NPIMap

Organization Active NPI

Ms Nutritional Wellness PLLC

  • Registered Dietitian
  • Manhasset, NY
National Provider Identifier
1003446709
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
MS NUTRITIONAL WELLNESS PLLC
Practice address
1129 Northern Blvd Ste 404
Manhasset, NY 11030-3022
Phone
(516) 851-0401
Fax
(516) 740-0285
NPI assigned
Jan 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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

Authorized official

Name
Mrs. Mahtab Soleimanzadeh, RD, CDNNPI 1063925964
Title
Registered Dietitian
Phone
(516) 851-0401

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

1129 Northern Blvd Ste 404
Manhasset, NY 11030-3022

Mailing address

1129 Northern Blvd Ste 404
Manhasset, NY 11030-3022
Phone (516) 851-0401

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200203001151 NY Part B Supplier - Clinic/Group Practice 2860828233 Receives reassigned benefits from 9 practitioners
Practice locations: Manhasset, NY; Great Neck, NY

National Provider Directory

National Provider Directory

Locations

55 Cuttermill Rd
Great Neck Plaza, NY 11021
Phone (516) 751-5736

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579651200000",
    "number": "1003446709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 NORTHERN BLVD STE 404",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303022",
            "telephone_number": "516-851-0401",
            "fax_number": "516-740-0285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 NORTHERN BLVD STE 404",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303022",
            "telephone_number": "516-851-0401",
            "fax_number": "516-740-0285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MS NUTRITIONAL WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-22",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A",
        "authorized_official_last_name": "SOLEIMANZADEH",
        "authorized_official_first_name": "MAHTAB",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "516-851-0401",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RD, CDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; 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.