Individual provider Active NPI

Molly Meehan Roache, MS, RD, LDN

  • Registered Dietitian
  • Cambridge, MA
National Provider Identifier
1861110439
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
4847 Issued in MA
Practice address
3 Bow St
Cambridge, MA 02138-5109
Phone
(888) 900-2332
NPI assigned
Aug 18, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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 4847 MA Primary

Addresses

Primary practice location

3 Bow St
Cambridge, MA 02138-5109

Mailing address

111 Piermont St
Quincy, MA 02170-2517
Phone (617) 894-2416

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221004002557 MA Practitioner - Registered Dietitian Or Nutrition Professional 1456737170 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4847MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
President and Fellows of Harvard College CurrentSince Sep 13, 2022 Accepting new patients
President & Fellows of Harvard College CurrentSince Sep 13, 2022 Accepting new patients

Locations

188 Longwood Ave
Boston, MA 02115
Phone (617) 432-1434

75 Mount Auburn St
Cambridge, MA 02138
Phone (617) 495-2042

75 Mount Auburn St
#H
Cambridge, MA 02138
Phone (617) 495-4414

Organizations & group practices 2

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": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1861110439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 PIERMONT ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021702517",
            "telephone_number": "617-894-2416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BOW ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385109",
            "telephone_number": "888-900-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACHE",
        "first_name": "MOLLY",
        "middle_name": "MEEHAN",
        "name_prefix": "Mrs.",
        "credential": "MS, RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-18",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "4847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.