DR. ACHAL PANKAJ MODI MD
NPI 1255540514
Urology in Waxahachie, TX

Q: What is Achal Modi's NPI number?

The NPI number for Achal Modi is 1255540514. It was assigned to this individual provider in the NPPES registry on May 22, 2007.

Q: What is Achal Modi's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Achal Modi was last updated on February 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 May 22, 2007PECOS EnrolledAccepts Medicare Assignment

2360 N I 35 STE 310, WAXAHACHIE, TX 75165(469) 800-9930(469) 800-9940 Get Directions Write a Review

NPPES record last updated: February 13, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 26, 2019, Jun 14, 2016 (2 updates tracked since 2016).

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About Dr. Achal Pankaj Modi Md NPPES

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

DR. ACHAL PANKAJ MODI MD (NPI 1255540514) is an individual urology provider in Waxahachie, Texas, licensed in Texas (N9270) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Baylor University Medical Center, and is a graduate of Ohio State University College Of Medicine (2006).

NPPES Registry Identity

NPI1255540514

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameDR. ACHAL PANKAJ MODICredential: MD

Location Address2360 N I 35 STE 310Waxahachie, TX 75165-5336

Mailing Address2360 N I 35 Ste 310Waxahachie, TX 75165-5336 · (469) 800-9930 · Fax (469) 800-9940

Phone(469) 800-9930

Fax(469) 800-9940

Sole ProprietorNo

Medical School CMSOhio State University College Of MedicineGraduated 2006

Enumeration DateMay 22, 2007

Last NPPES UpdateFebruary 13, 20262 updates tracked since enumeration

NPPES CertifiedFebruary 13, 2026

✔ NPI 1255540514 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

Licenses✔ Licensed in TX · N9270✔ Licensed in OH · 57012170

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

2360 N I 35 STE 310, Waxahachie, TX 75165

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Other Identifiers 3

Medicaid282992103TX

Medicaid282992105TX

Other282992104TX · Medicaid Other

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas.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

Dr. Achal Pankaj 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 ID4688843949

PECOS Enrollment IDI20110803000517

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 19

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.

512 services395 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

299 services262 patients

Ultrasound measurement of bladder capacity after voiding 51798

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

258 services220 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

220 services189 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.

157 services157 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.

109 services92 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

88 services75 patients

Psa (prostate specific antigen) measurement, total 84153

PSA measurement is a simple blood test that checks for a specific protein produced by your body. High levels could indicate a health issue that needs further investigation. It's often used to monitor general wellness and is part of routine health screening.

50 services50 patients

Imaging of urinary tract following injection of a contrast agent 74420

This procedure involves injecting a contrast agent into your body to help highlight the urinary tract during imaging. The contrast agent makes your urinary tract more visible on the images, providing detailed information about its structure and function. This can help in diagnosing any potential issues.

27 services24 patients

Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope 52310

This is a procedure to remove an object, stone, or tube from your urinary tract. An endoscope, a thin, flexible tube with a light and camera, is used to locate and remove the object. It is a safe and effective way to address the issue.

25 services24 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.

24 services23 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.

22 services13 patients

Crushing of stone of ureter with insertion of stent using an endoscope 52356

This procedure involves using a thin, flexible tube (endoscope) to locate and break down kidney stones in the ureter. After this, a small tube (stent) is inserted to help maintain an open pathway for urine to flow.

21 services19 patients

Bacterial colony count, urine 87086

A bacterial colony count, urine, is a laboratory test that checks a urine sample for bacteria. It helps to identify if an infection is present in the urinary system. High numbers of bacteria in the urine can indicate a urinary tract infection (UTI).

21 services21 patients

Complicated insertion of bladder tube 51703

This procedure involves placing a tube into your bladder to help with urine flow. It may be needed if you have trouble urinating naturally. The process requires specialized skill due to certain complexities but is done with utmost care for your comfort.

18 services11 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

15 services15 patients

Biopsy of prostate gland 55700

A biopsy of the prostate gland is a procedure where a small sample of tissue is taken from your body's internal gland, located near the bladder, for testing. This helps in diagnosing potential health issues. It's usually done with a fine needle and imaging technology for accuracy.

13 services13 patients

Ultrasonic guidance for needle placement 76942

Ultrasonic guidance for needle placement is a technique where sound waves create images that help accurately position the needle during procedures. This method ensures precision, minimizes discomfort, and increases safety.

13 services13 patients

Removal of prostate gland using an electrocautery knife through urethra with control of bleeding using an endoscope 52601

This procedure involves the careful removal of a small gland located in the lower body using a special heated knife, inserted through a natural body passage. An endoscope, a thin tube with a light and camera, helps to manage any bleeding. The aim is to alleviate discomfort and improve overall health.

12 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Baylor University Medical Center

Acute Care Hospitals · Dallas, TX

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number450021

Location3500 Gaston AveDallas, TX 75246 · Dallas County

Emergency services Birthing friendly

Baylor Scott & White Medical Center- Waxahachie

Acute Care Hospitals · Waxahachie, TX

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450372

Location2400 N Interstate Highway 35EWaxahachie, TX 75165 · Ellis County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75165 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

$126.40 typical visit price

range $54.84 – $166.88

Typical copayment $31.60 (range $13.71 – $41.72)

Most-billed visit code 99204

Established Patient

$68.55 typical visit price

range $17.52 – $136.11

Typical copayment $17.13 (range $4.38 – $34.02)

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.

Referred Medical Equipment & Supplies CMS DME claims

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

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

10 suppliers47 claims11,275 services$1.73 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 Achal Modi's NPI number?

The NPI number for Achal Modi is 1255540514. It was assigned to this individual provider in the NPPES registry on May 22, 2007.

Where is Achal Modi located?

Achal Modi practices at 2360 N I 35 Ste 310, Waxahachie, TX 75165. The listed phone number is (469) 800-9930.

What is Achal Modi's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Achal Modi enrolled in Medicare?

Yes. Achal 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 Achal Modi accept?

Health plans from Baylor Scott and White Health Plan and Blue Cross and Blue Shield of Texas list Achal 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 Achal Modi affiliated with any hospitals?

According to CMS data, Achal Modi is affiliated with Baylor University Medical Center and Baylor Scott & White Medical Center- Waxahachie.

When was this NPI record last updated?

The NPPES record for Achal Modi was last updated on February 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.