SUJAL HEMANT MODI MD
NPI 1184068561
Internal Medicine - Cardiovascular Disease in Indianapolis, IN

Q: What is Sujal Modi's NPI number?

The NPI number for Sujal Modi is 1184068561. It was assigned to this individual provider in the NPPES registry on April 29, 2013.

Q: What is Sujal Modi's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Q: When was this NPI record last updated?

The NPPES record for Sujal Modi was last updated on March 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.

Active since April 29, 2013PECOS EnrolledAccepts Medicare Assignment

97.58/100

CMS Quality Rating

720 ESKENAZI AVE, INDIANAPOLIS, IN 46202(317) 880-7666(317) 880-0448 Get Directions Write a Review

NPPES record last updated: March 14, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 14, 2025, Sep 7, 2023, Dec 2, 2021 and 2 more (5 updates tracked since 2019).

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About Sujal Hemant Modi Md NPPES

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

SUJAL HEMANT MODI MD (NPI 1184068561) is an individual cardiovascular disease provider in Indianapolis, Indiana, licensed in Indiana (01090483A) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS, is affiliated with Indiana University Health, and is a graduate of West Virginia University School Of Medicine (2009).

NPPES Registry Identity

NPI1184068561

Entity TypeIndividualMale

Primary Taxonomy207RC0000X

Provider Legal NameSUJAL HEMANT MODICredential: MD

Location Address720 ESKENAZI AVEIndianapolis, IN 46202-5187

Mailing AddressOsu Divsion Of Cardiovascular Medicine, 473 W 12th Ave Ste 200Columbus, OH 43210-1252 · (614) 292-4967

Phone(317) 880-7666

Fax(317) 880-0448

Sole ProprietorNo

Medical School CMSWest Virginia University School Of MedicineGraduated 2009

Enumeration DateApril 29, 2013

Last NPPES UpdateMarch 14, 20255 updates tracked since enumeration

NPPES CertifiedMarch 14, 2025

✔ NPI 1184068561 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

Licenses✔ Licensed in IN · 01090483A✔ Licensed in PA · MD467708

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Also ListedInternal MedicineTaxonomy 207R00000X · License 01090483A (IN)

Also ListedInternal Medicine · Advanced Heart Failure and Transplant CardiologyTaxonomy 207RA0001X · License 01090483A (IN)

720 ESKENAZI AVE, Indianapolis, IN 46202

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Other Identifiers 2

Medicaid300081931IN

Other1102845520IN · Anthem Ptan

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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

Sujal Hemant 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 ID5496058042

PECOS Enrollment IDI20230912001636

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 10

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.

108 services30 patients

Evaluation of lower heart chamber assist device 93750

An evaluation of a lower heart chamber assist device is a procedure to check the function of an implanted device aiding your heart's lower chambers. This helps ensure optimal heart function by monitoring the device's performance and your heart's response to it.

102 services16 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

72 services19 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.

62 services41 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.

62 services22 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

53 services31 patients

Hospital Affiliations CMS Care Compare 3

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

Indiana University Health

Acute Care Hospitals · Indianapolis, IN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150056

Location1701 N Senate BlvdIndianapolis, IN 46202 · Marion County

Emergency services Birthing friendly

Indiana University Health Ball Memorial Hospital

Acute Care Hospitals · Muncie, IN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150089

Location2401 University AveMuncie, IN 47303 · Delaware County

Emergency services Birthing friendly

Indiana University Health North Hospital

Acute Care Hospitals · Carmel, IN

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150161

Location11700 N Meridian StCarmel, IN 46032 · Hamilton County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46202 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

$122.49 typical visit price

range $53.07 – $161.76

Typical copayment $30.62 (range $13.26 – $40.44)

Most-billed visit code 99204

Established Patient

$66.48 typical visit price

range $16.93 – $132.22

Typical copayment $16.62 (range $4.23 – $33.05)

Most-billed visit code 99213

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.

97.58/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

86.53

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 20

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

MRS. ALEXIS A DAVIS LCSW

Marriage & Family Therapist