KEYUR MODI
NPI 1255869616
General Practice in Edison, NJ
NPI Status: Active since May 30, 2017
Contact Information
1036 AMBOY AVE
EDISON, NJ
ZIP 08837
Phone: (732) 225-2300
- Individual
- Male
- General Practice
- Accepts Insurance
- PECOS Enrolled
About KEYUR MODI
This page provides the complete NPI Profile along with additional information for Keyur Modi, a primary care provider established in Edison, New Jersey with a medical specialization in General Practice. The healthcare provider is registered in the NPI registry with number 1255869616 assigned on May 2017. The practitioner's primary taxonomy code is 208D00000X with license number 22DI02686700 (NJ). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1255869616
- Provider Name
- KEYUR MODI
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1036 AMBOY AVE EDISON, NJ 08837
- Location Phone
- (732) 225-2300
- Mailing Address
- 1036 AMBOY AVE EDISON, NJ 08837
- Mailing Phone
- (732) 225-2300
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-30-2017
- Last Update Date
- 04-26-2022
- Code Navigator
A primary care provider (PCP) like Keyur Modi sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Secondary Locations
- 30 Prospect Ave
Hackensack, NJ 07601
(201) 755-1525
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
General Practice
- Taxonomy Code
- 208D00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 22DI02686700
- License State
- NJ
- Taxonomy Description
- A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Essential 10150 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Essential 10150 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Essential 6500 HSA (+ Incentives) - HMO
- Anthem Bronze Essential 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Essential POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Essential POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Pathway 10150 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 10600 ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway 10600 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway 8500 for HSA - HMO
- Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Catastrophic Essential (+ Incentives) - HMO
- Anthem Catastrophic Pathway (+ Incentives) - EPO
- Anthem Gold Essential 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Essential 2200 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- BEST Life Preferred Dental Plan - PPO
- BEST Life Superior Dental Plan - PPO
- BEST Life Essental Preferred Dental Plan - PPO
- BEST Life Essental Value Dental Plan - PPO
- BEST Life Essential Basic Dental Plan - PPO
- BEST Life Essential Basic Dental - PPO
- BEST Life Essential Basic Dental Plan - Indemnity
- BEST Life Essential Basic Dental Plan - PPO
- BEST Life Essential Value Dental Plan - PPO
- BEST Life Essential Value Dental - PPO
- BEST Life Essential Value Dental Plan - Indemnity
- BEST Life Essential Value Dental Plan - PPO
- BEST Life Preferred Dental - PPO
- BEST Life Preferred Dental Plan - PPO
- BEST Life Preferred Dental Plan - Indemnity
- BEST Life Preferred Dental Plan - PPO
- BEST Life Superior Dental - PPO
- BEST Life Superior Dental Plan - PPO
- BEST Life Superior Dental Plan - Indemnity
- BEST Life Superior Dental Plan - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueDental Copayment Q - PPO
- HRI Essential Plus Plan - HMO
- HRI Essential Plus Plan - PPO
- HRI Preventive Family Plan - HMO
- HRI Preventive Family Plan - PPO
- HRI Total Care Plan - HMO
- HRI Total Care Plan - PPO
- Humana Dental Smart Choice - PPO
- Humana Dental Smart Choice - Basic - PPO
- Humana Dental Smart Choice - High - PPO
- Humana Dental Smart Choice - Lite - PPO
- Humana Dental Smart Choice - Low - PPO
- Paramount Dental Essential Plus Plan - EPO
- Paramount Dental Preventive Family Plan - EPO
- Paramount Dental Total Care Plan - EPO
- Alabama Preferred Plan - PPO
- Alabama Preferred Plan (Pediatric Only) - PPO
- Alabama Preferred Plus Plan - PPO
- Alabama Preferred Plus Plan (Pediatric Only) - PPO
- Alabama Wellness Essentials Plan - PPO
- Florida Preferred Plan - PPO
- Florida Preferred Plan (Pediatric Only) - PPO
- Florida Preferred Plus Plan - PPO
- Florida Preferred Plus Plan (Pediatric Only) - PPO
- Florida Wellness Essentials Plan - PPO
- High PPO Dental Plan - PPO
- High PPO Dental Plan (Pediatric Only) - PPO
- Kansas Preferred Plan - PPO
- Kansas Preferred Plan (Pediatric Only) - PPO
- Kansas Wellness Essentials Plan - PPO
- Low PPO Dental Plan - PPO
- Low PPO Dental Plan (Pediatric Only) - PPO
- Mississippi Preferred Plan - PPO
- Mississippi Preferred Plan (Pediatric Only) - PPO
- Mississippi Wellness Essentials Plan - PPO
- Lone Star - Smile Now - PPO
- Smile Now Arizona - No Waiting Period PPO - PPO
- Smile Now Michigan - No Waiting Period PPO - PPO
- Smile Now Ohio - No Waiting Period PPO - PPO
- Smile Now Texas- No Waiting Period Plan - PPO
- Smile Now Utah - No Waiting Period PPO - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Keyur Modi is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: No
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1255869616, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 64 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 8 providers are registered at the same or a nearby location.
EDISON, NJ 08837
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1255869616, enumerated as an "individual" on May 30, 2017.
The provider is located at 1036 AMBOY AVE EDISON, NJ 08837 and the phone number is (732) 225-2300.
General Practice with taxonomy code 208D00000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, BEST Life, Blue. Please consult your insurance carrier or call the provider to verify.
