DR. SCOTT ALAN MODENA (NPI# 1659339133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659339133 |
| Entity Type | Individual |
| Full Name | DR. SCOTT ALAN MODENA |
| Credential | M.D. |
| Practice Address |
103 Old Marlton Pike Ste 101 Medford NJ 08055-8772 |
| Practice Telephone | 6099533440 |
| Practice Fax Number | 8569964002 |
| Mailing Telephone | 6099535757 |
| Mailing Fax Number | 8569964002 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2020-10-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
MD417817 | PA | Allopathic & Osteopathic Physicians |
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
25MA07874900 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | GROUP NPI # | 1659328698 | 01 |
| NJ | GROUP NPI # | 1659328698 | 01 |
| Street Address |
103 OLD MARLTON PIKE STE 101 |
| City | MEDFORD |
| State | NJ |
| Zip Code | 08055-8772 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588622740 | David Ross Salowe | Internal Medicine | 103 Old Marlton Pike Ste 101, Medford, NJ 08055-8772 | 2006-05-03 |
| 1144423765 | Angela D. Frates | Internal Medicine | 103 Old Marlton Pike Ste 101, Medford, NJ 08055-8772 | 2007-06-10 |
| 1659328698 | The Gastroenterology Group, P.a. | Internal Medicine | 103 Old Marlton Pike Ste 101, Medford, NJ 08055-8772 | 2006-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215406459 | Natalia Eltabaa | Nurse Practitioner | 143b Atsion Rd, Medford, NJ 08055 | 2018-11-16 |
| 1922574326 | Emily G Wilkins | Psychiatry & Neurology | 239 Taunton, A-2, Medford, NJ 08055 | 2018-10-23 |
| 1508348863 | Gerald D Mingin Jr. | Psychologist | 135 Eayrestown Rd. Suite A, Southampton, NJ 08055 | 2018-09-04 |
| 1316465750 | Gabriella Marie Francis | Specialist/Technologist | 133 Apache Trail, Medford Lakes, NJ 08055 | 2017-09-06 |
| 1265968572 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 609 Eugenia, Medford, NJ 08055 | 2017-05-05 |
| 1326574690 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1503 Cedar Dr, Medford, NJ 08055 | 2017-05-05 |
| 1780110007 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1610 Cedar Dr, Medford, NJ 08055 | 2017-05-05 |
| 1902332216 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1909 Cedar Dr, Medford, NJ 08055 | 2017-05-05 |
| 1083140396 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 503 Eugenia Dr, Medford, NJ 08055 | 2017-05-05 |
| 1457887762 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 905 Eugenia Dr, Medford, NJ 08055 | 2017-05-05 |
| Find all providers in zip 08055 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588622740 | David Ross Salowe | Internal Medicine | 103 Old Marlton Pike Ste 101, Medford, NJ 08055-8772 | 2006-05-03 |
| 1952381394 | Peter W Adesman | Internal Medicine | 2860 Creekside Circle, Medford, OR 97504 | 2006-01-20 |
| 1245860048 | La Clinica Del Valle Family Healthcare Center Inc. | Internal Medicine | 910 S Central Ave, Medford, OR 97501-7822 | 2020-01-21 |
| 1942793583 | La Clinica Del Valle Family Healthcare Center Inc. | Internal Medicine | 3617 S Pacific Hwy, Medford, OR 97501-8957 | 2018-06-08 |
| 1700379419 | La Clinica Del Valle Family Health Care Center Inc. | Internal Medicine | 1307 W Main St, Medford, OR 97501-2936 | 2018-06-08 |
| 1982011813 | Zain Kassam | Internal Medicine | 196 Boston Ave, Suite #1000, Medford, MA 02155-4236 | 2014-07-11 |
| 1558702514 | Vinshi Naz Khan | Internal Medicine | 1698 E Mcandrews Rd Ste 400, Medford, OR 97504-5590 | 2013-07-07 |
| 1821388083 | Meghan E Gilroy | Internal Medicine | 2860 Creekside Cir, Medford, OR 97504 | 2011-04-08 |
| 1144423765 | Angela D. Frates | Internal Medicine | 103 Old Marlton Pike Ste 101, Medford, NJ 08055-8772 | 2007-06-10 |
| 1316011422 | Richard J Hebert | Internal Medicine | 2860 Creekside Cir, Medford, OR 97504 | 2006-11-20 |
| Find all providers in MEDFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.