ANIL R MODI MD
NPI 1508868704
Internal Medicine in Lagrange, GA

Q: What is Anil Modi's NPI number?

The NPI number for Anil Modi is 1508868704. It was assigned to this individual provider in the NPPES registry on June 1, 2005.

Q: What is Anil Modi's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Anil Modi was last updated on May 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since June 01, 2005PECOS EnrolledAccepts Medicare Assignment

92.93/100

CMS Quality Rating

300 MEDICAL DR, SUITE 701, LAGRANGE, GA 30240(706) 882-8971(706) 882-8991 Get Directions Write a Review

NPPES record last updated: May 28, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Anil R Modi Md NPPES

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

ANIL R MODI MD (NPI 1508868704) is an individual internal medicine provider in Lagrange, Georgia, licensed in Georgia (048066) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, is affiliated with Wellstar West Georgia Medical Center, and is a graduate of Other (1989).

NPPES Registry Identity

NPI1508868704

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameANIL R MODICredential: MD

Location Address300 MEDICAL DR, SUITE 701Lagrange, GA 30240-4130

Mailing Address300 Medical Dr, Suite 701Lagrange, GA 30240-4130 · (706) 882-8971 · Fax (706) 882-8971

Phone(706) 882-8971

Fax(706) 882-8991

Sole ProprietorNo

Medical School CMSOtherGraduated 1989

Enumeration DateJune 1, 2005

Last NPPES UpdateMay 28, 2024

NPPES CertifiedMay 28, 2024

✔ NPI 1508868704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in GA · 048066

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.

300 MEDICAL DR, Lagrange, GA 30240

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Other Identifiers 1

Medicaid00843873GGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.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

Anil R 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 ID4587687611

PECOS Enrollment IDI20060104000532

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 16

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

918 services287 patients

Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454

This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.

746 services113 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

672 services146 patients

Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457

This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.

401 services123 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

268 services148 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

216 services214 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

158 services158 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

92 services18 patients

Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment 99453

Remote monitoring of physiologic parameters involves using special equipment to track vital signs like heart rate and blood pressure from a distance. The initial set-up includes installing the device and teaching the patient how to use it correctly for accurate readings.

91 services88 patients

Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow G0181

This service involves a physician overseeing your care while you receive Medicare-covered services from a home health agency. The care you're receiving is complex and involves various disciplines. The physician isn't physically present but regularly supervises your treatment to ensure optimal health outcomes.

45 services20 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

23 services18 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

20 services17 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

17 services17 patients

Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) G0506

This service involves a thorough evaluation of patients needing ongoing care for chronic conditions. It includes creating a tailored care plan, coordinating with healthcare providers, and monitoring progress regularly. The goal is to provide optimal, personalized care for your long-term health needs.

15 services15 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

13 services11 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.

12 services12 patients

Hospital Affiliations CMS Care Compare

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

Wellstar West Georgia Medical Center

Acute Care Hospitals · Lagrange, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110016

Location1514 Vernon RoadLagrange, GA 30240 · Troup County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30240 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

$124.10 typical visit price

range $53.31 – $164.04

Typical copayment $31.02 (range $13.32 – $41.01)

Most-billed visit code 99204

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

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.

92.93/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

80.38

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

96%583 patients4/55-star benchmark: 100%

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.

Referred Medical Equipment & Supplies CMS DME claims 9

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

13 suppliers61 claims155 services$5.79 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

8 suppliers40 claims60 services$1.00 avg. paid by Medicare

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

2 suppliers12 claims1,740 services$1.68 avg. paid by Medicare

Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034

Other-Enteral and Parenteral · category OB006N

1 supplier11 claims66 services$3.76 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers30 claims30 services$19.79 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

2 suppliers12 claims12 services$908.73 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 16

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

MEDICAL CARE OF LAGRANGE, LLC

Internal Medicine

300 MEDICAL DR, SUITE 701
LAGRANGE, GA 30240

Troup County (706) 882-8971

HEIDI ANN HALLA-BAUER PSY.D

Psychologist

300 MEDICAL DR, STE 705
LAGRANGE, GA 30240

Troup County (706) 885-0111

DR. PETER PING LEE M.D.

Psychiatry & Neurology (Neurology)

300 MEDICAL DR, SUITE 701
LAGRANGE, GA 30240

Troup County (706) 882-0552

GEORGE M HENRY M.D.

Specialist

300 MEDICAL DR, SUITE 705
LAGRANGE, GA 30240

Troup County (706) 885-0111

M. DIANNE WAGES LPC

Counselor (Mental Health)

300 MEDICAL DR, M. DIANNE WAGES, LPC
LAGRANGE, GA 30240

Troup County (706) 885-0111

PETER PING LEE MD PC

Psychiatry & Neurology (Neurology)

300 MEDICAL DR, SUITE 701
LAGRANGE, GA 30240

Troup County (706) 882-0552

LAURA D BYARD LPC

Counselor (Professional)

300 MEDICAL DR, STE 705
LAGRANGE, GA 30240

Troup County (706) 885-0111

PSY-VISIONS OF GA, LLC

Psychiatry & Neurology (Psychiatry)

300 MEDICAL DR, SUITE 705
LAGRANGE, GA 30240

Troup County (706) 885-0111

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 Anil Modi's NPI number?

The NPI number for Anil Modi is 1508868704. It was assigned to this individual provider in the NPPES registry on June 1, 2005.

Where is Anil Modi located?

Anil Modi practices at 300 Medical Dr Suite 701, Lagrange, GA 30240. The listed phone number is (706) 882-8971.

What is Anil Modi's specialty?

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

Is Anil Modi enrolled in Medicare?

Yes. Anil 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.

What insurance does Anil Modi accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Anil 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 Anil Modi affiliated with any hospitals?

According to CMS data, Anil Modi is affiliated with Wellstar West Georgia Medical Center.

When was this NPI record last updated?

The NPPES record for Anil Modi was last updated on May 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.