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DHRUV KAMLESHKUMAR MODI MD
NPI 1891185815
Internal Medicine in Fayetteville, GA

Active since January 29, 2015PECOS EnrolledAccepts Medicare Assignment
1267 HIGHWAY 54 W STE 5400, FAYETTEVILLE, GA 30214(678) 817-5542 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 11, 2025, Mar 7, 2023, May 27, 2022 and 2 more (5 updates tracked since 2016).

About Dhruv Kamleshkumar Modi Md NPPES

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

DHRUV KAMLESHKUMAR MODI MD (NPI 1891185815) is an individual internal medicine provider in Fayetteville, Georgia, licensed in Florida (ME130877) and active in the NPI registry since January 2015. He is enrolled in Medicare PECOS, is affiliated with Piedmont Hospital, and maintains a secondary practice location in Newnan.

NPPES Registry Identity

NPI1891185815
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDHRUV KAMLESHKUMAR MODICredential: MD
Location Address1267 HIGHWAY 54 W STE 5400Fayetteville, GA 30214-2113
Mailing Address275 Collier Rd Nw Ste 290Atlanta, GA 30309-1700 · (404) 352-3300
Phone(678) 817-5542
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateJanuary 29, 2015
Last NPPES UpdateSeptember 11, 20255 updates tracked since enumeration
NPPES CertifiedSeptember 22, 2023
✔ NPI 1891185815 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · ME130877
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.

Secondary Practice Location 1

Location 1795 Poplar Rd Ste 403Newnan, GA 30265-2582 · Phone (470) 683-6020

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

Dhruv Kamleshkumar 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 ID4486936408
PECOS Enrollment IDI20220602003182
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 10

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.
957 services311 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.
371 services214 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.
344 services121 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.
126 services117 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.
110 services108 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
51 services37 patients

Hospital Affiliations CMS Care Compare 4

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

Piedmont Hospital

Acute Care Hospitals · Atlanta, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110083
Location1968 Peachtree Rd NWAtlanta, GA 30309 · Fulton County
Emergency services Birthing friendly

Piedmont Henry Hospital

Acute Care Hospitals · Stockbridge, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110191
Location1133 Eagle's Landing ParkwayStockbridge, GA 30281 · Henry County
Emergency services Birthing friendly

Piedmont Fayette Hospital

Acute Care Hospitals · Fayetteville, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110215
Location1255 Highway 54 WestFayetteville, GA 30214 · Fayette County
Emergency services Birthing friendly

Piedmont Newnan Hospital, Inc

Acute Care Hospitals · Newnan, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110229
Location745 Poplar RoadNewnan, GA 30265 · Coweta County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30214 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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.

Referred Medical Equipment & Supplies CMS DME claims

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

Stationary oxygen contents, liquid, 1 month's supply = 1 unit E0442
DME-Oxygen and Supplies · category DC000N
1 supplier12 claims12 services$45.89 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

ASISH REGMI M.D.
Internal Medicine (Nephrology)
1267 HIGHWAY 54 W STE 5400
FAYETTEVILLE, GA 30214
Fayette County (678) 817-5542

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 Dhruv Modi's NPI number?

The NPI number for Dhruv Modi is 1891185815. It was assigned to this individual provider in the NPPES registry on January 29, 2015.

Where is Dhruv Modi located?

Dhruv Modi practices at 1267 Highway 54 W Ste 5400, Fayetteville, GA 30214. The listed phone number is (678) 817-5542.

What is Dhruv Modi's specialty?

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

Is Dhruv Modi enrolled in Medicare?

Yes. Dhruv 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 Dhruv 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 Dhruv 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 Dhruv Modi affiliated with any hospitals?

According to CMS data, Dhruv Modi is affiliated with Piedmont Hospital, Piedmont Henry Hospital, Piedmont Fayette Hospital and Piedmont Newnan Hospital, Inc.

When was this NPI record last updated?

The NPPES record for Dhruv Modi was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.