1. Home
  2. Directory
  3. Louisiana
  4. Thibodaux
  5. Internal Medicine
  6. NPI Profile

MR. JAMES KEVIN MODISETTE M.D.
NPI 1063413995
Internal Medicine - Nephrology in Thibodaux, LA

Active since August 02, 2005PECOS EnrolledAccepts Medicare Assignment
80.5/100
CMS Quality Rating
604 N. ACADIA RD., SUITE 405, THIBODAUX, LA 70301(985) 446-0871(985) 446-0874 Get Directions Write a Review

NPPES record last updated: September 25, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. James Kevin Modisette M.d. NPPES

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

MR. JAMES KEVIN MODISETTE M.D. (NPI 1063413995) is an individual nephrology provider in Thibodaux, Louisiana, licensed in Louisiana (22699) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Thibodaux Regional Medical Center, and is a graduate of Louisiana State University School Of Medicine In New Orleans (1996).

NPPES Registry Identity

NPI1063413995
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameMR. JAMES KEVIN MODISETTECredential: M.D.
Location Address604 N. ACADIA RD., SUITE 405Thibodaux, LA 70301
Mailing Address604 N. Acadia Rd., Suite 405Thibodaux, LA 70301 · (985) 446-0871 · Fax (985) 446-0874
Phone(985) 446-0871
Fax(985) 446-0874
Sole ProprietorNo
Medical School CMSLouisiana State University School Of Medicine In New OrleansGraduated 1996
Enumeration DateAugust 2, 2005
Last NPPES UpdateSeptember 25, 2009
✔ NPI 1063413995 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 LA · 22699
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.
604 N. ACADIA RD., Thibodaux, LA 70301
Open in Google Maps ↗

Other Identifiers 5

Medicare ID-Type Unspecified390005972Railroad
Medicare UPING57889
Medicare ID-Type Unspecified4A019CE76
Other7814220Aetna
Medicaid1492141LA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, HMO Louisiana.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

Mr. James Kevin Modisette 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 ID3072571637
PECOS Enrollment IDI20101015000296
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 9

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.

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.
483 services204 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.
302 services160 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.
137 services19 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.
104 services67 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.
75 services72 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
42 services42 patients

Hospital Affiliations CMS Care Compare 4

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

Thibodaux Regional Medical Center

Acute Care Hospitals · Thibodaux, LA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number190004
Location602 N Acadia RoadThibodaux, LA 70301 · Lafourche County
Emergency services Birthing friendly

Terrebonne General Medical Center - Parish

Acute Care Hospitals · Houma, LA
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number190008
Location8166 Main StreetHouma, LA 70360 · Terrebonne County
Emergency services Birthing friendly

Ochsner St Anne General Hospital

Critical Access Hospitals · Raceland, LA
OwnershipVoluntary non-profit - Other
CMS Certification Number191324
Location4608 Highway 1Raceland, LA 70394 · Lafourche County
Emergency services Birthing friendly

Lady Of The Sea General Hospital

Critical Access Hospitals · Cut Off, LA
OwnershipGovernment - Hospital District or Authority
CMS Certification Number191325
Location200 West 134th PlaceCut Off, LA 70345 · Lafourche County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 70301 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
$124.60 typical visit price
range $53.43 – $164.73
Typical copayment $31.15 (range $13.35 – $41.18)
Most-billed visit code 99204
Established Patient
$95.09 typical visit price
range $16.64 – $133.62
Typical copayment $23.77 (range $4.16 – $33.40)
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.

80.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality69.81
Promoting Interoperability100
Improvement Activities40
Cost41.4

Reported Quality Measures

Controlling High Blood Pressure
67%341 patients3/55-star benchmark: 98%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
100%116 patients1/55-star benchmark: 98%
Documentation of Current Medications in the Medical Record
94%803 patients4/55-star benchmark: 100%
e-Prescribing
99%155 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
98%417 patients4/55-star benchmark: 100%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
18%803 patients2/55-star benchmark: 61%
Provide Patients Electronic Access to Their Health Information
93%187 patients4/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
85%129 patients4/55-star benchmark: 91%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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 suppliers11 claims1,830 services$0.32 avg. paid by Medicare
Mycophenolate mofetil, oral, 250 mg J7517
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers14 claims1,680 services$0.21 avg. paid by Medicare
Sirolimus, oral, 1 mg J7520
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier12 claims180 services$2.80 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
3 suppliers20 claims20 services$18.02 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 suppliers16 claims17 services$12.67 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

KIDNEY CENTER OF SOUTH LOUISIANA, AMC
Internal Medicine (Nephrology)
604 N. ACADIA RD., SUITE 405
THIBODAUX, LA 70301
Lafourche Parish (985) 446-0871

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 James Modisette's NPI number?

The NPI number for James Modisette is 1063413995. It was assigned to this individual provider in the NPPES registry on August 2, 2005.

Where is James Modisette located?

James Modisette practices at 604 N. Acadia Rd. Suite 405, Thibodaux, LA 70301. The listed phone number is (985) 446-0871.

What is James Modisette's specialty?

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

Is James Modisette enrolled in Medicare?

Yes. James Modisette 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 James Modisette accept?

Health plans from Blue Cross and Blue Shield of Louisiana and HMO Louisiana list James Modisette 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 James Modisette affiliated with any hospitals?

According to CMS data, James Modisette is affiliated with Thibodaux Regional Medical Center, Terrebonne General Medical Center - Parish, Ochsner St Anne General Hospital and Lady Of The Sea General Hospital.

When was this NPI record last updated?

The NPPES record for James Modisette was last updated on September 25, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.