Naz Maduro Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

NAZ MADURO NUTRITION LLC

Practice address

11835 Queens Blvd Ste 400
Forest Hills, NY 11375-7211

Phone

(929) 307-0050

NPI assigned

Aug 3, 2021

Organization subpart

No

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

Authorized official

Name

Nazirber D Maduro, RDN, CDN, CDCESNPI 1306391586

Title

President

Phone

(347) 898-6680

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 5

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

• Nazirber D Maduro, RDN, CDN, CDCES

  • Registered Dietitian
  • Forest Hills, NY
  • NPI 1306391586
  Medicare reassignment Authorized official
• Stephanie Aviles, CDN

  • Registered Dietitian
  • Bronx, NY
  • NPI 1063093698

  Dietitian, Registered

  Medicare reassignment NPD
• Leddy Wilma Mezarina, RDN, CDN

  • Registered Dietitian
  • Forest Hills, NY
  • NPI 1619643343

  Dietitian, Registered

  Medicare reassignment NPD
• Yandra Marisol Doering, RDN, CDN

  • Registered Dietitian
  • Forest Hills, NY
  • NPI 1952079329

  Dietitian, Registered

  NPD (past)
• Maeda Mir, RD

  • Registered Dietitian
  • Forest Hills, NY
  • NPI 1780350017

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709078400000",
    "number": "1013681063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11835 QUEENS BLVD STE 400",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757211",
            "telephone_number": "929-307-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 QUEENS BLVD STE 400",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757211",
            "telephone_number": "929-307-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAZ MADURO NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-03",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "MADURO",
        "authorized_official_first_name": "NAZIRBER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-898-6680",
        "authorized_official_credential": "RDN, CDN, CDCES"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NAZIRBER MADURO INDIVIDUAL NPI",
            "identifier": "1306391586",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03813283",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "SIMPLEPRACTICE.COM",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "11835 Queens Blvd Ste 400",
            "city": "Forest Hills",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113757211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Natalya Raytses Medical PC
• Kristina Natan, M.D.
• Arthur Natanov, D.D.S.
• Yelena Natanov Jr.
• Shamira Nayeem
• Samantha Nazareth, M.D.
• Michael Nazario, LMSW
• Julia Nazarov, DPT
• Neal Simkovic MD PC
• Annette Neglia, R.N.

• Registered Dietitian in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.