Individual provider Active NPI

Justine Dellatte, RDN

  • Registered Dietitian
  • Bay Head, NJ
National Provider Identifier
1023745221
Registry record updated Aug 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86085171 Issued in NY
Practice address
92 Bridge Ave Ste 202
Bay Head, NJ 08742-5068
Phone
(732) 701-7126
NPI assigned
Aug 7, 2022
Last updated
Aug 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2022

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 86085171 NY Primary

Addresses

Primary practice location

92 Bridge Ave Ste 202
Bay Head, NJ 08742-5068

Mailing address

21 Van Orden Ave
Suffern, NY 10901-6330
Phone (845) 596-8615

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240318001388 TX Practitioner - Registered Dietitian Or Nutrition Professional 8325485048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nourish, Inc.Group PAC ID 1557724937, 288 clinicians

Practice addresses (Care Compare)

3724 Jefferson St
Suite 104
Austin, TX 78731-6204
Phone (512) 693-7045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86085171NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nourish, Inc. Dietitian, Registered CurrentSince Jan 24, 2024 Accepting new patients
Chandler Ray, RDN LLC Dietitian, Registered CurrentSince Aug 14, 2022 Accepting new patients

Locations

500 Westover Dr
Sanford, NC 27330
Phone (478) 766-4000

92 Bridge Ave
Ste 202
Bay Head, NJ 08742
Phone (732) 586-3575

3724 Jefferson St
Ste 104
Austin, TX 78731
Phone (512) 399-9039

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1659830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659830400000",
    "number": "1023745221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 VAN ORDEN AVE",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109016330",
            "telephone_number": "845-596-8615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 BRIDGE AVE STE 202",
            "city": "BAY HEAD",
            "state": "NJ",
            "postal_code": "087425068",
            "telephone_number": "732-701-7126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELLATTE",
        "first_name": "JUSTINE",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-07",
        "last_updated": "2022-08-07",
        "certification_date": "2022-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "86085171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Head, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.