1. Home
  2. Directory
  3. Georgia
  4. Canton
  5. Nurse Anesthetist Certified Registered
  6. NPI Profile

KHUSHBU MODI
NPI 1083166383
Nurse Anesthetist, Certified Registered in Canton, GA

Active since November 03, 2016
276 HARMONY LAKE DR, CANTON, GA 30115(404) 488-5590 Get Directions Write a Review

NPPES record last updated: November 3, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Khushbu Modi NPPES

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

KHUSHBU MODI (NPI 1083166383) is an individual nurse anesthetist, certified registered in Canton, Georgia, licensed in Georgia (RN202188) and active in the NPI registry since November 2016. She is affiliated with Wellstar North Fulton Hospital and is a graduate of Other (2016).

NPPES Registry Identity

NPI1083166383
Entity TypeIndividualFemale
Primary Taxonomy367500000X
Provider Legal NameKHUSHBU MODI
Location Address276 HARMONY LAKE DRCanton, GA 30115-4781
Mailing Address276 Harmony Lake DrCanton, GA 30115-4781
Phone(404) 488-5590
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateNovember 3, 2016
✔ NPI 1083166383 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in GA · RN202188
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
276 HARMONY LAKE DR, Canton, GA 30115
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Khushbu Modi is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5698056620
PECOS Enrollment IDI20170104002413

Medicare Billing Reassignments

2

Medicare enrollment records show Khushbu Modi reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mak Anesthesia Georgia, LLC
15 mi
Anesthesiology
1300 RIDENOUR BLVD NW STE 300
Kennesaw, GA 30152
  • Reassigned Medicare billing, Georgia enrollment
  • 213 clinicians in this Medicare group
NPI 1609390103 (770) 702-1806
Mak Anesthesia Holdings LLC
15 mi
Anesthesiology
1300 RIDENOUR BLVD NW STE 300
Kennesaw, GA 30152
  • Reassigned Medicare billing, Georgia enrollment
  • 629 clinicians in this Medicare group
NPI 1912452939 (770) 702-1806

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

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

Wellstar North Fulton Hospital

Acute Care Hospitals · Roswell, GA
2/5 CMS rating
OwnershipProprietary
CMS Certification Number110198
Location3000 Hospital BoulevardRoswell, GA 30076 · Fulton County
Emergency services Birthing friendly

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 Khushbu Modi's NPI number?

The NPI number for Khushbu Modi is 1083166383. It was assigned to this individual provider in the NPPES registry on November 3, 2016.

Where is Khushbu Modi located?

Khushbu Modi practices at 276 Harmony Lake Dr, Canton, GA 30115. The listed phone number is (404) 488-5590.

What is Khushbu Modi's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Khushbu Modi enrolled in Medicare?

Yes. Khushbu Modi is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Khushbu Modi's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Khushbu Modi reassigns Medicare benefits to 2 organizations: Mak Anesthesia Georgia, LLC (Kennesaw, GA) and Mak Anesthesia Holdings LLC (Kennesaw, GA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Khushbu Modi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Khushbu Modi affiliated with any hospitals?

According to CMS data, Khushbu Modi is affiliated with Wellstar North Fulton Hospital.

When was this NPI record last updated?

The NPPES record for Khushbu Modi was last updated on November 3, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.