DR. PAUL STEVEN MODLINGER M.D.
NPI 1053405688
Internal Medicine - Nephrology in Fairfax, VA

Q: What is Paul Modlinger's NPI number?

The NPI number for Paul Modlinger is 1053405688. It was assigned to this individual provider in the NPPES registry on October 3, 2006.

Q: What is Paul Modlinger's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Q: When was this NPI record last updated?

The NPPES record for Paul Modlinger was last updated on February 26, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 03, 2006PECOS EnrolledAccepts Medicare Assignment

3930 WALNUT STREET, SUITE 101, FAIRFAX, VA 22030(703) 246-9246(703) 246-9257 Get Directions Write a Review

NPPES record last updated: February 26, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Paul Steven Modlinger M.d. NPPES

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

DR. PAUL STEVEN MODLINGER M.D. (NPI 1053405688) is an individual nephrology provider in Fairfax, Virginia, licensed in Virginia (0101236049) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Inova Alexandria Hospital, and is a graduate of New York University School Of Medicine (1997).

NPPES Registry Identity

NPI1053405688

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameDR. PAUL STEVEN MODLINGERCredential: M.D.

Location Address3930 WALNUT STREET, SUITE 101Fairfax, VA 22030-4738

Mailing Address3930 Walnut Street, Suite 101Fairfax, VA 22030-4738 · (703) 246-9246 · Fax (703) 246-9257

Phone(703) 246-9246

Fax(703) 246-9257

Sole ProprietorNo

Medical School CMSNew York University School Of MedicineGraduated 1997

Enumeration DateOctober 3, 2006

Last NPPES UpdateFebruary 26, 2013

✔ NPI 1053405688 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in VA · 0101236049

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

3930 WALNUT STREET, Fairfax, VA 22030

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Other Identifiers 19

Medicaid010085721VA

Medicaid010085811VA

Medicaid010083753VA

Medicaid010085683VA

Medicaid010085837VA

Medicaid010085870VA

Medicaid010085918VA

Other2128905Mamsi

Other47430007Carefirst

Medicaid010083770VA

Medicaid010085829VA

Medicaid010085691VA

Medicaid010124743VA

Medicare UPINH12340

Other9202002Cigna

Medicare ID-Type Unspecified015252V63

Medicaid010085934VA

Medicaid010085845VA

Medicaid010184983VA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee.Insurance ›

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. Paul Steven Modlinger M.d. 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 ID5597729160

PECOS Enrollment IDI20041113000078, I20120724000239

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 14

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.

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.

631 services324 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

584 services301 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.

242 services80 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

105 services103 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

90 services63 patients

Dialysis services, 4 or more physician visits per month (20 years or older) 90960

Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.

81 services17 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

80 services80 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

78 services78 patients

Dialysis procedure including 1 evaluation 90945

Dialysis is a treatment that filters and purifies the blood when your kidneys can't do their job. The procedure involves circulating your blood through a machine that removes waste products. An evaluation is done beforehand to assess your health and determine the best approach for your treatment.

63 services21 patients

Hemodialysis procedure with physician evaluation 90935

Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.

49 services38 patients

Dialysis services, 2-3 physician visits per month (20 years or older) 90961

Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.

25 services15 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

21 services21 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

14 services14 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.

12 services12 patients

Hospital Affiliations CMS Care Compare 4

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

Inova Alexandria Hospital

Acute Care Hospitals · Alexandria, VA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490040

Location4320 Seminary RdAlexandria, VA 22304 · Alexandria City County

Emergency services Birthing friendly

Virginia Hospital Center

Acute Care Hospitals · Arlington, VA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490050

Location1701 North George Mason DriveArlington, VA 22205 · Arlington County

Emergency services Birthing friendly

Inova Fairfax Hospital

Acute Care Hospitals · Falls Church, VA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490063

Location3300 Gallows RoadFalls Church, VA 22042 · Fairfax County

Emergency services Birthing friendly

Inova Fair Oaks Hospital

Acute Care Hospitals · Fairfax, VA

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number490101

Location3600 Joseph Siewick DriveFairfax, VA 22033 · Fairfax County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22030 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

$147.85 typical visit price

range $65.18 – $194.86

Typical copayment $36.96 (range $16.29 – $48.71)

Most-billed visit code 99204

Established Patient

$113.72 typical visit price

range $21.40 – $158.88

Typical copayment $28.43 (range $5.35 – $39.72)

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.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tacrolimus, immediate release, oral, 1 mg J7507

Treatment-Treatment - Miscellaneous · category RX029N

2 suppliers24 claims3,240 services$0.29 avg. paid by Medicare

Mycophenolate mofetil, oral, 250 mg J7517

Treatment-Treatment - Miscellaneous · category RX029N

1 supplier12 claims1,440 services$0.18 avg. paid by Medicare

Mycophenolic acid, oral, 180 mg J7518

Treatment-Treatment - Miscellaneous · category RX029N

1 supplier12 claims720 services$0.89 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511

Treatment-Chemotherapy · category RH012N

4 suppliers30 claims30 services$17.67 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512

Treatment-Chemotherapy · category RH012N

3 suppliers26 claims27 services$11.68 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 5

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

VIRGINIA NEPHROLOGY GROUP, LLP

Internal Medicine (Nephrology)