DR. PRACHI MAHENDRA MODI M.D.
NPI 1053583849
Emergency Medicine in East Norriton, PA

Active since April 01, 2008PECOS EnrolledAccepts Medicare Assignment
559 W GERMANTOWN PIKE, EAST NORRITON, PA 19403(484) 622-0611 Get Directions Write a Review

NPPES record last updated: October 23, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Prachi Mahendra Modi M.d. NPPES

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

DR. PRACHI MAHENDRA MODI M.D. (NPI 1053583849) is an individual emergency medicine provider in East Norriton, Pennsylvania, licensed in Pennsylvania (MD443559) and active in the NPI registry since April 2008. She is enrolled in Medicare PECOS, is affiliated with Nyu Langone Hospitals, and is a graduate of State University Of New York At Stony Brook, School Of Medicine (2005).

NPPES Registry Identity

NPI1053583849
Entity TypeIndividualFemale
Primary Taxonomy207P00000X
Provider Legal NameDR. PRACHI MAHENDRA MODICredential: M.D.
Location Address559 W GERMANTOWN PIKEEast Norriton, PA 19403-4250
Mailing AddressPo Box 8500-8735Philadelphia, PA 19178-8735 · (215) 456-4695
Sole ProprietorNo
Medical School CMSState University Of New York At Stony Brook, School Of MedicineGraduated 2005
Enumeration DateApril 1, 2008
Last NPPES UpdateOctober 23, 2013
NPI 1053583849 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License Licensed in PA · MD443559
Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

559 W GERMANTOWN PIKE, East Norriton, PA 19403

Accepted 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. Prachi Mahendra Modi 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 ID1557421591
PECOS Enrollment IDI20230314002414
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 5

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.

Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
183 services183 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
160 services160 patients
Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
28 services27 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
16 services16 patients
Emergency department visit with straightforward medical decision making 99282
An emergency department visit for a mild to moderate issue is when you seek immediate medical attention for a non-life-threatening condition. This could include minor injuries, moderate pain, or illnesses like the flu. During the visit, healthcare professionals assess your condition, provide treatment, and may recommend follow-up care.
15 services14 patients

Hospital Affiliations CMS Care Compare

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

Nyu Langone Hospitals

Acute Care Hospitals · New York, NY
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330214
Location550 First AvenueNew York, NY 10016 · New York County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19403 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
$92.69 typical visit price
range $59.88 – $180.99
Typical copayment $23.17 (range $14.97 – $45.24)
Most-billed visit code 99203
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
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.

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.

Nurse Practitioner (Acute Care)
559 W GERMANTOWN PIKE
EAST NORRITON, PA 19403
Hospitalist
559 W GERMANTOWN PIKE
EAST NORRITON, PA 19403
Internal Medicine
559 W GERMANTOWN PIKE
EAST NORRITON, PA 19403
Pediatrics
559 W GERMANTOWN PIKE, ROOM 2242
EAST NORRITON, PA 19403
Internal Medicine
559 W GERMANTOWN PIKE
EAST NORRITON, PA 19403
Student in an Organized Health Care Education/Training Program
559 W GERMANTOWN PIKE
EAST NORRITON, PA 19403
Family Medicine
559 W GERMANTOWN PIKE
EAST NORRITON, PA 19403
Nurse Practitioner (Acute Care)
559 W GERMANTOWN PIKE
EAST NORRITON, PA 19403

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 Prachi Modi's NPI number?

The NPI number for Prachi Modi is 1053583849. It was assigned to this individual provider in the NPPES registry on April 1, 2008.

Where is Prachi Modi located?

Prachi Modi practices at 559 W Germantown Pike, East Norriton, PA 19403. The listed phone number is (484) 622-0611.

What is Prachi Modi's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Prachi Modi enrolled in Medicare?

Yes. Prachi Modi 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.

What insurance does Prachi Modi accept?

Health plans from Blue Cross and Blue Shield of Texas list Prachi Modi as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Prachi Modi affiliated with any hospitals?

According to CMS data, Prachi Modi is affiliated with Nyu Langone Hospitals.

When was this NPI record last updated?

The NPPES record for Prachi Modi was last updated on October 23, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.