Active NPI
Maryann Gorman, RD
- Nutritionist
- Rego Park, NY
National Provider Identifier
1144203191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- 003481
- Practice address
- 98120 Queens Blvd
Rego Park, NY 11374-4357 - Phone
- (718) 268-9598
- Fax
- (516) 488-3749
- NPI assigned
- Nov 23, 2005
- 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 |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 003481 | NY | Primary |
Addresses
Primary practice location
98120 Queens Blvd
Rego Park, NY 11374-4357
Mailing address
202 Cherry LN
Floral Park, NY 11001-1300
Phone (781) 268-9598
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 164460 | Other | NY | ELDERPLAN |
| P2706184 | Other | NY | OXFORD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100429000009 | NY | Practitioner - Registered Dietitian Or Nutrition Professional | 7315074077 | Practice locations: Rego Park, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264550400000",
"number": "1144203191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 CHERRY LN",
"city": "FLORAL PARK",
"state": "NY",
"postal_code": "110011300",
"telephone_number": "781-268-9598",
"fax_number": "516-488-3749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "98120 QUEENS BLVD",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113744357",
"telephone_number": "718-268-9598",
"fax_number": "516-488-3749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORMAN",
"first_name": "MARYANN",
"name_prefix": "Ms.",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-11-23",
"last_updated": "2010-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "NY",
"license": "003481",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ELDERPLAN",
"identifier": "164460",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P2706184",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rego Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; 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.