Individual provider Active NPI

Bethany M Doerfler, DIET NUTRITIONIST

  • Registered Dietitian
  • Chicago, IL
National Provider Identifier
1801971049
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
150 E Huron St
Suite 1100
Chicago, IL 60611-2999
Phone
(312) 926-9355
NPI assigned
Oct 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X IL Primary

Addresses

Primary practice location

150 E Huron St
Suite 1100
Chicago, IL 60611-2999

Mailing address

150 E Huron St
Suite 1100
Chicago, IL 60611-2999

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070307000339 IL Practitioner - Registered Dietitian Or Nutrition Professional 5890898134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

259 E Erie St
Chicago, IL 60611-2930
Phone (312) 503-1944

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince May 1, 2007 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince May 1, 2007 Accepting new patients
Central Dupage Physician Group Past Accepting new patients
Northwestern Memorial Physicians Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

111 W Washington St
Ste 1801
Chicago, IL 60602
Phone (312) 726-8800

150 E Huron St
Ste 1100
Chicago, IL 60611
Phone (312) 926-9355

251 E Huron St
#16
Chicago, IL 60611

259 E Erie St
Chicago, IL 60611
Phone (312) 472-6023

259 E Erie St
Fl 16
Chicago, IL 60611
Phone (312) 695-2300

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 4

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801971049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E HURON ST",
            "address_2": "SUITE 1100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E HURON ST",
            "address_2": "SUITE 1100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112999",
            "telephone_number": "312-926-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOERFLER",
        "first_name": "BETHANY",
        "middle_name": "M",
        "credential": "DIET NUTRITIONIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.