NV
National Provider Identifier
1962762997
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
DO3284 Issued in NV
Practice address
1524 Pinto LN FL 2
Las Vegas, NV 89106-4195
Phone
(702) 383-3707
Fax
(702) 383-1982
NPI assigned
May 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X DO3284 NV Primary

Addresses

Primary practice location

1524 Pinto LN FL 2
Las Vegas, NV 89106-4195

Mailing address

1800 W Charleston Blvd
Las Vegas, NV 89102-2386
Phone (702) 383-2799

Other identifiers 2

IdentifierTypeStateIssuer
1710607221MedicaidNV
1962762997MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, PA, NV3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20200921002607 AZ Practitioner - General Surgery 9830459452 Reassigns benefits to 1 organization
I20220209002042 PA Practitioner - General Surgery 9830459452 Reassigns benefits to 1 organization
I20230413002356 NV Practitioner - General Surgery 9830459452 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
New York College of Osteo Medicine of New York Institute of Technology, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kingman Healthcare IncGroup PAC ID 6901791367, 185 clinicians
Jon S Williams PLLCGroup PAC ID 4183090384, 3 clinicians

Practice addresses (Care Compare)

3104 N Stockton Hill Rd
Kingman, AZ 86401-4183
Phone (928) 681-8720

6030 S Rainbow Blvd
Suite D2
Las Vegas, NV 89118-2548
Phone (702) 329-0229

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.85 of 100Reported as group
Quality
84.49
Promoting interoperability
83
Improvement activities
40
Cost
79.17

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kingman Healthcare, Inc CurrentSince Nov 1, 2024 Accepting new patients
St. Luke's Physician Group, Inc. Family Medicine Current Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Nov 9, 2021 Accepting new patients
Kingman Healthcare, Inc CurrentSince Nov 1, 2024 Accepting new patients
Jon S. Williams, PLLC. Surgery CurrentSince Jul 20, 2024 Accepting new patients
St Luke's Physician Group Inc Family Medicine CurrentSince Nov 9, 2021 Accepting new patients
Kingman Healthcare, Inc Family Medicine Current Accepting new patients
Mercy Health Physicians Kentucky LLC Family Medicine Past Accepting new patients
Kingman Healthcare, Inc Family Medicine Past Accepting new patients

Locations

3104 N Stockton Hill Rd
Kingman, AZ 86401
Phone (928) 681-8720

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

1800 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 207-8253

6030 S Rainbow Blvd
Ste D2
Las Vegas, NV 89118
Phone (702) 329-0229

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Interoperability endpoints

  • Direct secure messaging: mody.poojagirish@direct.azkrmc.md

Organizations & group practices 10

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1962762997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022386",
            "telephone_number": "702-383-2799",
            "fax_number": "702-383-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 PINTO LN FL 2",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064195",
            "telephone_number": "702-383-3707",
            "fax_number": "702-383-1982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODY",
        "first_name": "POOJA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-24",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NV",
            "license": "DO3284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710607221",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962762997",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.