Modern Medical Group Inc is a medicare enrolled "Clinic/center - Multi-specialty" provider in Saint Louis, Missouri. Their current practice location is
5139 Mattis Rd Ste 102, Saint Louis, Missouri. You can reach out to their office (for appointments etc.) via phone at
(314) 396-9517.
Modern Medical Group Inc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Modern Medical Group Inc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1811752900.
Healthcare Provider's Profile
| Full Name | Modern Medical Group Inc |
|---|
| Type | Facility |
|---|
| Speciality | Clinic/center - Multi-specialty |
|---|
| Location | 5139 Mattis Rd Ste 102, Saint Louis, Missouri |
|---|
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1811752900
- Provider Enumeration Date: 02/16/2024
- Last Update Date: 01/31/2025
Medicare PECOS Information:
- PECOS PAC ID: 5193166403
- Enrollment ID: O20240516002741
Medical Identifiers
Medical identifiers for Modern Medical Group Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1811752900 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 261QP1100X | Clinic/center - Podiatric | (* (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.
Modern Medical Group Inc acts as a billing entity for following providers:
| Provider Name | Robert Hacker |
|---|
| Provider Type | Practitioner - General Surgery |
|---|
| Provider Identifiers | NPI Number: 1295985554
PECOS PAC ID: 1254556855
Enrollment ID: I20190409000373 |
|---|
| Provider Name | Jesse R Wolfe |
|---|
| Provider Type | Practitioner - Podiatry |
|---|
| Provider Identifiers | NPI Number: 1467802595
PECOS PAC ID: 6901135300
Enrollment ID: I20230104000651 |
|---|
| Provider Name | Nichole Miller |
|---|
| Provider Type | Practitioner - Nurse Practitioner |
|---|
| Provider Identifiers | NPI Number: 1881046092
PECOS PAC ID: 0143513010
Enrollment ID: I20240719000064 |
|---|
| Provider Name | Jacqueline Mogusu |
|---|
| Provider Type | Practitioner - Nurse Practitioner |
|---|
| Provider Identifiers | NPI Number: 1881162527
PECOS PAC ID: 4981942828
Enrollment ID: I20240820000591 |
|---|
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. Modern Medical Group Inc 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 |
|---|
Modern Medical Group Inc
5139 Mattis Rd Ste 102,
Saint Louis, MO 63128-2250
Ph: (314) 396-9517 | Modern Medical Group Inc
5139 Mattis Rd Ste 102,
Saint Louis, MO 63128-2250
Ph: (314) 396-9517 |
Reviews and Comments