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NISHTHA RAJENDRA MODI MD
NPI 1396205589
Internal Medicine in Morgantown, WV

Active since March 22, 2019PECOS EnrolledAccepts Medicare Assignment
90.11/100
CMS Quality Rating
1200 J D ANDERSON DR, MORGANTOWN, WV 26505(304) 598-1200(304) 598-1699 Get Directions Write a Review

NPPES record last updated: June 24, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 14, 2023, Apr 14, 2022, Oct 22, 2021 and 1 more (4 updates tracked since 2019).

About Nishtha Rajendra Modi Md NPPES

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

NISHTHA RAJENDRA MODI MD (NPI 1396205589) is an individual internal medicine provider in Morgantown, West Virginia, licensed in West Virginia (30595) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS, is affiliated with Mon Health Medical Center, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1396205589
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameNISHTHA RAJENDRA MODICredential: MD
Location Address1200 J D ANDERSON DRMorgantown, WV 26505-3494
Mailing Address1200 J D Anderson DrMorgantown, WV 26505-3494 · (304) 598-1200 · Fax (304) 598-1699
Phone(304) 598-1200
Fax(304) 598-1699
Sole ProprietorYes
Medical School CMSWest Virginia University School Of MedicineGraduated 2018
Enumeration DateMarch 22, 2019
Last NPPES UpdateJune 24, 20264 updates tracked since enumeration
NPPES CertifiedJune 24, 2026
✔ NPI 1396205589 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in WV · 30595
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1200 J D ANDERSON DR, Morgantown, WV 26505
Open in Google Maps ↗

Secondary Practice Locations 3

Location 11 Medical Center DriveClarksburg, WV 26301 · Phone (304) 623-3461
Location 2140 Middletown LoopWhite Hall, WV 26554-8701 · Phone (304) 333-1150
Location 3150 Memorial DrKingwood, WV 26537-1141 · Phone (304) 329-1400

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nishtha Rajendra 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 ID446648265
PECOS Enrollment IDI20211028000872
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Nishtha Modi reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Monongalia County General Hospital Company
Same address
Emergency Medicine
1200 J D ANDERSON DR
Morgantown, WV 26505
  • Reassigned Medicare billing, West Virginia enrollment
  • 318 clinicians in this Medicare group
NPI 1477890440 (304) 598-1200
Preston Memorial Hospital Corporation
20 mi
Emergency Medicine
150 MEMORIAL DR
Kingwood, WV 26537
  • Reassigned Medicare billing, West Virginia enrollment
  • 159 clinicians in this Medicare group
NPI 1841230661 (304) 329-1400
Mon Health Marion Neighborhood Hospital, Inc.
20 mi
Hospitalist
140 MIDDLETOWN LOOP
White Hall, WV 26554
  • Reassigned Medicare billing, West Virginia enrollment
  • 70 clinicians in this Medicare group
NPI 1417521337 (304) 333-1150

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare 2

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

Mon Health Medical Center

Acute Care Hospitals · Morgantown, WV
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510024
Location1200 Jd Anderson DriveMorgantown, WV 26505 · Monongalia County
Emergency services Birthing friendly

Preston Memorial Hospital

Critical Access Hospitals · Kingwood, WV
OwnershipProprietary
CMS Certification Number511312
Location150 Memorial DriveKingwood, WV 26537 · Preston County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 26505 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
$124.46 typical visit price
range $53.20 – $164.59
Typical copayment $31.11 (range $13.30 – $41.14)
Most-billed visit code 99204
Established Patient
$94.81 typical visit price
range $16.47 – $133.29
Typical copayment $23.70 (range $4.11 – $33.32)
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.

90.11/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality66.96
Promoting Interoperability100
Improvement Activities40

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.

FILIP IONESCU MD
Internal Medicine (Hematology & Oncology)
1200 J D ANDERSON DR
MORGANTOWN, WV 26505
Monongalia County (304) 598-6560
BRITTANY RACHELLE POLETTI RN, CRNA
Nurse Anesthetist, Certified Registered
1200 J D ANDERSON DR
MORGANTOWN, WV 26505
Monongalia County (304) 598-1200
LAUREN PATSY
Nurse Anesthetist, Certified Registered
1200 J D ANDERSON DR
MORGANTOWN, WV 26505
Monongalia County (304) 598-1200
CHELSEA COLLINS NP
Nurse Practitioner (Family)
1200 J D ANDERSON DR
MORGANTOWN, WV 26505
Monongalia County (304) 285-3870
GARRETT W. STOVER M.D.
Radiology (Diagnostic Radiology)
1200 J D ANDERSON DR
MORGANTOWN, WV 26505
Monongalia County (304) 366-2600
ALI N AL-HABIB M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
1200 J D ANDERSON DR
MORGANTOWN, WV 26505
Monongalia County (304) 598-1200
TAMMI CLUTTER PPCNP
Nurse Practitioner
1200 J D ANDERSON DR
MORGANTOWN, WV 26505
Monongalia County (888) 988-2273
DR. CHRISTOPHER EDWARDS D.O.
Emergency Medicine
1200 J D ANDERSON DR
MORGANTOWN, WV 26505
Monongalia County (304) 598-1200

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 Nishtha Modi's NPI number?

The NPI number for Nishtha Modi is 1396205589. It was assigned to this individual provider in the NPPES registry on March 22, 2019.

Where is Nishtha Modi located?

Nishtha Modi practices at 1200 J D Anderson Dr, Morgantown, WV 26505. The listed phone number is (304) 598-1200.

What is Nishtha Modi's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Nishtha Modi enrolled in Medicare?

Yes. Nishtha 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.

Which organizations bill Medicare for Nishtha Modi's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nishtha Modi reassigns Medicare benefits to 3 organizations: Monongalia County General Hospital Company (Morgantown, WV), Preston Memorial Hospital Corporation (Kingwood, WV) and Mon Health Marion Neighborhood Hospital, Inc. (White Hall, WV). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nishtha Modi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Nishtha Modi accept?

Health plans from CareSource list Nishtha 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 Nishtha Modi affiliated with any hospitals?

According to CMS data, Nishtha Modi is affiliated with Mon Health Medical Center and Preston Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Nishtha Modi was last updated on June 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.