Individual provider Active NPI

Bethany Grace Moran, RDN

  • Registered Dietitian
  • Rochester, NY
National Provider Identifier
1417672007
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
000000 Issued in NY
Practice address
46 Prince St Ste 3001
Rochester, NY 14607-1023
Phone
(585) 602-0801
NPI assigned
Oct 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 000000 NY Primary
Registered Dietitian 133V00000X
Health Educator 174H00000X

Addresses

Primary practice location

46 Prince St Ste 3001
Rochester, NY 14607-1023

Mailing address

46 Prince St Ste 3001
Rochester, NY 14607-1023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230307000886 NY Practitioner - Registered Dietitian Or Nutrition Professional 4486027885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Internal Medicine GroupGroup PAC ID 3476454661, 166 clinicians

Practice addresses (Care Compare)

46 Prince St
Rochester, NY 14607-1023
Phone (585) 530-2050

Merit-based Incentive Payment System (MIPS)

Final score
99.12 of 100Reported as group
Quality
66.85
Promoting interoperability
100
Improvement activities
40
Cost
96.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011274NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Group CurrentSince Oct 9, 2022 Accepting new patients
Internal Medicine Group Health Educator CurrentSince Feb 15, 2023 Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients

Locations

46 Prince St
Rochester, NY 14607
Phone (585) 313-7748

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

46 Prince St
Ste 3001
Rochester, NY 14607
Phone (585) 530-2050

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1417672007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 PRINCE ST STE 3001",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146071023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 PRINCE ST STE 3001",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146071023",
            "telephone_number": "585-602-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "BETHANY",
        "middle_name": "GRACE",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-06",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "000000",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.