Payal Modi, MD
NPI 1306166301 · Emergency Medicine Physician · Worcester, MA
Enrolled with Medicare as Practitioner - Emergency Medicine · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Payal Modi, MD is a Emergency Medicine Physician provider in Worcester, MA (NPI 1306166301).
Provider details
- NPI number
- 1306166301
- Entity type
- Individual
- Primary specialty
- Emergency Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- License
- 258647 (MA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
16 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
37 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Emergency Department Visit With High Level of Medical Decision Making99285 | 37 | $176 |
Typical Medicare-allowed amounts for these services range $176–$176 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Registry dates
- Enumerated
- 2010-06-02
- Last updated
- 2023-08-30
- Certified
- 2023-08-30
Frequently asked questions
- What is Payal Modi's NPI number?
- Payal Modi's National Provider Identifier (NPI) is 1306166301, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Payal Modi's specialty?
- Payal Modi is listed in the NPPES registry with a primary specialty of Emergency Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Payal Modi located?
- Payal Modi's practice location on file with NPPES is 55 Lake Ave N, Worcester, MA 01655-0002.
- What is Payal Modi's phone number?
- The practice phone number listed in the NPPES registry for Payal Modi is (508) 421-1400.
- Does Payal Modi accept Medicare?
- Payal Modi is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Payal Modi's NPI active?
- Yes — Payal Modi's NPI (1306166301) is active in the NPPES registry as of the last update on 2023-08-30.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.