Individual provider Active NPI

Kasandra P Reid, RD

  • Registered Dietitian
  • Worcester, MA
National Provider Identifier
1033931365
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86326593 Issued in CA
Practice address
44 Portland St FL 1
Worcester, MA 01608-2023
Phone
(617) 249-3253
NPI assigned
Oct 28, 2024
Last updated
Oct 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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 86326593 CA Primary

Addresses

Primary practice location

44 Portland St FL 1
Worcester, MA 01608-2023

Mailing address

265 Chelmsford St Ste 7
Chelmsford, MA 01824-2335

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241122001632 MA Practitioner - Registered Dietitian Or Nutrition Professional 1658806906 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86326593CAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Everlong Inc. Dietitian, Registered CurrentSince Dec 1, 2024 Accepting new patients

Locations

10089 Willow Creek Rd
Ste 2
San Diego, CA 92131

10089 Willow Creek Rd
Ste 200
San Diego, CA 92131
Phone (858) 621-1514

2629 Lindberg Rd
Anderson, IN 46012

265 Chelmsford St
Ste 7
Chelmsford, MA 01824
Phone (603) 255-7076

44 Portland St
Fl 4
Worcester, MA 01608
Phone (617) 249-3253

428 Minnesota St
#500
Saint Paul, MN 55101
Phone (651) 353-9342

601 Allen St
Ste 209
Syracuse, NY 13210

1806 Summit Ave
Ste 300
Richmond, VA 23230
Phone (804) 315-3771

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, 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": "1730073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1033931365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 CHELMSFORD ST STE 7",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "018242335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 PORTLAND ST FL 1",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016082023",
            "telephone_number": "617-249-3253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "KASANDRA",
        "middle_name": "P",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86326593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

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