Individual provider Active NPI

Molly B Bederian, RN, CDE

  • Diabetes Educator Registered Nurse
  • Albany, NY
National Provider Identifier
1073753216
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
273819 Issued in NY
Practice address
63 Shaker Rd Ste 201
Albany, NY 12204-1030
Phone
(518) 471-3636
NPI assigned
Feb 28, 2009
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 005459 NY
Diabetes Educator Registered Nurse 163WD0400X 273819 NY Primary

Addresses

Primary practice location

63 Shaker Rd Ste 201
Albany, NY 12204-1030

Mailing address

PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634

Other practice location 1

147 Hoosick St
Troy, NY 12180-2393
Phone (518) 268-5584

Other practice location 2

2 New Hampshire Ave Ste 200
Troy, NY 12180-1762
Phone (518) 272-0331

Other identifiers 1

IdentifierTypeStateIssuer
04073814MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
005459NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Amsterdam Memorial Hospital Past Accepting new patients
The Endocrine Group Dietitian, Registered Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1235779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1073753216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-525-5634",
            "fax_number": "518-649-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 SHAKER RD STE 201",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122041030",
            "telephone_number": "518-471-3636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "147 Hoosick St",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802393",
            "country_code": "US",
            "telephone_number": "518-268-5584",
            "fax_number": "518-268-5596",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 New Hampshire Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121801762",
            "country_code": "US",
            "telephone_number": "518-272-0331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEDERIAN",
        "first_name": "MOLLY",
        "middle_name": "B",
        "credential": "RN, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "005459",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "NY",
            "license": "273819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04073814",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.