DR. MICHAEL MODICA M.D.
NPI 1295926061
Radiology - Diagnostic Radiology in Beverly Hills, CA

Active since August 07, 2007PECOS EnrolledAccepts Medicare Assignment
93.46/100
CMS Quality Rating
8750 WILSHIRE BLVD STE 100, BEVERLY HILLS, CA 90211(310) 689-3100 Get Directions Write a Review

NPPES record last updated: October 23, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Michael Modica M.d. NPPES

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

DR. MICHAEL MODICA M.D. (NPI 1295926061) is an individual diagnostic radiology provider in Beverly Hills, California, licensed in California (C193571) and active in the NPI registry since August 2007. He is enrolled in Medicare PECOS, is affiliated with West Valley Medical Center, and maintains a secondary practice location in Boise.

NPPES Registry Identity

NPI1295926061
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameDR. MICHAEL MODICACredential: M.D.
Location Address8750 WILSHIRE BLVD STE 100Beverly Hills, CA 90211-2708
Mailing Address877 W Main St, Suite 603Boise, ID 83702-5883 · (208) 367-2161 · Fax (208) 367-2989
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateAugust 7, 2007
Last NPPES UpdateOctober 23, 2024
NPPES CertifiedOctober 23, 2024
NPI 1295926061 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
Licenses Licensed in CA · C193571 Licensed in MA · 251042
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
8750 WILSHIRE BLVD STE 100, Beverly Hills, CA 90211

Secondary Practice Location 1

Location 1877 W Main St, Suite 603Boise, ID 83702-5883 · Phone (208) 367-2161 · Fax (208) 367-2989

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

Dr. Michael Modica 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 ID5890941652
PECOS Enrollment IDI20130816000497, I20240216000776
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 55

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.

Injection, gadoterate meglumine, 0.1 ml A9575
Gadoterate meglumine is a contrast agent used in MRI scans to help visualize certain areas of your body more clearly. It's injected into your bloodstream, typically through a vein in your arm, and helps doctors get more detailed images.
6,570 services41 patients
Mri scan of lower spinal canal without contrast 72148
An MRI scan of the lower spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to produce detailed images of your lower spine. This helps identify issues like disc problems, tumors, or nerve conditions. No dye is used.
647 services630 patients
Mri scan of upper spinal canal without contrast 72141
An MRI scan of the upper spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your upper spine. This helps doctors identify issues such as injuries, infections or diseases. No dye is used.
313 services306 patients
Mri scan of brain without contrast 70551
An MRI scan of the brain without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your brain. It helps in detecting abnormalities like tumors, stroke, inflammation, or infection.
267 services260 patients
Mri scan of brain before and after contrast 70553
An MRI scan of the brain, both before and after contrast, helps visualize different brain structures. Initially, images are taken without a contrast agent. Then, a safe dye is injected which helps highlight certain areas, providing clearer, more detailed images.
232 services227 patients
X-ray of chest, 1 view 71045
A chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.
150 services128 patients

Hospital Affiliations CMS Care Compare 2

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

West Valley Medical Center

Acute Care Hospitals · Caldwell, ID
5/5 CMS rating
OwnershipProprietary
CMS Certification Number130014
Location1717 Arlington StreetCaldwell, ID 83605 · Canyon County
Emergency services

Alomere Health

Acute Care Hospitals · Alexandria, MN
4/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number240030
Location111 17th Avenue EastAlexandria, MN 56308 · Douglas County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90211 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
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
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.

93.46/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality92.3
Improvement Activities40

Other Providers at the Same Location NPPES 13

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

Radiology (Diagnostic Radiology)
8750 WILSHIRE BLVD STE 100
BEVERLY HILLS, CA 90211
Radiology (Diagnostic Radiology)
8750 WILSHIRE BLVD STE 100
BEVERLY HILLS, CA 90211
Radiology (Diagnostic Radiology)
8750 WILSHIRE BLVD STE 100
BEVERLY HILLS, CA 90211
Radiology (Diagnostic Radiology)
8750 WILSHIRE BLVD STE 100
BEVERLY HILLS, CA 90211
Radiology (Diagnostic Radiology)
8750 WILSHIRE BLVD STE 100
BEVERLY HILLS, CA 90211
Radiology (Diagnostic Radiology)
8750 WILSHIRE BLVD STE 100
BEVERLY HILLS, CA 90211
Radiology (Diagnostic Radiology)
8750 WILSHIRE BLVD STE 100
BEVERLY HILLS, CA 90211
Radiology (Diagnostic Radiology)
8750 WILSHIRE BLVD STE 100
BEVERLY HILLS, CA 90211

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 Michael Modica's NPI number?

The NPI number for Michael Modica is 1295926061. It was assigned to this individual provider in the NPPES registry on August 7, 2007.

Where is Michael Modica located?

Michael Modica practices at 8750 Wilshire Blvd Ste 100, Beverly Hills, CA 90211. The listed phone number is (310) 689-3100.

What is Michael Modica's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Michael Modica enrolled in Medicare?

Yes. Michael Modica 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 Michael Modica accept?

Health plans from Blue Cross Blue Shield of Arizona list Michael Modica 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 Michael Modica affiliated with any hospitals?

According to CMS data, Michael Modica is affiliated with West Valley Medical Center and Alomere Health.

When was this NPI record last updated?

The NPPES record for Michael Modica was last updated on October 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.