Individual provider Active NPI

Mary Elizabeth Degnan, MS RD

  • Metabolic Nutrition Registered Dietitian
  • Niagara Falls, NY
National Provider Identifier
1821328758
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
License
007089 Issued in NY
Practice address
621 10TH St
Niagara Falls, NY 14301-1813
Phone
(716) 278-4360
Fax
(716) 278-4266
NPI assigned
Dec 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Metabolic Nutrition Registered Dietitian 133VN1006X 007089 NY Primary

Addresses

Primary practice location

621 10TH St
Niagara Falls, NY 14301-1813

Mailing address

176 B Highland Drive
Williamsville, NY 14221-1235
Phone (716) 957-2285

Other identifiers 1

IdentifierTypeStateIssuer
8668370241MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160922002037 TX Practitioner - Registered Dietitian Or Nutrition Professional 7214113182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
77.59 of 100Reported as group
Quality
47.51
Promoting interoperability
69
Improvement activities
40
Cost
86.96

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
007089NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tuba City Regional Health Care Corporation Current Accepting new patients

Organizations & group practices 1

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": "1261612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1821328758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 B HIGHLAND DRIVE",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142211235",
            "telephone_number": "716-957-2285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 10TH ST",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143011813",
            "telephone_number": "716-278-4360",
            "fax_number": "716-278-4266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGNAN",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "MS RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-24",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "NY",
            "license": "007089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8668370241",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niagara Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; 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.