FALGUN M. MODHIA MD
NPI 1942470414
Internal Medicine - Hematology & Oncology in Springfield, MO

Q: What is Falgun Modhia's NPI number?

The NPI number for Falgun Modhia is 1942470414. It was assigned to this individual provider in the NPPES registry on March 11, 2008.

Q: What is Falgun Modhia'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 Falgun Modhia was last updated on June 6, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 March 11, 2008PECOS EnrolledAccepts Medicare Assignment

2055 S FREMONT AVE STE 1000, SPRINGFIELD, MO 65804(417) 820-8099 Get Directions Write a Review

NPPES record last updated: June 6, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Falgun M. Modhia Md NPPES

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

FALGUN M. MODHIA MD (NPI 1942470414) is an individual hematology & oncology provider in Springfield, Missouri, licensed in Missouri (2019011177) and active in the NPI registry since March 2008. He is enrolled in Medicare PECOS, is affiliated with Mercy Hospital Lebanon, and maintains a secondary practice location in Oklahoma City.

NPPES Registry Identity

NPI1942470414

Entity TypeIndividualMale

Primary Taxonomy207RH0003X

Provider Legal NameFALGUN M. MODHIACredential: MD

Location Address2055 S FREMONT AVE STE 1000Springfield, MO 65804

Mailing Address2055 S Fremont Ave Ste 1000Springfield, MO 65804-2206 · (417) 820-8099

Phone(417) 820-8099

Sole ProprietorNo

Medical School CMSOtherGraduated 1999

Enumeration DateMarch 11, 2008

Last NPPES UpdateJune 6, 2019

✔ NPI 1942470414 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0003X

Licenses✔ Licensed in MO · 2019011177✔ Licensed in OK · 29790

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.

2055 S FREMONT AVE STE 1000, Springfield, MO 65804

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Secondary Practice Location 1

Location 1800 NE 10th StOklahoma City, OK 73104-5418 · Phone (405) 271-4022

Accepted Insurance

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

Falgun M. Modhia 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 ID7911082482

PECOS Enrollment IDI20190613002989

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 12

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.

467 services200 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.

317 services164 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.

224 services111 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.

219 services107 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.

145 services59 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.

109 services36 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.

96 services89 patients

Magnesium level 83735

A magnesium level test is a simple blood test that measures the amount of magnesium in your body. Magnesium is a crucial mineral that helps your nerves, muscles, and heart function properly. The test can help detect health conditions like kidney disease or malnutrition.

84 services38 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.

52 services46 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

48 services48 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.

33 services17 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.

11 services11 patients

Hospital Affiliations CMS Care Compare 4

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

Mercy Hospital Lebanon

Acute Care Hospitals · Lebanon, MO

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number260059

Location100 Hospital DriveLebanon, MO 65536 · Laclede County

Emergency services Birthing friendly

Mercy Hospital Springfield

Acute Care Hospitals · Springfield, MO

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260065

Location1235 E CherokeeSpringfield, MO 65804 · Greene County

Emergency services Birthing friendly

Mercy Hospital Aurora

Critical Access Hospitals · Aurora, MO

OwnershipVoluntary non-profit - Church

CMS Certification Number261316

Location500 Porter AvenueAurora, MO 65605 · Lawrence County

Emergency services Birthing friendly

Mercy St Francis Hospital

Critical Access Hospitals · Mountain View, MO

OwnershipVoluntary non-profit - Private

CMS Certification Number261335

Location100 West Highway 60, PO Box 82Mountain View, MO 65548 · Howell County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65804 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

$161.24 typical visit price

range $52.28 – $161.24

Typical copayment $40.31 (range $13.07 – $40.31)

Most-billed visit code 99205

Established Patient

$93.24 typical visit price

range $16.30 – $131.05

Typical copayment $23.31 (range $4.07 – $32.76)

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.

Capecitabine, oral, 500 mg J8521

Treatment-Treatment - Miscellaneous · category RX029N

2 suppliers12 claims1,296 services$0.74 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES

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

DR. SHARLA STILLWELL PHARMD

Pharmacist (Oncology)

2055 S FREMONT AVE STE 1000
SPRINGFIELD, MO 65804

Greene County (417) 820-1347

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 Falgun Modhia's NPI number?

The NPI number for Falgun Modhia is 1942470414. It was assigned to this individual provider in the NPPES registry on March 11, 2008.

Where is Falgun Modhia located?

Falgun Modhia practices at 2055 S Fremont Ave Ste 1000, Springfield, MO 65804. The listed phone number is (417) 820-8099.

What is Falgun Modhia's specialty?

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

Is Falgun Modhia enrolled in Medicare?

Yes. Falgun Modhia 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 Falgun Modhia accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 5 other insurers list Falgun Modhia 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 Falgun Modhia affiliated with any hospitals?

According to CMS data, Falgun Modhia is affiliated with Mercy Hospital Lebanon, Mercy Hospital Springfield, Mercy Hospital Aurora and Mercy St Francis Hospital.

When was this NPI record last updated?

The NPPES record for Falgun Modhia was last updated on June 6, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.