DR. JOSEPH SAMUEL MODICA MD
NPI 1023545654
Psychiatry & Neurology - Neurology in Buffalo, NY

Active since May 13, 2017PECOS EnrolledAccepts Medicare Assignment
85.47/100
CMS Quality Rating
40 GEORGE KARL BLVD, BUFFALO, NY 14221(716) 250-2000 Get Directions Write a Review

NPPES record last updated: May 4, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 4, 2026, Aug 2, 2021, May 10, 2021 and 1 more (4 updates tracked since 2017).

About Dr. Joseph Samuel Modica Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JOSEPH SAMUEL MODICA MD (NPI 1023545654) is an individual neurology provider in Buffalo, New York, licensed in New York (301104) and active in the NPI registry since May 2017. He is enrolled in Medicare PECOS, is affiliated with Sisters Of Charity Hospital, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1023545654
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NameDR. JOSEPH SAMUEL MODICACredential: MD
Location Address40 GEORGE KARL BLVDBuffalo, NY 14221-7183
Mailing Address3980 Sheridan DrAmherst, NY 14226-1727 · (716) 250-2000
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateMay 13, 2017
Last NPPES UpdateMay 4, 20264 updates tracked since enumeration
NPPES CertifiedMay 4, 2026
NPI 1023545654 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
License Licensed in NY · 301104
Definition

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

40 GEORGE KARL BLVD, Buffalo, NY 14221

Other Identifiers 1

Medicaid06488279NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Joseph Samuel Modica Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7416200563
PECOS Enrollment IDI20210511002240
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 15

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg J1561
This is an injection of immune globulin, specifically Gamunex-C or Gammaked. It's a liquid form, not freeze-dried. Immune globulin is a blood product that helps your immune system to fight infections. It's given in a dose of 500 mg.
3,230 services16 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
145 services106 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
126 services98 patients
Infusion, normal saline solution, 250 cc J7050
An infusion of normal saline solution, 250 cc, involves administering a sterile saltwater solution into your body through a vein, usually in your arm. This helps to replenish fluids, maintain hydration, and balance electrolytes in your body.
88 services38 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
75 services46 patients
Administration of chemotherapy into vein, 1 hour or less 96413
Chemotherapy is a treatment that uses drugs to destroy cancer cells. When administered into a vein, it's often through an IV. This procedure usually lasts 1 hour or less. You may feel a slight pinch as the needle is inserted, but it's generally painless.
68 services27 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Sisters Of Charity Hospital

Acute Care Hospitals · Buffalo, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330078
Location2157 Main StreetBuffalo, NY 14214 · Erie County
Emergency services Birthing friendly

Brooks-Tlc Hospital System, Inc

Acute Care Hospitals · Dunkirk, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330229
Location529 Central AvenueDunkirk, NY 14048 · Chautauqua County
Emergency services

Upmc Chautauqua At Wca

Acute Care Hospitals · Jamestown, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330239
Location207 Foote AvenueJamestown, NY 14701 · Chautauqua County
Emergency services Birthing friendly

Mercy Hospital Of Buffalo

Acute Care Hospitals · Buffalo, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330279
Location565 Abbott RoadBuffalo, NY 14220 · Erie County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14221 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.40 typical visit price
range $54.87 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

85.47/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality74.9
Promoting Interoperability52
Improvement Activities40
Cost99.99

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Neurological Surgery
40 GEORGE KARL BLVD
WILLIAMSVILLE, NY 14221
Pain Medicine (Interventional Pain Medicine)
40 GEORGE KARL BLVD
WILLIAMSVILLE, NY 14221
Physical Therapist
40 GEORGE KARL BLVD
WILLIAMSVILLE, NY 14221
Physician Assistant (Surgical)
40 GEORGE KARL BLVD
WILLIAMSVILLE, NY 14221
Neurological Surgery
40 GEORGE KARL BLVD
WILLIAMSVILLE, NY 14221
Nurse Practitioner (Family)
40 GEORGE KARL BLVD
WILLIAMSVILLE, NY 14221
Psychiatry & Neurology (Neurology)
40 GEORGE KARL BLVD
BUFFALO, NY 14221
Neurological Surgery
40 GEORGE KARL BLVD
WILLIAMSVILLE, NY 14221

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Joseph Modica's NPI number?

The NPI number for Joseph Modica is 1023545654. It was assigned to this individual provider in the NPPES registry on May 13, 2017.

Where is Joseph Modica located?

Joseph Modica practices at 40 George Karl Blvd, Buffalo, NY 14221. The listed phone number is (716) 250-2000.

What is Joseph Modica's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Joseph Modica enrolled in Medicare?

Yes. Joseph Modica is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Joseph Modica affiliated with any hospitals?

According to CMS data, Joseph Modica is affiliated with Sisters Of Charity Hospital, Brooks-Tlc Hospital System, Inc, Upmc Chautauqua At Wca and Mercy Hospital Of Buffalo.

When was this NPI record last updated?

The NPPES record for Joseph Modica was last updated on May 4, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.