Dr Shailja Modi, DO - Medicare Pediatrics in Edison, NJ

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Dr Shailja Modi, DO is a medicare enrolled "Pediatrics" physician in Edison, New Jersey. Her current practice location is 65 James St, Edison, New Jersey. You can reach out to her office (for appointments etc.) via phone at (732) 321-7641.

Dr Shailja Modi is licensed to practice in New Jersey (license number 25MB11619200) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1477180263.

Contact Information

Dr Shailja Modi, DO
65 James St,
Edison, NJ 08820
(732) 321-7641
Not Available

Map and Direction




Physician's Profile

Full NameDr Shailja Modi
GenderFemale
SpecialityPediatrics
Location65 James St, Edison, New Jersey
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1477180263
  • Provider Enumeration Date: 03/24/2020
  • Last Update Date: 10/31/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 0648703959
  • Enrollment ID: I20241024004012

Medical Identifiers

Medical identifiers for Dr Shailja Modi such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1477180263NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics 25MB11619200 (New Jersey)Primary
390200000XStudent In An Organized Health Care Education/training Program (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Shailja Modi allows following entities to bill medicare on her behalf.
Entity NameHackensack Meridian Health Medical Group - Specialty Care Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1215989249
PECOS PAC ID: 9133032519
Enrollment ID: O20031111000524
Entity NamePractice Associates Medical Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1427016385
PECOS PAC ID: 5890703177
Enrollment ID: O20060330000690

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Shailja Modi is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Shailja Modi, DO
331 Newman Springs Rd, Bldg 2, Ste 220,
Red Bank, NJ 07701-5688

Ph: () -		Dr Shailja Modi, DO
65 James St,
Edison, NJ 08820

Ph: (732) 321-7641

Reviews and Comments


Pediatrics Doctors in Edison, NJ

Dr. Bina Kapila, M.D
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 145 Coppertree Ct, Edison, NJ 08820
Phone: 973-641-4777    
Dr. Alan Salas, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 65 James St, Edison, NJ 08820
Phone: 732-321-7000    Fax: 732-906-4906
Margarette R. Pierre, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 65 James St, Edison, NJ 08820
Phone: 732-321-7010    Fax: 732-744-5873
Dr. Elana F. Altzman, M.D.
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 65 James St, Edison, NJ 08820
Phone: 732-321-7010    Fax: 732-744-5873
Kavitha Velicheti, MD
Pediatrics
Medicare: Accepting Medicare Assignments
Practice Location: 65 James St, Edison, NJ 08818
Phone: 732-321-7010    Fax: 732-744-5873
Dr. Vrunda Patel,
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 2 State Route 27 Ste 500, Edison, NJ 08820
Phone: 732-516-9868    
Paula Estefania Lopez-perez, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 65 James St, Edison, NJ 08820
Phone: 856-782-2212    Fax: 856-782-2266

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.