Individual provider Active NPI

Marisa Anne Tassi, MS, RDN, LDN

  • Registered Dietitian
  • Gloucester, MA
National Provider Identifier
1104699875
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
5679 Issued in MA
Practice address
298 Washington St
Gloucester, MA 01930-4889
Phone
(978) 381-7505
NPI assigned
Nov 3, 2023
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 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 5679 MA Primary

Addresses

Primary practice location

298 Washington St
Gloucester, MA 01930-4889

Mailing address

8 Birch Pond Dr
Saugus, MA 01906-1292
Phone (617) 383-1763

Other practice location 1

85 Herrick St
Beverly, MA 01915-1777
Phone (978) 816-2501

Other practice location 2

60 Granite St
Lynn, MA 01904-2915
Phone (920) 059-9781

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

LicenseStateTypeSpecialty
5679MAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1698969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1104699875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 BIRCH POND DR",
            "city": "SAUGUS",
            "state": "MA",
            "postal_code": "019061292",
            "telephone_number": "617-383-1763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 WASHINGTON ST",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019304889",
            "telephone_number": "978-381-7505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "85 Herrick St",
            "address_purpose": "LOCATION",
            "city": "Beverly",
            "state": "MA",
            "postal_code": "019151777",
            "country_code": "US",
            "telephone_number": "978-816-2501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "60 Granite St",
            "address_purpose": "LOCATION",
            "city": "Lynn",
            "state": "MA",
            "postal_code": "019042915",
            "country_code": "US",
            "telephone_number": "920-059-9781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TASSI",
        "first_name": "MARISA",
        "middle_name": "ANNE",
        "name_prefix": "Miss",
        "credential": "MS, RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-03",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "5679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.