DR. MICHAEL MODICA (M.D.) – Diagnostic Radiology Physician, NPI 1295926061
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
195 DIAGNOSTIC RADIOLOGY in ID
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Provider Addresses for DR. MICHAEL MODICA (M.D.)
877, West Main Street, Downtown, Boise, Ada County, Idaho, 83702, United States
SUITE 603
BOISE, ID 837025883
Phone: (208) 367-2161
Fax: (208) 367-2989
Type: Location
877 W Main St
Suite 603
Boise, ID 837025883
Phone: (208) 367-2161
Fax: (208) 367-2989
Type: Location
8750 WILSHIRE BLVD STE 100
BEVERLY HILLS, CA 902112708
Phone: (310) 689-3100
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-02-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130816000497 | I | Diagnostic Radiology | ID | TBD |
| I20240216000776 | I | Diagnostic Radiology | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| A9575 | Injection, gadoterate meglumine, 0.1 ml | 13,680 | 78 | $0 |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 1,796 | 36 | $0 |
| 71045 | X-ray of chest, 1 view | 552 | 506 | $0 |
| 70450 | Ct scan head or brain without contrast | 239 | 236 | $0 |
| 72148 | Mri scan of lower spinal canal without contrast | 185 | 184 | $0 |
Insurance plans in this area (ZIP 83702)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | IN | |
| Diagnostic Radiology | ID | |
| Diagnostic Radiology | MA | |
| Diagnostic Radiology, Interventional Radiology | CA | |
| Diagnostic Radiology | TX | |
| Diagnostic Radiology | ID | |
| Diagnostic Radiology | MN | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | VT |
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