Superior Physician Group
NPI 1164912754ActiveOrganization· Internal Medicine· Temple Terrace, FL
Internal Medicine in Temple Terrace, Florida, registered in NPPES in May 2018. The authorized official on file is Renii Modisette, Operations Manager.
Overview
| NPI | 1164912754 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 18, 2018 |
| Last updated in NPPES | May 22, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
| Pain Medicine, Pain Medicine | 208VP0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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