Individual provider Active NPI

Stephanie Forstall

  • Registered Dietitian
  • New York, NY
National Provider Identifier
1043031594
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
011692 Issued in NY
Practice address
215 E 95TH St Apt 24L
New York, NY 10128-4085
Phone
(810) 444-6762
NPI assigned
Oct 17, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 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 011692 NY Primary

Addresses

Primary practice location

215 E 95TH St Apt 24L
New York, NY 10128-4085

Mailing address

215 E 95TH St Apt 24L
New York, NY 10128-4085
Phone (810) 444-6762

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251210000857 NY Practitioner - Registered Dietitian Or Nutrition Professional 6608360458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19 W 24TH St
FL 4
New York, NY 10010-3239

19 W 24TH St FL
Suite 4
New York, NY 10010-3239

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011692NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
BSH Health PA Dietitian, Registered CurrentSince Oct 1, 2025 Accepting new patients

Locations

19 W 24th St
Fl 4
New York, NY 10010
Phone (646) 844-2332

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": "1729123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1043031594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E 95TH ST APT 24L",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101284085",
            "telephone_number": "810-444-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E 95TH ST APT 24L",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101284085",
            "telephone_number": "810-444-6762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORSTALL",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-17",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "011692",
            "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 Oct 17, 2024; 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.