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DIPABEN D MODI MD
NPI 1114971850
Internal Medicine - Pulmonary Disease in Houston, TX

Active since May 19, 2006PECOS EnrolledAccepts Medicare Assignment
91.34/100
CMS Quality Rating
7200 MCNAIR, SUITE 8A, HOUSTON, TX 77030(713) 798-2400(713) 798-2688 Get Directions Write a Review

NPPES record last updated: September 29, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 29, 2021, Aug 20, 2021, Sep 28, 2018 (3 updates tracked since 2018).

About Dipaben D Modi Md NPPES

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

DIPABEN D MODI MD (NPI 1114971850) is an individual pulmonary disease provider in Houston, Texas, licensed in Texas (M1244) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with Chi St Luke's Health Baylor College Of Medicine Me, and is a graduate of Other (1992).

NPPES Registry Identity

NPI1114971850
Entity TypeIndividualFemale
Primary Taxonomy207RP1001X
Provider Legal NameDIPABEN D MODICredential: MD
Location Address7200 MCNAIR, SUITE 8AHouston, TX 77030
Mailing Address1 Baylor PlzHouston, TX 77030-3411 · (832) 744-9390
Phone(713) 798-2400
Fax(713) 798-2688
Sole ProprietorNo
Medical School CMSOtherGraduated 1992
Enumeration DateMay 19, 2006
Last NPPES UpdateSeptember 29, 20213 updates tracked since enumeration
NPPES CertifiedSeptember 29, 2021
✔ NPI 1114971850 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License✔ Licensed in TX · M1244
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedInternal MedicineTaxonomy 207R00000X · License M1244 (TX)
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License M1244 (TX)
7200 MCNAIR, Houston, TX 77030
Open in Google Maps ↗

Other Identifiers 1

Other8M5415TX · Bcbstx Prov No

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dipaben D Modi Md 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 ID5890731053
PECOS Enrollment IDI20050628001428
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.

Medicare Billing Reassignments

2

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

Texas Children's Physician Group
0.1 mi
Pediatrics
6621 FANNIN ST
Houston, TX 77030
  • Reassigned Medicare billing, Texas enrollment
  • Medicare enrollment name: Texas Childrens Physician Group
  • 2,498 clinicians in this Medicare group
NPI 1861675506 (832) 824-1000
Baylor College Of Medicine
0.7 mi
Medical Genetics, Ph.D. Medical Genetics
7200 CAMBRIDGE ST FL 10
Houston, TX 77030
  • Reassigned Medicare billing, Texas enrollment
  • 2,554 clinicians in this Medicare group
NPI 1881026664 (713) 798-0000

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

Areas of Expertise CMS Part B claims 8

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.

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.
291 services177 patients
Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
82 services77 patients
Test to determine lung volumes using sensors 94726
This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.
80 services75 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
63 services63 patients
Test to measure expiratory airflow and volume 94010
This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.
57 services53 patients
Test to measure expiratory airflow and volume changes before and after medication administration 94060
This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.
33 services32 patients

Hospital Affiliations CMS Care Compare 2

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

Chi St Luke's Health Baylor College Of Medicine Me

Acute Care Hospitals · Houston, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number450193
Location6720 Bertner Ave, Ste Mc1-266Houston, TX 77030 · Harris County
Emergency services

St Luke's The Woodlands Hospital

Acute Care Hospitals · The Woodlands, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450862
Location17200 St Luke's WayThe Woodlands, TX 77384 · Montgomery County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77030 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
$134.06 typical visit price
range $58.24 – $176.98
Typical copayment $33.51 (range $14.56 – $44.24)
Most-billed visit code 99204
Established Patient
$102.71 typical visit price
range $18.60 – $143.93
Typical copayment $25.67 (range $4.65 – $35.98)
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.

91.34/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality81.64
Promoting Interoperability89.13
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 9

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
5 suppliers25 claims25 services$13.39 avg. paid by Medicare
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) E0465
DME-Other DME · category DE005N
1 supplier11 claims11 services$921.50 avg. paid by Medicare
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
4 suppliers27 claims27 services$907.63 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
9 suppliers133 claims133 services$63.21 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
6 suppliers92 claims92 services$30.45 avg. paid by Medicare
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
DME-Drugs Administered Through DME · category DG006N
9 suppliers21 claims4,037 services$0.03 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Dipaben Modi's NPI number?

The NPI number for Dipaben Modi is 1114971850. It was assigned to this individual provider in the NPPES registry on May 19, 2006.

Where is Dipaben Modi located?

Dipaben Modi practices at 7200 Mcnair Suite 8A, Houston, TX 77030. The listed phone number is (713) 798-2400.

What is Dipaben Modi's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Dipaben Modi enrolled in Medicare?

Yes. Dipaben 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.

Which organizations bill Medicare for Dipaben Modi's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dipaben Modi reassigns Medicare benefits to 2 organizations: Texas Children's Physician Group (Houston, TX) and Baylor College Of Medicine (Houston, TX). 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 Dipaben Modi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Dipaben Modi accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 3 other insurers list Dipaben 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 Dipaben Modi affiliated with any hospitals?

According to CMS data, Dipaben Modi is affiliated with Chi St Luke's Health Baylor College Of Medicine Me and St Luke's The Woodlands Hospital.

When was this NPI record last updated?

The NPPES record for Dipaben Modi was last updated on September 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.