Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Michael John Modrow

Individual provider Surgical Physician Assistant · NPI 1740448182

Mr. Michael John Modrow is a Physician Assistant in Raleigh, North Carolina. Qualified in 2005, 21 years ago. Practices with Wakemed Specialists Group LLC, a 869-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
21
Licensed in
NC
In the registry since
2008
Specialties on file
2
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Practice location Address checks out

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone: (919) 350-7601
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 102199 (NC)
Physician Assistant Taxonomy 363A00000X · Licence 1032066 (NC)

Record details

NPI number1740448182
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 31, 2008
Last updated in NPPESMarch 9, 2021
Certification dateMarch 9, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Wakemed Specialists Group Llc — 869 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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