Individual provider Active NPI

Diane M Molter, RN

  • School Registered Nurse
  • Bay Shore, NY
National Provider Identifier
1407333560
Registry record updated Jul 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
5185771 Issued in NY
Practice address
795 Wisconsin Ave
Bay Shore, NY 11706-2336
Phone
(631) 434-2401
NPI assigned
Jul 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 5185771 NY Primary

Addresses

Primary practice location

795 Wisconsin Ave
Bay Shore, NY 11706-2336

Mailing address

839 Lafayette Ave
Bohemia, NY 11716-4407
Phone (631) 218-4711

Other identifiers 1

IdentifierTypeStateIssuer
5185771OtherNYRN LICENSE NUMBER

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
5185771NYMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1532217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532217600000",
    "number": "1407333560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 LAFAYETTE AVE",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117164407",
            "telephone_number": "631-218-4711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 WISCONSIN AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117062336",
            "telephone_number": "631-434-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLTER",
        "first_name": "DIANE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-22",
        "last_updated": "2018-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "5185771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE NUMBER",
            "identifier": "5185771",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.