Harshil Dhananjay Modi, MD
Family Practice · Walnut Creek
- Medicare standing
- Clear
- Enrolled, allowed to bill and order, not excluded
- Plans that list them
- 13
- 2 carriers
- Offices
- 2
Offices
2 locations · Jiva Health Inc · County of Santa Clara
Looking this up.
Hospitals listed: Mercy Medical Center. That is not proof they admit you there this week.
Plans that list them
13 plans · 2 carriers
A missing listing does not mean out of network. Directories change, and a listing does not cover every office. Call Dr. Modi’s office to confirm they take your plan. Ask about the office you use, its medical group, referrals and appointments.
13 of 13 plans
| Alignment Health BreathEasy (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Clarity (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Harmony (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Heart & Diabetes (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Heart & Diabetes CalPlus (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | Alignment Health Plan | Listed | Sep 28, 2026 |
| Alignment Health Heart & Diabetes Choice (HMO C-SNP) | Alignment Health Plan | Listed | Sep 28, 2026 |
| Alignment Health Honor+ Plan (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health My Choice CalCare (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Silicon (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health smartHMO (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health the ONE (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
| SCAN Strive (HMO C-SNP) | SCAN Health Plan | Listed | Oct 3, 2026 |
Hospitals they work in
1 hospital
These rate the hospital, not this clinician. Most measures at most hospitals are no different from the national rate.
- Mercy Medical CenterMerced, CAAcute Care Hospital · Voluntary non-profit - Private · Has an emergency department · Birthing-friendlyPart of CommonSpirit Health, which runs 145 hospitals in 19 statesPatients rate it 3 of 5 · 59% would definitely recommend itOverall rating: 3 of 5 starsBetter than the national rate — Catheter Associated Urinary Tract Infections (ICU + select Wards): 0, Oct 2024 – Sep 2025Better than the national rate — Central Line Associated Bloodstream Infection (ICU + select Wards): 0.168, Oct 2024 – Sep 2025Better than the national rate — Clostridium Difficile (C.Diff): 0.364, Oct 2024 – Sep 2025
See every measure and the patient survey for Mercy Medical Center
Behind the star rating — Deaths: 0 better, 5 the same, 1 worse of 6 measures. Safety: 3 better, 3 the same, 0 worse of 6 measures. Readmissions: 0 better, 7 the same, 2 worse of 9 measures. The star rating is worked out from an earlier period than the measures below, so the two can disagree.
| Catheter Associated Urinary Tract Infections (ICU + select Wards)Infections | 0 | Better | Oct 2024 – Sep 2025 |
| Central Line Associated Bloodstream Infection (ICU + select Wards)Infections | 0.168 | Better | Oct 2024 – Sep 2025 |
| Clostridium Difficile (C.Diff)Infections | 0.364 | Better | Oct 2024 – Sep 2025 |
| Abdominopelvic accidental puncture or laceration rateComplications and deaths | 1.1 (0.11 to 2.09) · 798 cases | No different | Jul 2022 – Jun 2024 |
| CMS Medicare PSI 90: Patient safety and adverse events compositeComplications and deaths | 0.74 (0.37 to 1.11) | No different | Jul 2022 – Jun 2024 |
| Death rate for COPD patientsComplications and deaths | 7.7 · 165 cases | None | Jul 2022 – Jun 2025 |
| Death rate for heart attack patientsComplications and deaths | 11.7 · 69 cases | None | Jul 2022 – Jun 2025 |
| Death rate for heart failure patientsComplications and deaths | 11.3 · 449 cases | None | Jul 2022 – Jun 2025 |
| Death rate for pneumonia patientsComplications and deaths | 17.5 · 544 cases | None | Jul 2022 – Jun 2025 |
| Death rate for stroke patientsComplications and deaths | 11 · 206 cases | None | Jul 2023 – Jun 2025 |
| Hybrid Hospital-Wide All-Cause Risk Standardized Mortality RateComplications and deaths | 3.6 · 1,843 cases | None | Jul 2024 – Jun 2025 |
| Iatrogenic pneumothorax rateComplications and deaths | 0.16 (0 to 0.37) · 5,594 cases | No different | Jul 2022 – Jun 2024 |
| In-hospital fall-associated fracture rateComplications and deaths | 0.23 (0.03 to 0.43) · 5,647 cases | No different | Jul 2022 – Jun 2024 |
| Perioperative pulmonary embolism or deep vein thrombosis rateComplications and deaths | 2.53 (0.28 to 4.78) · 763 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative acute kidney injury requiring dialysis rateComplications and deaths | 1.64 (0 to 3.35) · 161 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative hemorrhage or hematoma rateComplications and deaths | 1.96 (0.37 to 3.55) · 791 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative respiratory failure rateComplications and deaths | 7.67 (0 to 16.88) · 163 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative sepsis rateComplications and deaths | 4.84 (0.67 to 9.02) · 115 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative wound dehiscence rateComplications and deaths | 1.92 (0.46 to 3.38) · 273 cases | No different | Jul 2022 – Jun 2024 |
| Pressure ulcer rateComplications and deaths | 0.16 (0 to 0.85) · 4,979 cases | No different | Jul 2022 – Jun 2024 |
| MRSA BacteremiaInfections | 0 | No different | Oct 2024 – Sep 2025 |
| SSI - Colon SurgeryInfections | 0.764 | No different | Oct 2024 – Sep 2025 |
| Acute Myocardial Infarction (AMI) 30-Day Readmission RateUnplanned return visits | 14 · 31 cases | None | Jul 2023 – Jun 2025 |
| Heart failure (HF) 30-Day Readmission RateUnplanned return visits | 21.5 · 477 cases | None | Jul 2023 – Jun 2025 |
| Hospital return days for heart failure patientsUnplanned return visits | 62.8 · 511 cases | None | Jul 2022 – Jun 2025 |
| Hospital return days for pneumonia patientsUnplanned return visits | 43.6 · 554 cases | None | Jul 2022 – Jun 2025 |
| Pneumonia (PN) 30-Day Readmission RateUnplanned return visits | 18.8 · 462 cases | None | Jul 2023 – Jun 2025 |
| Rate of emergency department (ED) visits for patients receiving outpatient chemotherapyUnplanned return visits | 5.7 (3.8 to 8.2) · 152 cases | No different | Jan 2024 – Dec 2024 |
| Rate of inpatient admissions for patients receiving outpatient chemotherapyUnplanned return visits | 10.7 (8 to 14.1) · 152 cases | No different | Jan 2024 – Dec 2024 |
| Rate of readmission for chronic obstructive pulmonary disease (COPD) patientsUnplanned return visits | 19.9 · 196 cases | None | Jul 2023 – Jun 2025 |
| Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)Unplanned return visits | 13.9 (10.2 to 19) · 70 cases | No different | Jan 2022 – Dec 2024 |
| Ratio of unplanned hospital visits after hospital outpatient surgeryUnplanned return visits | 1 (0.8 to 1.4) · 413 cases | No different | Jan 2024 – Dec 2024 |
What patients said (394 patients answered, 11% of those asked)
| Cleanliness | 4 |
| Nurse communication | 3 |
| Doctor communication | 2 |
| Communication about medicines | 3 |
| Discharge information | 3 |
| Overall hospital rating | 3 |
| Quietness | 3 |
| Recommend hospital | 2 |
| Room was "always" clean | 73% |
| Nurses "always" communicated well | 78% |
| Doctors "always" communicated well | 75% |
| Staff "always" explained | 61% |
| Yes, staff "did" give patients this information | 85% |
| Yes, staff "did" give patients information about help after discharge | 83% |
| Doctors "always" explained things so they could understand | 73% |
| Doctors "always" listened carefully | 72% |
| Doctors "always" treated them with courtesy and respect | 80% |
| Patients who gave a rating of "9" or "10" (high) | 64% |
| Staff "always" explained new medications | 74% |
| Nurses "always" explained things so they could understand | 74% |
| Nurses "always" listened carefully | 75% |
| Nurses "always" treated them with courtesy and respect | 85% |
| "Always" quiet at night | 49% |
| "YES", patients would definitely recommend the hospital | 59% |
| Staff "always" explained possible side effects | 49% |
| Yes, staff "did" give patients information about possible symptoms | 86% |
Original Medicare doctor bills
$3,849
Medicare paid this office $3,849 for 31 people.
This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.
| Initial hospital care with moderate level of medical decision making at least 75 minutes | 18 | $2,444 | $136 |
Who their Medicare patients are
31 Original Medicare patients in 2024. Average age 77 · Health risk score 2.30. Sicker patients than 9 in 10 peers; the typical family practice clinician is at 1.13.
Conditions among them: High blood pressure 75% · Diabetes 55% · Coronary heart disease 45% · Chronic kidney disease 45% · Depression 39%.
The office billed $40,986, Medicare allowed $4,831 and paid $3,849; for 34 services of 5 kinds.
Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.
Medicaid work
$26,864 in 2024
Medicaid paid $26,864 for 410 billed services this clinician did in 2024, up to 51 people in a month for one service.
Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.
| Clinic visit/encounter, all-inclusive | 149 | $26,684 |
| Short return visit (20+ min) | 249 | $96 |
| Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A | 12 | $84 |
| 2024 | 410 | 3 | 51 | $26,864 |
Drugs they prescribed that Part D paid
$201,381
Pharmacies billed $201,381 in 2024.
This is pharmacy cost, not the office bill, and not what patients paid.
Opioids were 0% of their Part D prescriptions (0 of 779) in 2024. At or below the middle of the specialty; the typical family practice clinician is at 2%.
576 generic and fewer than 11 brand-name prescriptions · $201,381 in drug cost.
Part D prescriptions only. The opioid rate is opioid prescriptions as a share of all this clinician's Part D prescriptions; surgeons and pain specialists run higher than others, so it is shown against the same specialty.
| Biktarvy | 13 | $59,007 | $4,539 |
| Jardiance | 22 | $27,951 | $1,270 |
| Farxiga | 16 | $9,958 | $622 |
| Januvia | 13 | $7,305 | $562 |
| Lantus Solostar | 15 | $1,362 | $91 |
See all 22 drugs
| Biktarvy | 13 | $59,007 | $4,539 |
| Jardiance | 22 | $27,951 | $1,270 |
| Farxiga | 16 | $9,958 | $622 |
| Januvia | 13 | $7,305 | $562 |
| Lantus Solostar | 15 | $1,362 | $91 |
| Humalog | 15 | $1,175 | $78 |
| Albuterol Sulfate Hfa | 11 | $459 | $42 |
| Tamsulosin | 25 | $400 | $16 |
| Atorvastatin | 51 | $330 | $6 |
| Metformin | 34 | $226 | $7 |
| Gabapentin | 18 | $225 | $12 |
| Losartan | 21 | $181 | $9 |
| Lisinopril | 27 | $157 | $6 |
| Fluticasone Propionate | 14 | $146 | $10 |
| Clopidogrel | 15 | $142 | $9 |
| Metoprolol | 17 | $141 | $8 |
| Omeprazole | 13 | $123 | $9 |
| Finasteride | 20 | $109 | $5 |
| Amlodipine Besylate | 37 | $104 | $3 |
| Pantoprazole | 15 | $93 | $6 |
| Carvedilol | 15 | $84 | $6 |
| Metformin Hcl Er | 14 | $63 | $4 |
Year by year
| 2024 | 779 | 85 | 0% (0) | None | $201,381 |
| 2023 | 303 | 55 | 0% (0) | None | $133,177 |
Part D prescriptions only. A drug prescribed to fewer than 11 people in a year is hidden.
See the drugs prescribed each year
2023: 4 drugs
| Atorvastatin | 15 | $567 | $38 |
| Tamsulosin | 12 | $379 | $32 |
| Pantoprazole | 13 | $150 | $12 |
| Latanoprost | 11 | $144 | $13 |
Money from drug and device companies
$1,499 in 2025
| 2025 | 12 | 28 | None | $1,499 |
| 2024 | 1 | 3 | None | $202 |
| 2023 | 1 | 1 | None | $18 |
Paid work is consulting, speaking, honoraria and royalties, as opposed to meals and travel.
A payment is not proof that care is biased.
| Inspire Medical Systems | Inspire | $989 | 13 payments
|
| Jazz Pharmaceuticals | Xywav | $208 | 3 payments
|
| Xeris Pharmaceuticals | Recorlev | $43 | 2 payments
|
| Salix Pharmaceuticals a division of Bausch Health US | Xifaxan | $42 | 2 payments
|
| Ionis Pharmaceuticals | Dawnzera | $39 | 1 payment
|
| Fresenius Kabi USA | None | $35 | 1 payment
|
See all 28 published payments
| Jazz Pharmaceuticals | Meals · 2025-12-27 | Xywav | $18 |
| Salix Pharmaceuticals a division of Bausch Health US | Meals · 2025-12-21 | Xifaxan | $23 |
| AstraZeneca Pharmaceuticals LP | Meals · 2025-12-19 | Tezspire | $18 |
| Boehringer Ingelheim Pharmaceuticals | Meals · 2025-12-15 | Jardiance | $24 |
| Inspire Medical Systems | Meals · 2025-12-05 | Inspire | $12 |
| Inspire Medical Systems | Meals · 2025-12-04 | Inspire | $19 |
| Inspire Medical Systems | Meals · 2025-12-03 | Inspire | $7 |
| Inspire Medical Systems | Meals · 2025-12-03 | Inspire | $22 |
| Inspire Medical Systems | Meals · 2025-12-03 | Inspire | $44 |
| Inspire Medical Systems | Meals · 2025-12-03 | Inspire | $32 |
| Inspire Medical Systems | Travel · 2025-12-03 | Inspire | $126 |
| Inspire Medical Systems | Meals · 2025-12-02 | Inspire | $99 |
| Inspire Medical Systems | Meals · 2025-12-02 | Inspire | $12 |
| Inspire Medical Systems | Meals · 2025-12-02 | Inspire | $41 |
| Inspire Medical Systems | Travel · 2025-12-02 | Inspire | $35 |
| Salix Pharmaceuticals a division of Bausch Health US | Meals · 2025-12-01 | Xifaxan | $19 |
| Novo Nordisk | Meals · 2025-11-27 | Rybelsus | $31 |
| Xeris Pharmaceuticals | Meals · 2025-11-25 | Recorlev | $24 |
| GlaxoSmithKline | Meals · 2025-11-24 | Nucala | $22 |
| Inspire Medical Systems | Travel · 2025-11-18 | Inspire | $400 |
| Inspire Medical Systems | Meals · 2025-11-12 | Inspire | $141 |
| Jazz Pharmaceuticals | Education · 2025-11-04 | Xywav | $100 |
| Jazz Pharmaceuticals | Education · 2025-11-04 | Xywav | $90 |
| Xeris Pharmaceuticals | Meals · 2025-10-28 | Recorlev | $20 |
| Avadel CNS Pharmaceuticals | Meals · 2025-10-20 | Lumryz | $28 |
| Lilly USA | Meals · 2025-10-03 | Mounjaro | $20 |
| Ionis Pharmaceuticals | Meals · 2025-09-23 | Dawnzera | $39 |
| Fresenius Kabi USA | Meals · 2025-09-03 | None | $35 |
See earlier years (2024, 2023)
2024: $202
| Jazz Pharmaceuticals | Xywav | $202 | 3 payments
|
2023: $18
| Genzyme | Dupixent | $18 | 1 payment
|
Professional record
- NPI
- 1639759020
- Group
- Jiva Health Inc · County of Santa Clara
- Video visits
- Lists video visits
- Gender
- Male
More record details
- Sole proprietor
- No
- Taxonomy
- Family medicine (207Q00000X); Federal specialty code 207QS1201X (207QS1201X)
- Mailing address
- 215 Lennon Ln Ste 200, Walnut Creek, CA, 94598
- NPI first listed
- 2021-04-10
- NPI last updated
- 2026-01-20
- NPI record certified
- 2026-01-20
This is when the NPI record was last certified, not a medical board exam.