NPIMap

Organization Active NPI

Dietetiko LLC

  • Registered Dietitian
  • Bayamon, PR
National Provider Identifier
1003641127
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
DIETETIKO LLC
Practice address
1845 Carr #2
Suite 509
Bayamon, PR 00959
Phone
(939) 225-7002
Fax
(939) 225-7741
NPI assigned
Sep 6, 2024
Last updated
Sep 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Authorized official

Name
Rickly Jose Torres Garcia, LCDO
Title
President
Phone
(787) 903-1703

Specialties & licenses 1

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

Addresses

Primary practice location

1845 Carr #2
Suite 509
Bayamon, PR 00959

Mailing address

V8 Calle 12
Bayamon, PR 00959-8017
Phone (787) 903-1703

Other practice location 1

1492 Ave Ponce de Leon
Suite 112 Centro Europa
San Juan, PR 00907-4012
Phone (939) 399-3494

Other practice location 2

1519 Ave Ponce De Leon Ste 1105
San Juan, PR 00909-1722
Phone (787) 977-0707

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241010004029 PR Part B Supplier - Clinic/Group Practice 5890227185 Receives reassigned benefits from 1 practitioner
Practice locations: Bayamon, PR; San Juan, PR

National Provider Directory

National Provider Directory

Locations

1845 Carr 2
Ste 502
Bayamon, PR 00959
Phone (787) 798-3194

1845 Carr 2
Ste 509
Bayamon, PR 00959
Phone (787) 210-7578

1492 Ave Ponce de Leon
Ste 112
San Juan, PR 00907
Phone (939) 399-3494

1519 Ave Ponce de Leon
Ste 1105
Santurce, PR 00909
Phone (787) 722-3963

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1725580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725580800000",
    "number": "1003641127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "V8 CALLE 12",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009598017",
            "telephone_number": "787-903-1703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 CARR #2",
            "address_2": "SUITE 509",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00959",
            "telephone_number": "939-225-7002",
            "fax_number": "939-225-7741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1492 AVE PONCE DE LEON",
            "address_2": "SUITE 112 CENTRO EUROPA",
            "address_purpose": "LOCATION",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009074012",
            "country_code": "US",
            "telephone_number": "939-399-3494",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1519 Ave Ponce De Leon Ste 1105",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "009091722",
            "country_code": "US",
            "telephone_number": "787-977-0707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DIETETIKO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-06",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-03",
        "status": "A",
        "authorized_official_last_name": "TORRES GARCIA",
        "authorized_official_first_name": "RICKLY",
        "authorized_official_middle_name": "JOSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-903-1703",
        "authorized_official_credential": "LCDO"
    },
    "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 Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; 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.