Individual ProviderPooja ModiInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701(260) 672-6620PECOS EnrollmentBased on the most recent information from CMS, provider Pooja Modi is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1891225504Provider TypeIndividualFull NameModi, PoojaCredentialMDGenderFemaleSole ProprietorYesEnumeration Date6/14/2017Last Updated3/29/2023Contact InformationPractice LocationPractice Address11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701Phone(260) 672-6620Fax(260) 672-6639Mailing LocationMailing Address11109 Parkview Plaza Dr # 117, Fort Wayne, IN 46845-1701PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense01084561AIndianaCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense4301112544MichiganCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense4351029322Michigan