Surbhibahen Sanjaykumar Modi, - Medicare Family Medicine in Gulfport, MS

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Surbhibahen Sanjaykumar Modi, is a medicare enrolled "Family Medicine" physician in Gulfport, Mississippi. Her current practice location is 4500 13th St, Gulfport, Mississippi. You can reach out to her office (for appointments etc.) via phone at (847) 769-9959.

Surbhibahen Sanjaykumar Modi is licensed to practice in Texas (license number V3053) 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 1104408004.

Contact Information

Surbhibahen Sanjaykumar Modi,
4500 13th St,
Gulfport, MS 39501-2569
(847) 769-9959
Not Available

Map and Direction




Physician's Profile

Full NameSurbhibahen Sanjaykumar Modi
GenderFemale
SpecialityFamily Medicine
Location4500 13th St, Gulfport, Mississippi
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1104408004
  • Provider Enumeration Date: 04/21/2021
  • Last Update Date: 01/22/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 2668879602
  • Enrollment ID: I20240917001939

Medical Identifiers

Medical identifiers for Surbhibahen Sanjaykumar Modi such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104408004NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine V3053 (Texas)Primary
207R00000XInternal Medicine V3053 (Texas)Secondary
390200000XStudent In An Organized Health Care Education/training Program (Mississippi)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. Surbhibahen Sanjaykumar Modi allows following entities to bill medicare on her behalf.
Entity NameNorth Texas Physician Services, Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1992586150
PECOS PAC ID: 6305295429
Enrollment ID: O20231213004113

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. Surbhibahen Sanjaykumar 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
Surbhibahen Sanjaykumar Modi,
4500 13th St,
Gulfport, MS 39501-2569

Ph: (847) 769-9959		Surbhibahen Sanjaykumar Modi,
4500 13th St,
Gulfport, MS 39501-2569

Ph: (847) 769-9959

Reviews and Comments


Family Medicine Doctors in Gulfport, MS

Daniel Salmeron, MD
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Practice Location: 14116 Customs Blvd, Gulfport, MS 39503
Phone: 601-957-6300    
Dr. Carmenza Marcella Valderrama, M.D.
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Practice Location: 1202 Broad Avenue, Gulfport, MS 39501
Phone: 228-822-9360    Fax: 228-822-9361
Dr. Paulette L. Foster-galbraith, M.D.
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Medicare: Accepting Medicare Assignments
Practice Location: 130 Darran St, Gulfport, MS 39503
Phone: 228-831-1988    Fax: 228-832-3844
Dr. Donald D. Weaver, M.D.
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Medicare: Not Enrolled in Medicare
Practice Location: 1612 31st Ave, Gulfport, MS 39501
Phone: 228-864-8454    Fax: 228-865-1457
Taylor Hairston, DO
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Medicare: Medicare Enrolled
Practice Location: 15190 Community Rd, Gulfport, MS 39503
Phone: 228-220-5200    
Candace Worsham, D.O.
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Medicare: Not Enrolled in Medicare
Practice Location: 1924 30th Ave, Gulfport, MS 39501
Phone: 228-863-7117    

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.