DR. PAUL STEVEN MODLINGER (M.D.) – Nephrology Physician, NPI 1053405688
Nephrology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
332 NEPHROLOGY in VA
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Provider Addresses for DR. PAUL STEVEN MODLINGER (M.D.)
3930, Walnut Street, Fairchester, Fairfax, Virginia, 22030, United States
SUITE 101
FAIRFAX, VA 220304738
Phone: (703) 246-9246
Fax: (703) 246-9257
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 49 Open Payments records for all available years, with a total value of $5,781.
Total Amount is formed as General ($5,781) + Research ($0) + Ownership ($0) = $5,781.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: ANI Pharmaceuticals, Inc. ($4,826).
Total Amount
$5,781
General + Research + Ownership
Payments
49
Total payment records
General Amount
$5,781
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2012-07-24
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 |
|---|---|---|---|---|
| I20041113000078 | I | Nephrology | DC | TBD |
| I20120724000239 | I | Nephrology | VA | 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 |
|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 681 | 316 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 598 | 318 | $0 |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 127 | 115 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 90 | 90 | $0 |
| 90960 | Dialysis services, 4 or more physician visits per month (20 years or older) | 89 | 29 | $0 |
Insurance plans in this area (ZIP 22030)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NEPHROLOGY | VA | 90961 | Dialysis services (2-3 physician visits per month), patient 20 years of age and older | 152 | 42 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | NY | |
| N E P H R O L O G Y | VA | |
| H O S P I T A L I S T | VA | |
| Nephrology, Internal Medicine | VA | |
| N E P H R O L O G Y | VA | |
| N E P H R O L O G Y | VA | |
| Nurse Practitioner | VA | |
| Internal Medicine, Nephrology | DC | |
| N E P H R O L O G Y | PA | |
| N E P H R O L O G Y | VA |
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