Individual provider Active NPI

Rahul Modi

  • Otolaryngology Physician
  • Boston, MA
National Provider Identifier
1972906642
Registry record updated Oct 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
261477 Issued in MA
Practice address
243 Charles St
Boston, MA 02114-3002
Phone
(617) 573-6354
Fax
(617) 573-3939
NPI assigned
Oct 8, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 261477 MA Primary

Addresses

Primary practice location

243 Charles St
Boston, MA 02114-3002

Mailing address

243 Charles St
Boston, MA 02114-3002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
261477MAMDOtolaryngology Physician

NPI Registry JSON

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412726400000",
    "number": "1972906642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 CHARLES ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 CHARLES ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143002",
            "telephone_number": "617-573-6354",
            "fax_number": "617-573-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODI",
        "first_name": "RAHUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-08",
        "last_updated": "2014-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "261477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.