Individual provider Active NPI

Diane Giammarino-Tedaldi, RD

  • Registered Dietitian
  • Brooklyn, NY
National Provider Identifier
1043931546
Registry record updated Sep 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
004840 Issued in NY
Practice address
5704 18TH Ave
Brooklyn, NY 11204-1913
Phone
(347) 746-0453
NPI assigned
Sep 5, 2022
Last updated
Sep 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 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 004840 NY Primary

Addresses

Primary practice location

5704 18TH Ave
Brooklyn, NY 11204-1913

Mailing address

1529 59TH St
Brooklyn, NY 11219-5029
Phone (917) 755-4747

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230515000877 NY Practitioner - Registered Dietitian Or Nutrition Professional 8325404551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
New York University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boro Park Nutrition LLCGroup PAC ID 7012334402, 10 clinicians

Practice addresses (Care Compare)

1225 44TH St
Brooklyn, NY 11219-2080
Phone (347) 746-0453

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Boro Park Nutrition, LLC CurrentSince Apr 1, 2023 Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients
Boro Park Dietitian Dietitian, Registered PastSince Jan 28, 2024 Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 3

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": "1662336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662336000000",
    "number": "1043931546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1529 59TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112195029",
            "telephone_number": "917-755-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5704 18TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112041913",
            "telephone_number": "347-746-0453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIAMMARINO-TEDALDI",
        "first_name": "DIANE",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-05",
        "last_updated": "2022-09-05",
        "certification_date": "2022-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "004840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.