Individual provider Active NPI

Anthony Honnold

  • Registered Dietitian
  • Melville, NY
National Provider Identifier
1073341566
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
150 Broadhollow Rd Ste 102
Melville, NY 11747-4901
Phone
(516) 441-9013
NPI assigned
Jul 25, 2024
Last updated
Jul 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 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 NU Primary

Addresses

Primary practice location

150 Broadhollow Rd Ste 102
Melville, NY 11747-4901

Mailing address

7 Blueberry CT
Melville, NY 11747-4237

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241204000512 NY Practitioner - Registered Dietitian Or Nutrition Professional 9537695366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Dietetics and Nutrition PLLCGroup PAC ID 8224563929, 13 clinicians

Practice addresses (Care Compare)

358 Veterans Memorial Hwy
Suite 10
Commack, NY 11725-4326
Phone (516) 441-9013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New York Dietetics and Nutrition PLLC Dietitian, Registered CurrentSince Dec 1, 2024 Accepting new patients

Locations

358 Veterans Memorial Hwy
Ste 10
Commack, NY 11725
Phone (516) 441-9013

150 Broadhollow Rd
Ste 102
Melville, NY 11747
Phone (516) 441-9013

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": "1721865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1073341566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 BLUEBERRY CT",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BROADHOLLOW RD STE 102",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474901",
            "telephone_number": "516-441-9013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HONNOLD",
        "first_name": "ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-25",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

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