TEJAS J MODI M.D.
NPI 1912245267
Internal Medicine - Hematology & Oncology in Madisonville, KY

Q: What is Tejas Modi's NPI number?

The NPI number for Tejas Modi is 1912245267. It was assigned to this individual provider in the NPPES registry on January 22, 2013.

Q: What is Tejas Modi's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Q: When was this NPI record last updated?

The NPPES record for Tejas Modi was last updated on December 4, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 January 22, 2013PECOS EnrolledAccepts Medicare Assignment

95.5/100

CMS Quality Rating

900 HOSPITAL DR, MADISONVILLE, KY 42431(270) 825-5800(270) 825-5810 Get Directions Write a Review

NPPES record last updated: December 4, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 4, 2020, Jul 1, 2016 (2 updates tracked since 2016).

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About Tejas J Modi M.d. NPPES

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

TEJAS J MODI M.D. (NPI 1912245267) is an individual hematology & oncology provider in Madisonville, Kentucky, licensed in Kentucky (4933) and active in the NPI registry since January 2013. He is enrolled in Medicare PECOS, is affiliated with Deaconess Hospital Inc, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1912245267

Entity TypeIndividualMale

Primary Taxonomy207RH0003X

Provider Legal NameTEJAS J MODICredential: M.D.

Location Address900 HOSPITAL DRMadisonville, KY 42431-1644

Mailing Address900 Hospital DrMadisonville, KY 42431-1644 · (270) 825-5800 · Fax (270) 825-5810

Phone(270) 825-5800

Fax(270) 825-5810

Sole ProprietorYes

Medical School CMSOtherGraduated 2007

Enumeration DateJanuary 22, 2013

Last NPPES UpdateDecember 4, 20202 updates tracked since enumeration

NPPES CertifiedDecember 4, 2020

✔ NPI 1912245267 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0003X

License✔ Licensed in KY · 4933

Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

900 HOSPITAL DR, Madisonville, KY 42431

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, 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

Tejas J 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 ID5496974198

PECOS Enrollment IDI20160726002397

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 8

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.

1,178 services338 patients

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.

334 services56 patients

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

72 services28 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.

68 services68 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.

51 services35 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.

47 services40 patients

Hospital Affiliations CMS Care Compare 3

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

Deaconess Hospital Inc

Acute Care Hospitals · Evansville, IN

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150082

Location600 Mary StEvansville, IN 47710 · Vanderburgh County

Emergency services

Jennie Stuart Medical Center

Acute Care Hospitals · Hopkinsville, KY

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180051

Location320 West 18th StreetHopkinsville, KY 42240 · Christian County

Emergency services Birthing friendly

Baptist Health Deaconess Madisonville

Acute Care Hospitals · Madisonville, KY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180093

Location900 Hospital DriveMadisonville, KY 42431 · Hopkins County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 42431 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

$162.27 typical visit price

range $52.76 – $162.27

Typical copayment $40.56 (range $13.19 – $40.56)

Most-billed visit code 99205

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

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.

95.5/100

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

Scored through an Alternative Payment Model

Quality

89.59

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

100%280 patients5/55-star benchmark: 100%

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…

100%302 patients5/55-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 2

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

Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4036

Other-Enteral and Parenteral · category OB006N

2 suppliers12 claims330 services$5.53 avg. paid by Medicare

Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152

Other-Enteral and Parenteral · category OB006N

2 suppliers12 claims6,877 services$0.37 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 20

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

CADE CUNNINGHAM

Pharmacist