Individual provider Active NPI

Jacqueline Rose Reed, MS, RDN, CDN, CDE

  • Registered Dietitian
  • New York, NY
National Provider Identifier
1104390574
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
009186 Issued in NY
Practice address
525 E 68TH St
New York, NY 10065-4870
Phone
(212) 305-2500
NPI assigned
Jan 17, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 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 009186 NY Primary

Addresses

Primary practice location

525 E 68TH St
New York, NY 10065-4870

Mailing address

622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-2200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190227002226 NY Practitioner - Registered Dietitian Or Nutrition Professional 4486993961 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009186NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brookdale Family Care Center, Inc. CurrentSince Mar 1, 2019 Accepting new patients
Bronxcare Health System Dietitian, Registered CurrentSince Jan 29, 2019 Accepting new patients
Brookdale Family Care Center, Inc. CurrentSince Mar 1, 2019 Accepting new patients
Bronxcare Health System CurrentSince Jan 29, 2019 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Mar 1, 2019 Accepting new patients
Bronxcare Health System Current Accepting new patients
Brookdale Hospital Medical Center CurrentSince Mar 1, 2019 Accepting new patients
Urban Strategies Brookdale Family Care Center Inc CurrentSince Mar 1, 2020 Accepting new patients
Jacqueline Reed Current Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Locations

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

1276 Fulton Ave
Rm 228
Bronx, NY 10456

465 New Lots Ave
Brooklyn, NY 11207
Phone (718) 240-5133

1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212

1873 Eastern Pkwy
Brooklyn, NY 11233
Phone (718) 240-5133

1095 Flatbush Ave
Brooklyn, NY 11226
Phone (718) 240-5132

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

2554 Linden Blvd
Brooklyn, NY 11208
Phone (718) 240-5132

Networks

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

Organizations & group practices 10

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": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1104390574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870",
            "telephone_number": "212-305-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REED",
        "first_name": "JACQUELINE",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "MS, RDN, CDN, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-17",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "009186",
            "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 Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.