Lisa Modesti, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

718852 Issued in NY

Practice address

20 Birling Gap
Fairport, NY 14450-3916

Phone

(585) 729-9364

NPI assigned

Sep 29, 2015

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1443484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443484800000",
    "number": "1407226871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 BIRLING GAP",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503916",
            "telephone_number": "585-729-9364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 BIRLING GAP",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503916",
            "telephone_number": "585-729-9364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODESTI",
        "first_name": "LISA",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-29",
        "last_updated": "2015-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "718852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley J Millner, LMSW
• Ashley Misciagna
• Laura K Mitchell, M.S., CCC-SLP
• Tessa Marie Mitchell, CCC-SLP
• Toni Mizma
• Ann M Moffitt I, CCC-SLP
• Anjoli Marie Moise, MS
• Andrew Molnar, LPN
• Ann Mongeau, MS, CCC/SLP
• Sandra Mongeon

• Registered Dietitian in Fairport, NY
• Providers in Fairport, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2015; 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.