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PAYAL URVIJ MODHIA M.D.
NPI 1083961072
Internal Medicine in Albuquerque, NM

Active since August 08, 2012PECOS EnrolledAccepts Medicare Assignment
83.84/100
CMS Quality Rating
1100 CENTRAL AVE SE FL 4, PMG HOSPITALIST, ALBUQUERQUE, NM 87106(505) 724-6124(505) 724-6125 Get Directions Write a Review

NPPES record last updated: February 3, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Payal Urvij Modhia M.d. NPPES

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

PAYAL URVIJ MODHIA M.D. (NPI 1083961072) is an individual internal medicine provider in Albuquerque, New Mexico, licensed in Illinois (125061482) and active in the NPI registry since August 2012. She is enrolled in Medicare PECOS, is affiliated with Unm Hospital, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1083961072
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NamePAYAL URVIJ MODHIACredential: M.D.
Location Address1100 CENTRAL AVE SE FL 4, PMG HOSPITALISTAlbuquerque, NM 87106-4930
Mailing AddressPo Box 26666, Phs Provider EnrollmentAlbuquerque, NM 87125-6666 · (505) 923-6770 · Fax (505) 923-5354
Phone(505) 724-6124
Fax(505) 724-6125
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateAugust 8, 2012
Last NPPES UpdateFebruary 3, 2024
NPPES CertifiedFebruary 3, 2024
✔ NPI 1083961072 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 125061482
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedHospitalistTaxonomy 208M00000X · License MD2014-0753 (NM)
1100 CENTRAL AVE SE FL 4, Albuquerque, NM 87106
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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

Payal Urvij Modhia 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 ID2365754249
PECOS Enrollment IDI20150707000781
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 7

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 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.
363 services159 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
67 services67 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
50 services27 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.
42 services42 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
40 services40 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.
24 services18 patients

Hospital Affiliations CMS Care Compare 3

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

Unm Hospital

Acute Care Hospitals · Albuquerque, NM
2/5 CMS rating
OwnershipGovernment - State
CMS Certification Number320001
Location2211 Lomas Boulevard NEAlbuquerque, NM 87106 · Bernalillo County
Emergency services Birthing friendly

Lovelace Medical Center

Acute Care Hospitals · Albuquerque, NM
3/5 CMS rating
OwnershipProprietary
CMS Certification Number320009
Location601 Dr Martin Luther King Jr Ave NEAlbuquerque, NM 87102 · Bernalillo County
Emergency services

Presbyterian Hospital

Acute Care Hospitals · Albuquerque, NM
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number320021
Location1100 Central Avenue SEAlbuquerque, NM 87106 · Bernalillo County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87106 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
$126.21 typical visit price
range $54.26 – $166.80
Typical copayment $31.55 (range $13.56 – $41.70)
Most-billed visit code 99204
Established Patient
$96.38 typical visit price
range $17.00 – $135.35
Typical copayment $24.09 (range $4.25 – $33.83)
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.

83.84/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality84.59
Promoting Interoperability100
Improvement Activities40
Cost58.63

Referred Medical Equipment & Supplies CMS DME claims 3

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers36 claims36 services$16.28 avg. paid by Medicare
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
2 suppliers24 claims24 services$889.32 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers37 claims37 services$78.83 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 6

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

SERGIU STEFANESCU MD
Internal Medicine
1100 CENTRAL AVE SE FL 4, PMG HOSPITALIST
ALBUQUERQUE, NM 87106
Bernalillo County (505) 724-6124
JAY TSENG M.D.
Internal Medicine
1100 CENTRAL AVE SE FL 4, PMG HOSPITALIST
ALBUQUERQUE, NM 87106
Bernalillo County (505) 724-6124
DR. PRADEEP MITTA MD
Internal Medicine
1100 CENTRAL AVE SE FL 4, PMG HOSPITALIST
ALBUQUERQUE, NM 87106
Bernalillo County (505) 724-6124
SIKANDER SURANA M.D.
Internal Medicine
1100 CENTRAL AVE SE FL 4, PMG HOSPITALIST
ALBUQUERQUE, NM 87106
Bernalillo County (505) 724-6124
DR. PRAJIT ARORA M.D
Internal Medicine (Nephrology)
1100 CENTRAL AVE SE FL 4
ALBUQUERQUE, NM 87106
Bernalillo County (505) 724-6124
SUSANNA MARIE GONZALES MD
Internal Medicine (Critical Care Medicine)
1100 CENTRAL AVE SE FL 4, PMG INTENSIVISTS
ALBUQUERQUE, NM 87106
Bernalillo County (505) 724-6145

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 Payal Modhia's NPI number?

The NPI number for Payal Modhia is 1083961072. It was assigned to this individual provider in the NPPES registry on August 8, 2012.

Where is Payal Modhia located?

Payal Modhia practices at 1100 Central Ave SE Fl 4 Pmg Hospitalist, Albuquerque, NM 87106. The listed phone number is (505) 724-6124.

What is Payal Modhia's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Payal Modhia enrolled in Medicare?

Yes. Payal Modhia 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.

Is Payal Modhia affiliated with any hospitals?

According to CMS data, Payal Modhia is affiliated with Unm Hospital, Lovelace Medical Center and Presbyterian Hospital.

When was this NPI record last updated?

The NPPES record for Payal Modhia was last updated on February 3, 2024. 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.