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MR. TROY G MODISETTE PMHNP
NPI 1255974549
Nurse Practitioner - Psychiatric/Mental Health in Baltimore, MD

Active since October 20, 2019PECOS Enrolled
76.58/100
CMS Quality Rating
2401 W BELVEDERE AVE, BALTIMORE, MD 21215(410) 601-1000 Get Directions Write a Review

NPPES record last updated: October 31, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 31, 2020, Oct 20, 2019 (2 updates tracked since 2019).

About Mr. Troy G Modisette Pmhnp NPPES

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

MR. TROY G MODISETTE PMHNP (NPI 1255974549) is an individual psychiatric/mental health provider in Baltimore, Maryland, licensed in Maryland (R148972) and active in the NPI registry since October 2019. He is enrolled in Medicare PECOS, is affiliated with Sinai Hospital Of Baltimore, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1255974549
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameMR. TROY G MODISETTECredential: PMHNP
Location Address2401 W BELVEDERE AVEBaltimore, MD 21215-5216
Mailing Address10601 Virginia AveCockeysville, MD 21030-2315 · (443) 742-9167
Phone(410) 601-1000
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateOctober 20, 2019
Last NPPES UpdateOctober 31, 20202 updates tracked since enumeration
NPPES CertifiedOctober 31, 2020
✔ NPI 1255974549 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in MD · R148972
2401 W BELVEDERE AVE, Baltimore, MD 21215
Open in Google Maps ↗

Other Identifiers 1

OtherR148972MD · Nurse Practitioner

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Troy G Modisette Pmhnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9335574771
PECOS Enrollment IDI20200114000580
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 4

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.

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.
193 services177 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.
75 services53 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
25 services25 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.
22 services22 patients

Hospital Affiliations CMS Care Compare 2

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

Sinai Hospital Of Baltimore

Acute Care Hospitals · Baltimore, MD
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number210012
Location2401 West Belvedere AvenueBaltimore, MD 21215 · Baltimore City County
Emergency services Birthing friendly

Levindale Hebrew Geriatric Center And Hospital

Acute Care Hospitals · Baltimore, MD
OwnershipVoluntary non-profit - Private
CMS Certification Number210064
Location2434 West Belvedere AvenueBaltimore, MD 21209 · Baltimore City County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21215 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
$94.08 typical visit price
range $60.73 – $183.44
Typical copayment $23.52 (range $15.18 – $45.86)
Most-billed visit code 99203
Established Patient
$106.59 typical visit price
range $19.60 – $149.17
Typical copayment $26.64 (range $4.90 – $37.29)
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.

76.58/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality64.56
Promoting Interoperability100
Improvement Activities40
Cost48.54

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.

KRISTEN MARLL
Nurse Anesthetist, Certified Registered
2401 W BELVEDERE AVE
BALTIMORE, MD 21215
Baltimore City (410) 601-5209
ANDREW BRAVE CRNP
Nurse Practitioner (Family)
2401 W BELVEDERE AVE
BALTIMORE, MD 21215
Baltimore City (410) 601-9000
DR. CHRISTIAN KADIRI MD
Internal Medicine
2401 W BELVEDERE AVE
BALTIMORE, MD 21215
Baltimore City (410) 601-0594
SNJEZANA JANKOVIC NP
Nurse Practitioner (Family)
2401 W BELVEDERE AVE
BALTIMORE, MD 21215
Baltimore City (410) 601-9802
KATHRYN KEMP
Pediatrics (Pediatric Critical Care Medicine)
2401 W BELVEDERE AVE
BALTIMORE, MD 21215
Baltimore City (410) 601-9000
YULANDA BLACKSTON LGPC
Counselor (Professional)
2401 W BELVEDERE AVE
BALTIMORE, MD 21215
Baltimore City (410) 459-3040
DUNCAN MCELFRESH CRNA
Nurse Anesthetist, Certified Registered
2401 W BELVEDERE AVE, ANESTHESIA DEPARTMENT
BALTIMORE, MD 21215
Baltimore City (410) 601-5209
MRS. KERRY SWEENEY MCCARTNEY FNP
Nurse Practitioner (Family)
2401 W BELVEDERE AVE
BALTIMORE, MD 21215
Baltimore City (410) 601-5373

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 Troy Modisette's NPI number?

The NPI number for Troy Modisette is 1255974549. It was assigned to this individual provider in the NPPES registry on October 20, 2019.

Where is Troy Modisette located?

Troy Modisette practices at 2401 W Belvedere Ave, Baltimore, MD 21215. The listed phone number is (410) 601-1000.

What is Troy Modisette's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Troy Modisette enrolled in Medicare?

Yes. Troy Modisette is registered in the Medicare PECOS enrollment system.

Is Troy Modisette affiliated with any hospitals?

According to CMS data, Troy Modisette is affiliated with Sinai Hospital Of Baltimore and Levindale Hebrew Geriatric Center And Hospital.

When was this NPI record last updated?

The NPPES record for Troy Modisette was last updated on October 31, 2020. 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.