Individual provider Active NPI

Phylicia Ruggieri, MS, RD, CDN, CNSC

  • Registered Dietitian
  • Great Neck, NY
National Provider Identifier
1073229779
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
009310 Issued in NY
Practice address
55 Cuttermill Rd
Great Neck, NY 11021-3259
Phone
(516) 751-5736
Fax
(516) 740-0285
NPI assigned
Jan 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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 009310 NY Primary

Addresses

Primary practice location

55 Cuttermill Rd
Great Neck, NY 11021-3259

Mailing address

183 Lincoln Ave
Island Park, NY 11558-1833
Phone (516) 375-1278

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230220001447 NY Practitioner - Registered Dietitian Or Nutrition Professional 1153793153 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
Group practices
Ms Nutritional Wellness PLLCGroup PAC ID 2860828233, 6 clinicians

Practice addresses (Care Compare)

55 Cuttermill Rd
Great Neck, NY 11021-3259
Phone (516) 851-0401

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ms Nutritional Wellness PLLC Dietitian, Registered CurrentSince Feb 20, 2023 Accepting new patients

Locations

55 Cuttermill Rd
Great Neck Plaza, NY 11021
Phone (516) 751-5736

1129 Northern Blvd
Ste 404
Manhasset, NY 11030
Phone (516) 305-5531

Networks

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

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": "1674604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1073229779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 LINCOLN AVE",
            "city": "ISLAND PARK",
            "state": "NY",
            "postal_code": "115581833",
            "telephone_number": "516-375-1278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CUTTERMILL RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213259",
            "telephone_number": "516-751-5736",
            "fax_number": "516-740-0285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUGGIERI",
        "first_name": "PHYLICIA",
        "credential": "MS, RD, CDN, CNSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "009310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.