Lillykutty Abraham Modoor, NURSE PRACTITIONER in Winston Salem, NC

Lillykutty Abraham Modoor, NURSE PRACTITIONER is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Winston Salem, North Carolina. She graduated from nursing school in 2012 and has 12 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Daymark Recovery Services Inc, Wake Forest University Health Sciences and her current practice location is 650 Highland Ave Ste 100, Winston Salem, North Carolina. You can reach out to her office (for appointments etc.) via phone at (336) 607-8523.

Lillykutty Abraham Modoor is licensed to practice in North Carolina (license number 5004280) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1013155969.

Contact Information

	Lillykutty Abraham Modoor, NURSE PRACTITIONER
	650 Highland Ave Ste 100, Winston Salem, NC 27101-4304
	(336) 607-8523
	(336) 773-0916

Map and Direction

Provider's Profile

Full Name	Lillykutty Abraham Modoor
Gender	Female
Speciality	Nurse Practitioner
Experience	12 Years
Location	650 Highland Ave Ste 100, Winston Salem, North Carolina
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Lillykutty Abraham Modoor graduated from nursing school in 2012

NPI Data:

NPI Number: 1013155969
Provider Enumeration Date: 01/30/2009
Last Update Date: 02/06/2023

Medicare PECOS Information:

PECOS PAC ID: 0648420679
Enrollment ID: I20121026000698

Medical Identifiers

Medical identifiers for Lillykutty Abraham Modoor such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1013155969	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	5004280 (North Carolina)	Secondary
363LF0000X	Nurse Practitioner - Family	5004280 (North Carolina)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	5004280 (North Carolina)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
High Point Regional Health System	High point, NC	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Daymark Recovery Services Inc	0547233975	96
Wake Forest University Health Sciences	4486564952	2048

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. Lillykutty Abraham Modoor allows following entities to bill medicare on her behalf.

Entity Name	Wake Forest University Health Sciences
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1003803032 PECOS PAC ID: 4486564952 Enrollment ID: O20031105000436

Entity Name	Daymark Recovery Services Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1558329243 PECOS PAC ID: 0547233975 Enrollment ID: O20040814000213

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. Lillykutty Abraham Modoor 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 Address	Practice Location Address
Lillykutty Abraham Modoor, NURSE PRACTITIONER 284 Executive Park Dr Ste 100, Concord, NC 28025-1833 Ph: (704) 939-1100	Lillykutty Abraham Modoor, NURSE PRACTITIONER 650 Highland Ave Ste 100, Winston Salem, NC 27101-4304 Ph: (336) 607-8523

Reviews and Comments

Nurse Practitioner Nurses in Winston Salem, NC

Kaila Haskins, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2085 Frontis Plaza Blvd, Winston Salem, NC 27103 Phone: 704-316-4136 Fax: 704-417-4814
Cora Robbins, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2025 Frontis Plaza Blvd Ste 100, Winston Salem, NC 27103 Phone: 336-718-6199 Fax: 336-718-6190
Mrs. Joy Lianne Justice, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2085 Frontis Plaza Blvd, Winston Salem, NC 27103 Phone: 704-316-4136 Fax: 704-417-4814
Dr. Marie Huffmaster Thomas, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3333 Silas Creek Pkwy, Winston Salem, NC 27103 Phone: 336-718-5000
Jennifer Adams, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1medical Center Blvd, Winston Salem, NC 27157 Phone: 336-716-2878
Deborah Krist Potticary, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3333 Silas Creek Pkwy, Winston Salem, NC 27103 Phone: 336-718-7041 Fax: 336-718-9622

Lillykutty Abraham Modoor, NURSE PRACTITIONER - Medicare Nurse Practitioner in Winston Salem, NC