DR. RANDOLPH EUGENE MODLIN M.D.
NPI 1942259114
Internal Medicine - Cardiovascular Disease in White Sulphur Springs, WV

Active since May 08, 2006PECOS EnrolledAccepts Medicare Assignment
89.4/100
CMS Quality Rating
320 W MAIN ST, WHITE SULPHUR SPRINGS, WV 24986(304) 536-4870 Get Directions Write a Review

NPPES record last updated: November 28, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Randolph Eugene Modlin M.d. NPPES

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

DR. RANDOLPH EUGENE MODLIN M.D. (NPI 1942259114) is an individual cardiovascular disease provider in White Sulphur Springs, West Virginia, licensed in West Virginia (25813) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Camc Greenbrier Valley Medical Center, Inc, and is a graduate of Uniformed Services Uhs Fe Hebert School Of Med (1985).

NPPES Registry Identity

NPI1942259114
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameDR. RANDOLPH EUGENE MODLINCredential: M.D.
Location Address320 W MAIN STWhite Sulphur Springs, WV 24986-2414
Mailing Address320 W Main StWhite Sulphur Springs, WV 24986-2414 · (304) 536-4870
Sole ProprietorYes
Medical School CMSUniformed Services Uhs Fe Hebert School Of MedGraduated 1985
Enumeration DateMay 8, 2006
Last NPPES UpdateNovember 28, 2016
NPI 1942259114 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Licenses Licensed in WV · 25813 Licensed in GA · 30837 Licensed in VA · 0101255193
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
320 W MAIN ST, White Sulphur Springs, WV 24986

Accepted 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

Dr. Randolph Eugene Modlin 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 ID4486873395
PECOS Enrollment IDI20140908001951
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 38

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.

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.
579 services319 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.
488 services300 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
284 services182 patients
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
281 services275 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
177 services135 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
174 services149 patients

Hospital Affiliations CMS Care Compare

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

Camc Greenbrier Valley Medical Center, Inc

Acute Care Hospitals · Ronceverte, WV
2/5 CMS rating
OwnershipProprietary
CMS Certification Number510002
Location1320 Maplewood AvenueRonceverte, WV 24970 · Greenbrier County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 24986 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
$124.46 typical visit price
range $53.20 – $164.59
Typical copayment $31.11 (range $13.30 – $41.14)
Most-billed visit code 99204
Established Patient
$66.84 typical visit price
range $16.47 – $133.29
Typical copayment $16.71 (range $4.11 – $33.32)
Most-billed visit code 99213
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.

89.4/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality88.04
Promoting Interoperability96
Improvement Activities40
Cost79.97

Reported Quality Measures

Advance Care Plan
82%552 patients4/55-star benchmark: 100%
Breast Cancer Screening
64%127 patients3/55-star benchmark: 93%
Cervical Cancer Screening
37%41 patients2/55-star benchmark: 98%
Closing the Referral Loop: Receipt of Specialist Report
20%51 patients1/55-star benchmark: 87%
Colorectal Cancer Screening
70%363 patients4/55-star benchmark: 88%
Controlling High Blood Pressure
76%440 patients4/55-star benchmark: 91%
Coronary Artery Disease (CAD): Beta-Blocker Therapy Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF <= 40%)
86%21 patients4/55-star benchmark: 99%
Diabetes: Eye Exam
9%98 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
43%98 patients3/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
94%1,413 patients4/55-star benchmark: 100%
e-Prescribing
99%327 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
4%539 patients1/55-star benchmark: 100%
HIV Screening
4%174 patients1/55-star benchmark: 60%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
25%694 patients2/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
25%594 patients2/55-star benchmark: 97%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
25%314 patients2/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 72% · 555 patients
Patients screened: 80% · 555 patients
9%46 patients1/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
65%331 patients3/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
82%493 patients4/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 549 patients
Patients totalRate: 3% · 559 patients
4%559 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

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

Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
1 supplier11 claims11 services$46.51 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 8

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

Nutritionist
320 W MAIN ST
WHITE SULPHUR SPRINGS, WV 24986
Internal Medicine (Cardiovascular Disease)
320 W MAIN ST
WHITE SULPHUR SPRINGS, WV 24986
Internal Medicine
320 W MAIN ST
WHITE SULPHUR SPRINGS, WV 24986
Clinic/Center (Ambulatory Surgical)
320 W MAIN ST
WHITE SULPHUR SPRINGS, WV 24986
Internal Medicine
320 W MAIN ST
WHITE SULPHUR SPRINGS, WV 24986
Emergency Medicine
320 W MAIN ST
WHITE SULPHUR SPRINGS, WV 24986
Pathology (Anatomic Pathology & Clinical Pathology)
320 W MAIN ST
WHITE SULPHUR SPRINGS, WV 24986
Internal Medicine (Gastroenterology)
320 W MAIN ST
WHITE SULPHUR SPRINGS, WV 24986

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 Randolph Modlin's NPI number?

The NPI number for Randolph Modlin is 1942259114. It was assigned to this individual provider in the NPPES registry on May 8, 2006.

Where is Randolph Modlin located?

Randolph Modlin practices at 320 W Main St, White Sulphur Springs, WV 24986. The listed phone number is (304) 536-4870.

What is Randolph Modlin's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Randolph Modlin enrolled in Medicare?

Yes. Randolph Modlin 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 Randolph Modlin accept?

Health plans from CareSource and Highmark Blue Cross Blue Shield West Virginia list Randolph Modlin 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 Randolph Modlin affiliated with any hospitals?

According to CMS data, Randolph Modlin is affiliated with Camc Greenbrier Valley Medical Center, Inc.

When was this NPI record last updated?

The NPPES record for Randolph Modlin was last updated on November 28, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.