Individual provider Active NPI

Kristi Garzo, MS, RDN, CDN, CLC

  • Registered Dietitian
  • Vestal, NY
National Provider Identifier
1003570250
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
00886901 Issued in NY
Practice address
3101 Shippers Rd Ste 203
Vestal, NY 13850-2082
Phone
(607) 251-2105
Fax
(607) 251-2010
NPI assigned
Oct 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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 00886901 NY Primary

Addresses

Primary practice location

3101 Shippers Rd Ste 203
Vestal, NY 13850-2082

Mailing address

169 Riverside Dr
Binghamton, NY 13905-4198

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211103002275 NY Practitioner - Registered Dietitian Or Nutrition Professional 1456749878 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00886901NYMDRegistered Dietitian
008869NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Oct 12, 2021 Accepting new patients
Our Lady of Lourdes Memorial Hospital Inc. Current Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Oct 12, 2021 Accepting new patients
Twin Tier Pathology Associates, PC Current Accepting new patients

Locations

169 Riverside Dr
Ste 206
Binghamton, NY 13905
Phone (607) 798-6701

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

500 5th Ave
Owego, NY 13827
Phone (607) 687-1122

3101 Shippers Rd
Ste 203
Vestal, NY 13850
Phone (607) 786-4822

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1003570250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 RIVERSIDE DR",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 SHIPPERS RD STE 203",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502082",
            "telephone_number": "607-251-2105",
            "fax_number": "607-251-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARZO",
        "first_name": "KRISTI",
        "credential": "MS, RDN, CDN, CLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "00886901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.