Lillykutty Abraham Modoor, NURSE PRACTITIONER - Medicare 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 NameLillykutty Abraham Modoor
GenderFemale
SpecialityNurse Practitioner
Experience12 Years
Location650 Highland Ave Ste 100, Winston Salem, North Carolina
Accepts Medicare AssignmentsYes. 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.
IdentifierTypeStateIssuer
1013155969NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner 5004280 (North Carolina)Secondary
363LF0000XNurse Practitioner - Family 5004280 (North Carolina)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health 5004280 (North Carolina)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Daymark Recovery Services Inc054723397572
Wake Forest University Health Sciences44865649522012

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 NameWake Forest University Health Sciences
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003803032
PECOS PAC ID: 4486564952
Enrollment ID: O20031105000436
Entity NameDaymark Recovery Services Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI 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 AddressPractice 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


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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.