Diane Marie Moulton, MSED

Primary specialty

SpecialistTaxonomy code 174400000X

License

321126901 Issued in NY

Practice address

149 N Main St
Fairport, NY 14450-1434

Phone

(585) 377-2230

Fax

(585) 377-2243

NPI assigned

Jun 14, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bright Start Pediatric Services

  • Early Intervention Provider Agency
  • Fairport, NY
  • NPI 1467618231
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339632000000",
    "number": "1053673061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 WOODBINE AVE",
            "city": "EAST ROCHESTER",
            "state": "NY",
            "postal_code": "144451823",
            "telephone_number": "585-747-1417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 N MAIN ST",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144501434",
            "telephone_number": "585-377-2230",
            "fax_number": "585-377-2243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULTON",
        "first_name": "DIANE",
        "middle_name": "MARIE",
        "credential": "MSED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-14",
        "last_updated": "2012-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "321126901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Morgan
• Laura Beth Morrissey
• Christine Mortimer
• Anne Mosehauer
• Anne Marie Moszak, MS,CCC-SLP
• Theresa Mount, RN
• Jane Mousso, LPN
• Bogdan Mscichowski, MD
• Reilly Mueller
• Jana L Mula, RPH

• Specialist in Fairport, NY
• Providers in Fairport, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.