| Charles S Modlin, MD | |
|
5165 Mccarty Ln, Lafayette, IN 47905-8764 | |
| (765) 448-8000 | |
| (765) 448-7619 |
| Full Name | Charles S Modlin |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 39 Years |
| Location | 5165 Mccarty Ln, Lafayette, Indiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578527891 | NPI | - | NPPES |
| 0232500 | Medicaid | OH | |
| 815500567 | Other | IN | MEDICARE PTAN |
| 300061295 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 35064578M (Ohio) | Secondary |
| 208800000X | Urology | 01067902A (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Metrohealth System | Cleveland, OH | Hospital |
| West Virginia University Hospitals | Morgantown, WV | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| The Metrohealth System | 8628982949 | 1065 |
| West Virginia University Medical Corporation | 1052224565 | 1722 |
| Entity Name | The Metrohealth System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053353896 PECOS PAC ID: 8628982949 Enrollment ID: O20031119000355 |
| Mailing Address | Practice Location Address |
|---|---|
| Charles S Modlin, MD 250 N Shadeland Ave, Indianapolis, IN 46219-4959 Ph: () - | Charles S Modlin, MD 5165 Mccarty Ln, Lafayette, IN 47905-8764 Ph: (765) 448-8000 |
Parth Udayan Thakker, MD, MS Urology Medicare: Accepting Medicare Assignments Practice Location: 5165 Mccarty Ln, Lafayette, IN 47905 Phone: 765-448-8000 Fax: 765-448-7619 | |
Dr. David Fumo Jr., MD Urology Medicare: Accepting Medicare Assignments Practice Location: 5165 Mccarty Ln, Lafayette, IN 47905 Phone: 765-448-8000 Fax: 765-448-7619 | |
Ashwin Ramaswamy, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 5165 Mccarty Ln, Lafayette, IN 47905 Phone: 765-448-8000 | |
Samuel Chan Kim, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 5165 Mccarty Ln, Lafayette, IN 47905 Phone: 765-448-8000 Fax: 765-448-7619 | |
John David Reisman, MD Urology Medicare: Medicare Enrolled Practice Location: 2600 Greenbush St, Lafayette, IN 47904 Phone: 765-448-8000 Fax: 765-448-7619 | |
Stephen D Beck, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 1345 Unity Pl, Suite 110a, Lafayette, IN 47905 Phone: 765-447-9308 Fax: 765-447-2387 | |
Dr. Shaheen R Alanee, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 5165 Mccarty Ln, Lafayette, IN 47905 Phone: 765-448-8000 Fax: 765-838-4758 |