Active NPI
Michelle Mock, RD
- Registered Dietitian
- New York, NY
National Provider Identifier
1003935842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 005610-1
- Practice address
- 525 East 68TH Street
New York, NY 10065 - Phone
- (212) 746-3520
- Fax
- (212) 746-8577
- NPI assigned
- Mar 29, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 005610-1 | NY | Primary |
Addresses
Primary practice location
525 East 68TH Street
New York, NY 10065
Mailing address
3 Centershore Rd S
Centerport, NY 11721-1758
Phone (631) 757-1817
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005610-1 | NY | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Networks
- TX HMO D-SNP
- TX HMO
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": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228953600000",
"number": "1003935842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 CENTERSHORE RD S",
"city": "CENTERPORT",
"state": "NY",
"postal_code": "117211758",
"telephone_number": "631-757-1817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 EAST 68TH STREET",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10065",
"telephone_number": "212-746-3520",
"fax_number": "212-746-8577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOCK",
"first_name": "MICHELLE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-29",
"last_updated": "2008-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "005610-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.