CHINTAN MODI M.D.
NPI 1649506932
Internal Medicine - Gastroenterology in Edison, NJ

Q: What is Chintan Modi's NPI number?

The NPI number for Chintan Modi is 1649506932. It was assigned to this individual provider in the NPPES registry on October 21, 2009.

Q: What is Chintan Modi's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Chintan Modi was last updated on September 10, 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 October 21, 2009PECOS EnrolledAccepts Medicare Assignment

95.47/100

CMS Quality Rating

98 JAMES STREET, # 200, EDISON, NJ 08820(732) 243-9695 Get Directions Write a Review

NPPES record last updated: September 10, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Chintan Modi M.d. NPPES

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

CHINTAN MODI M.D. (NPI 1649506932) is an individual gastroenterology provider in Edison, New Jersey, licensed in New Jersey (25 MA 086 37300) and active in the NPI registry since October 2009. He is enrolled in Medicare PECOS, is affiliated with Raritan Bay Medical Center, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1649506932

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameCHINTAN MODICredential: M.D.

Location Address98 JAMES STREET, # 200Edison, NJ 08820

Mailing Address331 Newman Springs Rd Ste 220Red Bank, NJ 07701-5792

Phone(732) 243-9695

Sole ProprietorNo

Medical School CMSOtherGraduated 2003

Enumeration DateOctober 21, 2009

Last NPPES UpdateSeptember 10, 2024

NPPES CertifiedSeptember 10, 2024

✔ NPI 1649506932 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in NJ · 25 MA 086 37300

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Also ListedInternal MedicineTaxonomy 207R00000X · License 25MA08637300 (NJ)

98 JAMES STREET, Edison, NJ 08820

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Other Identifiers 1

Medicaid0216844NJ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.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

Chintan Modi 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 ID648311415

PECOS Enrollment IDI20091231000230

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

Medicare enrollment records show Chintan Modi reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Hackensack Meridian Health Medical Group - Specialty Care PC

21 mi

Surgical Critical Care

331 NEWMAN SPRINGS RD STE 220
Red Bank, NJ 07701

Reassigned Medicare billing, New Jersey enrollment
2,844 clinicians in this Medicare group

NPI 1215989249 (732) 807-0800

New Jersey Medical And Health Associates,llc

21 mi

Internal Medicine

308 WILLOW AVE
Hoboken, NJ 07030

Reassigned Medicare billing, New Jersey enrollment
124 clinicians in this Medicare group

NPI 1558673582 (844) 427-4362

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

Areas of Expertise CMS Part B claims 14

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

1,391 services256 patients

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.

493 services296 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

252 services104 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

209 services192 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

179 services43 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.

153 services153 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

151 services146 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

124 services112 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.

109 services102 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

101 services100 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

67 services66 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

54 services54 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

39 services39 patients

Insertion of stomach tube using a flexible endoscope 43246

This procedure involves the use of a flexible endoscope, a thin tube with a light and camera, to insert a stomach tube. It helps doctors view and access your stomach without surgery. It's typically performed under sedation to ensure comfort.

16 services15 patients

Hospital Affiliations CMS Care Compare 2

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

Raritan Bay Medical Center

Acute Care Hospitals · Perth Amboy, NJ

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310039

Location530 New Brunswick AvePerth Amboy, NJ 08861 · Middlesex County

Emergency services Birthing friendly

Jfk Medical Center

Acute Care Hospitals · Edison, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310108

Location65 James StreetEdison, NJ 08820 · Middlesex County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08820 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

$144.86 typical visit price

range $63.84 – $190.92

Typical copayment $36.21 (range $15.96 – $47.73)

Most-billed visit code 99204

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

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.

95.47/100

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

Individually scored

Quality

100

Promoting Interoperability

100

Improvement Activities

Cost

53.92

Reported Quality Measures

Colorectal Cancer Screening

100%2,544 patients5/55-star benchmark: 100%

Controlling High Blood Pressure

99%67 patients5/55-star benchmark: 91%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

98%64 patients1/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

100%6,708 patients5/55-star benchmark: 100%

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

100%3,612 patients5/55-star benchmark: 100%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

81%5,790 patients5/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 83% · 2,745 patients

Patients screened: 83% · 2,745 patients

100%969 patients5/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

88%4,215 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.

Other Providers at the Same Location NPPES 3

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

MIDDLESEX CARDIAC DIAGNOSTIC CENTER

Nuclear Medicine (Nuclear Cardiology)

98 JAMES STREET, SUITE 100
EDISON, NJ 08820

Middlesex County (732) 494-6300

DR. MOHAMMED FARRUKH NIZAM M.D.

Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)

98 JAMES STREET, SUITE 301
EDISON, NJ 08820

Middlesex County (732) 738-8830

CINDY MARIE BREZNAK MD

Ophthalmology

98 JAMES STREET, SUITE 210
EDISON, NJ 08820

Middlesex County (732) 744-1800

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 Chintan Modi's NPI number?

The NPI number for Chintan Modi is 1649506932. It was assigned to this individual provider in the NPPES registry on October 21, 2009.

Where is Chintan Modi located?

Chintan Modi practices at 98 James Street # 200, Edison, NJ 08820. The listed phone number is (732) 243-9695.

What is Chintan Modi's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Chintan Modi enrolled in Medicare?

Yes. Chintan 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 Chintan Modi's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Chintan Modi reassigns Medicare benefits to 2 organizations: Hackensack Meridian Health Medical Group - Specialty Care PC (Red Bank, NJ) and New Jersey Medical And Health Associates,llc (Hoboken, NJ). 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 Chintan Modi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Chintan Modi accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Oscar Health list Chintan 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 Chintan Modi affiliated with any hospitals?

According to CMS data, Chintan Modi is affiliated with Raritan Bay Medical Center and Jfk Medical Center.

When was this NPI record last updated?

The NPPES record for Chintan Modi was last updated on September 10, 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.