Active NPI
Jeannine Kaiser, MS, RD, CDCES
- Registered Dietitian
- Patchogue, NY
National Provider Identifier
1083168231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1049577
- Practice address
- 40 W 4TH St Apt 22
Patchogue, NY 11772-2124 - Phone
- (917) 704-5182
- NPI assigned
- Aug 4, 2016
- Reactivated
- Nov 14, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1049577 | NY | Primary |
Addresses
Primary practice location
40 W 4TH St Apt 22
Patchogue, NY 11772-2124
Mailing address
40 West 4TH St Apt 22
Patchogue, NY 11772
Phone (917) 704-5182
Other names 1
- Jeannine Kaiser
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1049577 | NY | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cloud Health Medical Group of New Jersey, P.C. | Past | Accepting new patients | |
| Cloud Health Medical Group, P.a. | Past | Accepting new patients | |
| Nourish, Inc. | Dietitian, Registered | Past | 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.
-
- Internal Medicine Physician
- White Plains, NY
- NPI 1528744935
-
- Internal Medicine Physician
- Union City, NJ
- NPI 1043995467
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733875200000",
"number": "1083168231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 WEST 4TH ST APT 22",
"city": "PATCHOGUE",
"state": "NY",
"postal_code": "11772",
"telephone_number": "917-704-5182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 W 4TH ST APT 22",
"city": "PATCHOGUE",
"state": "NY",
"postal_code": "117722124",
"telephone_number": "917-704-5182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAISER",
"first_name": "JEANNINE",
"credential": "MS, RD, CDCES",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-04",
"last_updated": "2024-12-11",
"certification_date": "2024-12-11",
"deactivation_date": "2020-09-16",
"reactivation_date": "2024-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "1049577",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JEANNINE",
"last_name": "KAISER",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Patchogue, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.