PRADEEP MODUR M.D.
NPI 1346248515
Psychiatry & Neurology - Neurology in Austin, TX

Active since July 12, 2005PECOS EnrolledAccepts Medicare Assignment
72.52/100
CMS Quality Rating
1600 W 38TH ST STE 200, AUSTIN, TX 78731(512) 324-3540 Get Directions Write a Review

NPPES record last updated: February 5, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 5, 2024, Sep 7, 2023 (2 updates tracked since 2023).

About Pradeep Modur M.d. NPPES

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

PRADEEP MODUR M.D. (NPI 1346248515) is an individual neurology provider in Austin, Texas, licensed in Texas (M5841) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Ascension Seton Medical Center Austin, and is a graduate of Other (1988).

NPPES Registry Identity

NPI1346248515
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NamePRADEEP MODURCredential: M.D.
Location Address1600 W 38TH ST STE 200Austin, TX 78731-6405
Mailing Address1600 W 38th St Ste 200Austin, TX 78731-6405
Sole ProprietorNo
Medical School CMSOtherGraduated 1988
Enumeration DateJuly 12, 2005
Last NPPES UpdateFebruary 5, 20242 updates tracked since enumeration
NPPES CertifiedFebruary 5, 2024
NPI 1346248515 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
License Licensed in TX · M5841
Definition

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

Also ListedPsychiatry & Neurology · EpilepsyTaxonomy 2084E0001X · License M5841 (TX)
Also ListedPsychiatry & Neurology · Clinical NeurophysiologyTaxonomy 2084N0600X · License M5841 (TX)
1600 W 38TH ST STE 200, Austin, TX 78731

Other Identifiers 1

Medicaid64017767KY

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

Pradeep Modur 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 ID4082777990
PECOS Enrollment IDI20090120000111, I20241211004725, I20241213003517, I20241226001222, I20241231000123, I20241231000224, I20250115003679, I20250117003677, I20250312000486, I20250327002876
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 5

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.

Measurement of brain wave activity (eeg), awake and asleep 95819
The measurement of brain wave activity, known as an EEG, records the brain's electrical signals. It's performed when you're awake and asleep to monitor your brain's functioning. It helps in diagnosing conditions like epilepsy, sleep disorders, and other neurological issues.
154 services148 patients
Measurement of brain wave activity (eeg), awake and drowsy 95816
Measurement of brain wave activity, also known as an EEG, is a non-invasive test that records electrical patterns in your brain. This procedure is done when you're awake and drowsy to understand how your brain functions during different states of consciousness.
153 services152 patients
Measurement of brain wave activity with video (veeg), 12-26 hours with review and report by health care professional 95720
This procedure monitors brain wave activity over 12-26 hours using Video EEG (VEEG). It involves recording brain waves and video to detect irregularities. A healthcare professional will review the data and provide a report. It's non-invasive and safe.
111 services64 patients
Measurement of brain wave activity (eeg), in coma or asleep 95822
The measurement of brain wave activity, also known as an EEG, is a non-invasive test that records electrical patterns in your brain. This is done when you're asleep or in a coma, to help understand brain function and identify any abnormalities.
72 services67 patients
Measurement of brain wave activity with video (veeg), 2-12 hours with review and report by health care professional 95718
This procedure, known as a Video EEG (VEEG), records brain wave activity for 2-12 hours. It involves attaching electrodes to your scalp and monitoring brain waves while a video records your actions. This helps health professionals understand and diagnose neurological issues.
12 services12 patients

Hospital Affiliations CMS Care Compare 5

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

Ascension Seton Medical Center Austin

Acute Care Hospitals · Austin, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450056
Location1201 W 38th StAustin, TX 78705 · Travis County
Emergency services Birthing friendly

Dell Seton Med Center At The University Of Tx

Acute Care Hospitals · Austin, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450124
Location601 E 15th StreetAustin, TX 78701 · Travis County

Hendrick Medical Center

Acute Care Hospitals · Abilene, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450229
Location1900 PineAbilene, TX 79601 · Taylor County
Emergency services Birthing friendly

Ascension Seton Williamson

Acute Care Hospitals · Round Rock, TX
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number670041
Location201 Seton ParkwayRound Rock, TX 78664 · Williamson County
Emergency services Birthing friendly

Ascension Seton Hays

Acute Care Hospitals · Kyle, TX
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number670056
Location6001 Kyle PkwyKyle, TX 78640 · Hays County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78731 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
$131.95 typical visit price
range $57.88 – $174.00
Typical copayment $32.98 (range $14.47 – $43.50)
Most-billed visit code 99204
Established Patient
$101.65 typical visit price
range $18.88 – $142.23
Typical copayment $25.41 (range $4.72 – $35.55)
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.

72.52/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality61.27
Promoting Interoperability100
Improvement Activities40
Cost47.12

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
12%34 patients1/55-star benchmark: 92%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
6%80 patients
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
14%70 patients1/55-star benchmark: 85%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%351 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
97%546 patients4/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%102 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
29%293 patients2/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 94% · 71 patients
89%71 patients4/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
84%293 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
28%293 patients2/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
51%293 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

Clinical Nurse Specialist (Adult Health)
1600 W 38TH ST STE 200
AUSTIN, TX 78731
Physician Assistant
1600 W 38TH ST STE 200
AUSTIN, TX 78731
Physical Medicine & Rehabilitation
1600 W 38TH ST STE 200
AUSTIN, TX 78731
Psychiatry & Neurology (Neurology)
1600 W 38TH ST STE 200
AUSTIN, TX 78731
Psychiatry & Neurology (Clinical Neurophysiology)
1600 W 38TH ST STE 200
AUSTIN, TX 78731
Clinical Nurse Specialist (Adult Health)
1600 W 38TH ST STE 200
AUSTIN, TX 78731
Psychiatry & Neurology (Neurology)
1600 W 38TH ST STE 200
AUSTIN, TX 78731
Psychiatry & Neurology (Epilepsy)
1600 W 38TH ST STE 200
AUSTIN, TX 78731

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 Pradeep Modur's NPI number?

The NPI number for Pradeep Modur is 1346248515. It was assigned to this individual provider in the NPPES registry on July 12, 2005.

Where is Pradeep Modur located?

Pradeep Modur practices at 1600 W 38th St Ste 200, Austin, TX 78731. The listed phone number is (512) 324-3540.

What is Pradeep Modur's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Pradeep Modur enrolled in Medicare?

Yes. Pradeep Modur 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 Pradeep Modur accept?

Health plans from Blue Cross and Blue Shield of Texas, Oscar Insurance Company and Sendero Health Plans, Local Nonprofit list Pradeep Modur 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 Pradeep Modur affiliated with any hospitals?

According to CMS data, Pradeep Modur is affiliated with Ascension Seton Medical Center Austin, Dell Seton Med Center At The University Of Tx, Hendrick Medical Center, Ascension Seton Williamson and Ascension Seton Hays.

When was this NPI record last updated?

The NPPES record for Pradeep Modur was last updated on February 5, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.