Active NPI
Amanda Maria Laezza, RDN
- Registered Dietitian
- Providence, RI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 383 W Fountain St Ste 115
Providence, RI 02903-3515 - Phone
- (401) 297-3256
- NPI assigned
- Mar 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 | Primary |
Addresses
Primary practice location
383 W Fountain St Ste 115
Providence, RI 02903-3515
Mailing address
8 Fawn CT
Monroe TWP, NJ 08831-1180
Phone (908) 930-0353
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241104002460 | RI | Practitioner - Registered Dietitian Or Nutrition Professional | 2769915396 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Honest Nutrition | Dietitian, Registered | Current | Accepting new patients |
| Keepcare LLC | Dietitian, Registered | Past | Accepting new patients |
Locations
2220 Plainfield Pike
Ste 100
Cranston, RI 02921
Phone (401) 297-3256
2220 Plainfield Pike
Cranston, RI 02921
Phone (401) 383-3400
383 W Fountain St
#115
Providence, RI 02903
Phone (401) 297-3256
383 W Fountain St
Ste 115
Providence, RI 02903
Phone (401) 297-3256
Organizations & group practices 2
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": "1710374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718582400000",
"number": "1124887971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 FAWN CT",
"city": "MONROE TWP",
"state": "NJ",
"postal_code": "088311180",
"telephone_number": "908-930-0353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "383 W FOUNTAIN ST STE 115",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029033515",
"telephone_number": "401-297-3256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAEZZA",
"first_name": "AMANDA",
"middle_name": "MARIA",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-03-14",
"last_updated": "2024-06-17",
"certification_date": "2024-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.