Individual provider Active NPI

Jessica Marcus, RD

  • Registered Dietitian
  • Kensington, CA
National Provider Identifier
1104284207
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
007206 Issued in NY
Practice address
412 Colusa Ave
Kensington, CA 94707-1211
Phone
(586) 596-1242
NPI assigned
Feb 3, 2016
Last updated
Feb 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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 007206 NY Primary

Addresses

Primary practice location

412 Colusa Ave
Kensington, CA 94707-1211

Mailing address

412 Colusa Ave
Kensington, CA 94707-1211
Phone (586) 596-1242

Other practice location 1

53 Broadway
#308
Brooklyn, NY 11249-6103
Phone (586) 596-1242

Other names 1

  • Jessica Ess Former name

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

State licenses

LicenseStateTypeSpecialty
007206NYMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1454457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1104284207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 COLUSA AVE",
            "city": "KENSINGTON",
            "state": "CA",
            "postal_code": "947071211",
            "telephone_number": "586-596-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 COLUSA AVE",
            "city": "KENSINGTON",
            "state": "CA",
            "postal_code": "947071211",
            "telephone_number": "586-596-1242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "53 Broadway",
            "address_2": "#308",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112496103",
            "country_code": "US",
            "telephone_number": "586-596-1242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCUS",
        "first_name": "JESSICA",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-03",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "007206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "ESS",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kensington, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; 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.