Tejal R Modi, PA-C - Medicare Physician Assistant in Evanston, IL

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Tejal R Modi, PA-C is a medicare enrolled "Physician Assistant" in Evanston, Illinois. Her current practice location is 2650 Ridge Ave, Evanston, Illinois. You can reach out to her office (for appointments etc.) via phone at (847) 570-2111.

Tejal R Modi is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1639370794.

Contact Information

Tejal R Modi, PA-C
2650 Ridge Ave,
Evanston, IL 60201-1718
(847) 570-2111
Not Available

Map and Direction




Provider's Profile

Full NameTejal R Modi
GenderFemale
SpecialityPhysician Assistant
Location2650 Ridge Ave, Evanston, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1639370794
  • Provider Enumeration Date: 05/29/2007
  • Last Update Date: 06/13/2016
  Medicare PECOS Information:
  • PECOS PAC ID: 3577792811
  • Enrollment ID: I20140206001239

Medical Identifiers

Medical identifiers for Tejal R Modi such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1639370794NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant (* (Not Available))Primary

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. Tejal R Modi allows following entities to bill medicare on her behalf.
Entity NameEndeavor Health Medical Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1497701882
PECOS PAC ID: 2163334699
Enrollment ID: O20040524000118
Entity NameTri-county Emergency Physicians Ltd
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1700810470
PECOS PAC ID: 2567412240
Enrollment ID: O20050131000438
Entity NameCepamerica Illinois LLP
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1912283110
PECOS PAC ID: 3274793633
Enrollment ID: O20120322000587
Entity NamePremise Health of Illinois Medical PC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1427366921
PECOS PAC ID: 3971764762
Enrollment ID: O20120423000619
Entity NameCrystal Lake Immediate Care Physicians Ltd.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1538517198
PECOS PAC ID: 2961783139
Enrollment ID: O20161229001875
Entity NameBhril Schaumburg PC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1134977390
PECOS PAC ID: 2769929744
Enrollment ID: O20240808000961

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. Tejal R Modi 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
Tejal R Modi, PA-C
2650 Ridge Ave,
Evanston, IL 60201-1718

Ph: Not Available		Tejal R Modi, PA-C
2650 Ridge Ave,
Evanston, IL 60201-1718

Ph: (847) 570-2111

Reviews and Comments


Physician Assistant Nurses in Evanston, IL

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Practice Location: 2650 Ridge Ave, Walgreen Building, Suite 2507, Evanston, IL 60201
Phone: 847-570-1171    Fax: 847-570-2930

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.