JIGNESH MODI M.D.
NPI 1184935074
Internal Medicine - Infectious Disease in Decatur, IL

Active since June 25, 2010PECOS EnrolledAccepts Medicare Assignment
94.61/100
CMS Quality Rating
1730 E LAKE SHORE DR, DECATUR, IL 62521(217) 329-1000(217) 545-0825 Get Directions Write a Review

NPPES record last updated: January 6, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jignesh Modi M.d. NPPES

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

JIGNESH MODI M.D. (NPI 1184935074) is an individual infectious disease provider in Decatur, Illinois, licensed in Illinois (036.125721) and active in the NPI registry since June 2010. He is enrolled in Medicare PECOS, is affiliated with St Johns Hospital, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1184935074
Entity TypeIndividualMale
Primary Taxonomy207RI0200X
Provider Legal NameJIGNESH MODICredential: M.D.
Location Address1730 E LAKE SHORE DRDecatur, IL 62521-3809
Mailing Address1730 E Lake Shore DrDecatur, IL 62521-3809 · (217) 329-1000 · Fax (217) 545-0825
Fax(217) 545-0825
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateJune 25, 2010
Last NPPES UpdateJanuary 6, 2022
NPPES CertifiedJanuary 6, 2022
NPI 1184935074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
License Licensed in IL · 036.125721
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
Also ListedInternal MedicineTaxonomy 207R00000X · License 036.125721 (IL)
Also ListedHospitalistTaxonomy 208M00000X · License 036.125721 (IL)
1730 E LAKE SHORE DR, Decatur, IL 62521

Accepted 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

Jignesh Modi 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 ID1153587878
PECOS Enrollment IDI20120725000338
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 11

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.
1,149 services329 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.
308 services116 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
275 services244 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.
159 services134 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
154 services114 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.
138 services92 patients

Hospital Affiliations CMS Care Compare 5

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

St Johns Hospital

Acute Care Hospitals · Springfield, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140053
Location800 E Carpenter StSpringfield, IL 62769 · Sangamon County
Emergency services Birthing friendly

Hshs Holy Family Hospital Inc

Acute Care Hospitals · Greenville, IL
OwnershipVoluntary non-profit - Church
CMS Certification Number140137
Location200 Health Care DrGreenville, IL 62246 · Bond County
Emergency services

St Marys Hospital

Acute Care Hospitals · Decatur, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140166
Location1800 E Lake Shore DrDecatur, IL 62521 · Macon County
Emergency services Birthing friendly

Hshs St Elizabeth's Hospital

Acute Care Hospitals · O Fallon, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140187
LocationOne St Elizabeth BoulevardO Fallon, IL 62269 · St. Clair County
Emergency services Birthing friendly

St Joseph's Hospital

Critical Access Hospitals · Highland, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number141336
Location12866 Troxler AvenueHighland, IL 62249 · Madison County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62521 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
$127.46 typical visit price
range $54.80 – $168.44
Typical copayment $31.86 (range $13.70 – $42.11)
Most-billed visit code 99204
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

94.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.17
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 11

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

Surgery
1730 E LAKE SHORE DR
DECATUR, IL 62521
Internal Medicine (Pulmonary Disease)
1730 E LAKE SHORE DR
DECATUR, IL 62521
Internal Medicine (Rheumatology)
1730 E LAKE SHORE DR
DECATUR, IL 62521
Nurse Practitioner
1730 E LAKE SHORE DR
DECATUR, IL 62521
Surgery
1730 E LAKE SHORE DR
DECATUR, IL 62521
Surgery
1730 E LAKE SHORE DR
DECATUR, IL 62521
Internal Medicine (Gastroenterology)
1730 E LAKE SHORE DR
DECATUR, IL 62521
Internal Medicine (Gastroenterology)
1730 E LAKE SHORE DR
DECATUR, IL 62521

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 Jignesh Modi's NPI number?

The NPI number for Jignesh Modi is 1184935074. It was assigned to this individual provider in the NPPES registry on June 25, 2010.

Where is Jignesh Modi located?

Jignesh Modi practices at 1730 E Lake Shore Dr, Decatur, IL 62521. The listed phone number is (217) 329-1000.

What is Jignesh Modi's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Jignesh Modi enrolled in Medicare?

Yes. Jignesh 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.

What insurance does Jignesh Modi accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Jignesh 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 Jignesh Modi affiliated with any hospitals?

According to CMS data, Jignesh Modi is affiliated with St Johns Hospital, Hshs Holy Family Hospital Inc, St Marys Hospital, Hshs St Elizabeth's Hospital and St Joseph's Hospital.

When was this NPI record last updated?

The NPPES record for Jignesh Modi was last updated on January 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.