SUNJAY MODI
NPI 1609371855
Internal Medicine - Allergy & Immunology in Royal Oak, MI
NPI Status: Active since March 29, 2018
Contact Information
3600 W 13 MILE RD
ROYAL OAK, MI
ZIP 48073
Phone: (248) 549-0777
Fax: (248) 549-5888
- Individual
- Male
- Years of Experience 8
- Internal Medicine
- Allergy & Immunology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About SUNJAY MODI
This page provides the complete NPI Profile along with additional information for Sunjay Modi, an internist established in Royal Oak, Michigan with a medical specialization in Internal Medicine, focusing in allergy & immunology and more than 8 years of experience. He graduated from Wayne State University School Of Medicine in 2018. The healthcare provider is registered in the NPI registry with number 1609371855 assigned on March 2018. The practitioner's primary taxonomy code is 207RA0201X with license number 4301508720 (MI). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1609371855
- Provider Name
- SUNJAY MODI
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 3600 W 13 MILE RD ROYAL OAK, MI 48073
- Location Phone
- (248) 549-0777
- Location Fax
- (248) 549-5888
- Mailing Address
- 3600 W 13 MILE RD ROYAL OAK, MI 48073
- Mailing Phone
- (248) 549-0777
- Mailing Fax
- (248) 549-5888
- Medical School Name
- WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 2018
- Is Sole Proprietor?
- No
- Enumeration Date
- 03-29-2018
- Last Update Date
- 10-05-2023
- Code Navigator
An internist like Sunjay Modi is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Secondary Locations
- 500 University Dr
Hershey, PA 17033
(717) 531-0003 - 2799 W Grand Boulevard
Detroit, MI 48202
(313) 916-1888 - 3600 W 13 Mile Rd
Royal Oak, MI 48073
(248) 549-0777
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Allergy & Immunology
- Taxonomy Code
- 207RA0201X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 4301508720
- License State
- MI
- Taxonomy Description
- An internist doctor of osteopathy that specializes in the treatment of allergy and immunologic disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Special Qualifications in the field of Allergy & Immunology.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Cross� Metro Detroit HMO Bronze Extra - HMO
- Blue Cross� Metro Detroit HMO Silver Extra - HMO
- Blue Cross� Preferred HMO Bronze Extra - HMO
- Blue Cross� Preferred HMO Bronze Saver HSA - HMO
- Blue Cross� Preferred HMO Bronze Secure - HMO
- Blue Cross� Preferred HMO Gold - HMO
- Blue Cross� Preferred HMO Gold Extra - HMO
- Blue Cross� Preferred HMO Silver - HMO
- Blue Cross� Preferred HMO Silver Extra - HMO
- Blue Cross� Preferred HMO Silver Saver - HMO
- Blue Cross� Preferred HMO Value - HMO
- Blue Cross� Select HMO Bronze Extra - HMO
- Blue Cross� Select HMO Bronze Saver HSA - HMO
- Blue Cross� Select HMO Bronze Secure - HMO
- Blue Cross� Select HMO Silver - HMO
- Blue Cross� Select HMO Silver Extra - HMO
- Blue Cross� Select HMO Silver Saver - HMO
- Blue Cross� Select HMO Value - HMO
- Blue Cross� Premier PPO Bronze Extra - PPO
- Blue Cross� Premier PPO Bronze HSA - PPO
- Blue Cross� Premier PPO Bronze Secure - PPO
- Blue Cross� Premier PPO Gold - PPO
- Blue Cross� Premier PPO Gold Extra - PPO
- Blue Cross� Premier PPO Silver - PPO
- Blue Cross� Premier PPO Silver Extra - PPO
- Blue Cross� Premier PPO Silver Saver HSA - PPO
- Blue Cross� Premier PPO Value - PPO
- MHP Bronze - HMO
- MHP Bronze Saver (Expanded) - HMO
- MHP Expanded Bronze Standard - HMO
- MHP Gold - HMO
- MHP Gold Standard - HMO
- MHP Silver Exchange - HMO
- MHP Silver Exchange Rewards - HMO
- MHP Silver Standard - HMO
- MHP Young Adult/Catastrophic - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Sunjay Modi is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Sunjay Modi is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 4284978446
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20230712002152
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $33.57 for a new patient copayment and $18.09 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 48073 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $134.28
- Minimum New Patient Price $58.04
- Maximum New Patient Price $177.36
- Average New Patient Copayment $33.57
- Minimum New Patient Copayment $14.51
- Maximum New Patient Copayment $44.34
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $72.38
- Minimum Established Patient Price $18.32
- Maximum Established Patient Price $143.49
- Average Established Patient Copayment $18.09
- Minimum Established Patient Copayment $4.58
- Maximum Established Patient Copayment $35.87
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Sunjay Modi is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| BEAUMONT HOSPITAL ROYAL OAK | 3601 W THIRTEEN MILE RD ROYAL OAK, MI 48073 | (248) 898-5000 | Acute Care Hospitals |
Reviews for SUNJAY MODI
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 0 | 9 | 3 | 7 | 1 | 8 | 5 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 0 | 9 | 6 | 7 | 2 | 8 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 0 + 9 + 6 + 7 + 2 + 8 + 1 + 0 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1609371855 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 9 providers are registered at the same or nearby location.
DR. ABDUL H BAHRAINWALA M.D.
Allergy & Immunology
3600 W 13 MILE RD
ROYAL OAK, MI
ZIP 48073
ALLERGY & ASTHMA ASSOCIATES OF MI PC
Allergy & Immunology
3600 W 13 MILE RD
ROYAL OAK, MI
ZIP 48073
DR. AMRISH K PATEL M.D.
Allergy & Immunology
3600 W 13 MILE RD
ROYAL OAK, MI
ZIP 48073
DR. MOHAMAD Y TAWILA M.D.
Allergy & Immunology
3600 W 13 MILE RD
ROYAL OAK, MI
ZIP 48073
ALLERGY & ASTHMA PHYSICIANS OF ROYAL OAK PC
Allergy & Immunology
3600 W 13 MILE RD
ROYAL OAK, MI
ZIP 48073
ALLISON BARRINGTON PA-C
Physician Assistant
3600 W 13 MILE RD
ROYAL OAK, MI
ZIP 48073
KRISTIN JOY WELBOURN PA-C
Physician Assistant
(Medical)
3600 W 13 MILE RD
ROYAL OAK, MI
ZIP 48073
ELIZABETH RAU
Physician Assistant
3600 W 13 MILE RD
ROYAL OAK, MI
ZIP 48073
EMLILY KATHRYN MLYNAREK PA
Physician Assistant
3600 W 13 MILE RD
ROYAL OAK, MI
ZIP 48073
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1609371855, enumerated as an "individual" on March 29, 2018.
The provider is located at 3600 W 13 MILE RD ROYAL OAK, MI 48073 and the phone number is (248) 549-0777.
Internal Medicine with taxonomy code 207RA0201X and a focus in Allergy & Immunology.
The provider might be accepting Accepts: Blue Care Network of Michigan, Blue Cross Blue. Please consult your insurance carrier or call the provider to verify.
Sunjay Modi is affiliated with: BEAUMONT HOSPITAL ROYAL OAK.
