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MODERA GI
NPI 1063142115
Internal Medicine - Gastroenterology in Frisco, TX

Active since June 13, 2022CLIA Certified · 3 labs
5575 FRISCO SQUARE BLVD, 220, FRISCO, TX 75034(469) 920-2302 Get Directions Write a Review

NPPES record last updated: October 4, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 4, 2023, Jul 11, 2023, Jul 12, 2022 (3 updates tracked since 2022).

About Modera Gi NPPES

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

MODERA GI (NPI 1063142115) is a healthcare organization registered as a gastroenterology in Frisco, Texas and active in the NPI registry since June 2022. The organization holds 3 active CLIA laboratory certificates and lists Trevor Huber, President, as its authorized official.

NPPES Registry Identity

NPI1063142115
Entity TypeOrganization
Primary Taxonomy207RG0100X
Legal Business NameMODERA CLINIC GI, PLLC
Location Address5575 FRISCO SQUARE BLVD, 220Frisco, TX 75034-3303
Mailing Address5575 Frisco Square Blvd, #220Frisco, TX 75034-3303 · (469) 920-2302
Phone(469) 920-2302
Organization SubpartNo
Authorized OfficialTrevor HuberPresident · (972) 987-0458
Enumeration DateJune 13, 2022
Last NPPES UpdateOctober 4, 20233 updates tracked since enumeration
NPPES CertifiedOctober 4, 2023
✔ NPI 1063142115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
5575 FRISCO SQUARE BLVD, Frisco, TX 75034
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Other Names 1

Doing Business AsModera Gi

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2305957

Modera Clinic, PLLC (frisco) · Frisco, TX
Active · expires Jun 9, 2028
CLIA Number45D2305957
Laboratory TypePhysician Office
Certificate Effective DateJune 10, 2026
Certificate Expiration DateJune 9, 2028
Laboratory DirectorTrevor K. Huber
Laboratory Phone(469) 920-2302
Laboratory LocationModera Clinic, PLLC (frisco)5575 Frisco Square Blvd Ste 220, Frisco, TX 75034
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 45D2136683

Modera Clinic PLLC · Little Elm, TX
Active · expires Sep 12, 2027
CLIA Number45D2136683
Laboratory TypePhysician Office
Certificate Effective DateSeptember 13, 2025
Certificate Expiration DateSeptember 12, 2027
Laboratory DirectorTrevor K. Huber
Laboratory Phone(972) 987-0458
Laboratory LocationModera Clinic PLLC2700 E Eldorado Pkwy, Suite 104B, Little Elm, TX 75068
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 45D2211573

Modera Clinic · Prosper, TX
Active · expires Jan 27, 2027
CLIA Number45D2211573
Laboratory TypePhysician Office
Certificate Effective DateJanuary 28, 2025
Certificate Expiration DateJanuary 27, 2027
Laboratory DirectorStefanie Huber
Laboratory Phone(972) 987-0458
Laboratory LocationModera Clinic2381 E University Dr Suite 50, Prosper, TX 75078
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Modera Clinic Gi, PLLC's NPI number?

The NPI number for Modera Clinic Gi, PLLC is 1063142115. It was assigned to this organization in the NPPES registry on June 13, 2022. The provider is doing business as Modera Gi.

Where is Modera Clinic Gi, PLLC located?

Modera Clinic Gi, PLLC is located at 5575 Frisco Square Blvd 220, Frisco, TX 75034. The listed phone number is (469) 920-2302.

What is Modera Clinic Gi, PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Does Modera Clinic Gi, PLLC hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Modera Clinic Gi, PLLC was last updated on October 4, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.