Individual provider Active NPI

Nicole D'Ulisse, RD

  • Registered Dietitian
  • Wyomissing, PA
National Provider Identifier
1144998667
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN007510 Issued in PA
Practice address
1220 Broadcasting Rd Ste 101
Wyomissing, PA 19610-3221
Phone
(484) 628-5673
NPI assigned
Aug 31, 2021
Last updated
Aug 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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 DN007510 PA Primary

Addresses

Primary practice location

1220 Broadcasting Rd Ste 101
Wyomissing, PA 19610-3221

Mailing address

PO Box 13579
Reading, PA 19612-3579
Phone (484) 824-8157

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210908000087 PA Practitioner - Registered Dietitian Or Nutrition Professional 7012313620 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.1 of 100Reported as group
Quality
77.19
Promoting interoperability
98
Improvement activities
40
Cost
79.03

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Health Medical Group CurrentSince Aug 1, 2021 Accepting new patients
Phoenixville Clinic Company LLC CurrentSince Sep 1, 2023 Accepting new patients
Reading Hospital CurrentSince Jan 4, 2023 Accepting new patients
Tower Health Medical Group Current Accepting new patients
Phoenixville Clinic Company LLC CurrentSince Sep 1, 2023 Accepting new patients
Tower Health Medical Group CurrentSince Aug 1, 2021 Accepting new patients
Phoenixville Clinic Company LLC Current Accepting new patients
Reading Hospital Current Accepting new patients
Reading Professional Services Past Accepting new patients

Locations

420 W Linfield Trappe Rd
Ste 3100
Limerick, PA 19468
Phone (484) 750-3906

140 Nutt Rd
Phoenixville, PA 19460
Phone (610) 983-1000

206 S 6th Ave
West Reading, PA 19611
Phone (484) 628-5437

301 S 7th Ave
Ste 130
West Reading, PA 19611
Phone (610) 988-4630

1220 Broadcasting Rd
Ste 100
Wyomissing, PA 19610
Phone (484) 628-5673

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1606/brand/1/csg/101/fhir/r4

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1144998667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579",
            "telephone_number": "484-824-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 BROADCASTING RD STE 101",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103221",
            "telephone_number": "484-628-5673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ULISSE",
        "first_name": "NICOLE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN007510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.