Individual provider Active NPI

Ilene Michelle Cohen, MS, RD, CDN, CDE

  • Registered Dietitian
  • New York, NY
National Provider Identifier
1063704252
Registry record updated Nov 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
005703 Issued in NY
Practice address
33 W 19TH St Ste 404
New York, NY 10011-4333
Phone
(917) 658-0554
Fax
(208) 246-1433
NPI assigned
May 6, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2017

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 005703 NY Primary

Addresses

Primary practice location

33 W 19TH St Ste 404
New York, NY 10011-4333

Mailing address

909 3Rd Ave Unit 7857
New York, NY 10150-2119
Phone (917) 658-0554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
005703NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Pranaspirit Nutrition & Wellness, LLC Dietitian, Registered Current Accepting new patients
City Testing Centers LLC Past Accepting new patients
New York Allergy Asthma & Immunology PC Dietitian, Registered PastSince Sep 1, 2022 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1304640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509926400000",
    "number": "1063704252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 3RD AVE UNIT 7857",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101502119",
            "telephone_number": "917-658-0554",
            "fax_number": "208-246-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W 19TH ST STE 404",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100114333",
            "telephone_number": "917-658-0554",
            "fax_number": "208-246-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "ILENE",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "MS, RD, CDN, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-06",
        "last_updated": "2017-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "005703",
            "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 Nov 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.