Individual provider Active NPI

Irina Trakhtman, MS, RD, CDCES

  • Registered Dietitian
  • Fair Lawn, NJ
National Provider Identifier
1154022234
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
975348
Practice address
11 Sheridan PL
Fair Lawn, NJ 07410-4205
Phone
(551) 996-5684
NPI assigned
Mar 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 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 975348 Primary

Addresses

Primary practice location

11 Sheridan PL
Fair Lawn, NJ 07410-4205

Mailing address

11 Sheridan PL
Fair Lawn, NJ 07410-4205
Phone (917) 538-6588

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230413000458 NJ Practitioner - Registered Dietitian Or Nutrition Professional 3577938166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

350 Engle St
Englewood, NJ 07631-1808
Phone (201) 894-3158

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Englewood, PC CurrentSince Apr 10, 2023 Accepting new patients

Locations

350 Engle St
Englewood, NJ 07631
Phone (201) 871-6073

22-02 Broadway
Ste 301
Fair Lawn, NJ 07410
Phone (201) 414-5016

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

30 Montgomery St
Ste 720
Jersey City, NJ 07302
Phone (212) 524-7730

680 Kinderkamack Rd
Ste 205
Oradell, NJ 07649
Phone (201) 262-0608

680 Kinderkamack Rd
Ste 204
Oradell, NJ 07649
Phone (201) 261-9445

Organizations & group practices 1

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": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1154022234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 SHERIDAN PL",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074104205",
            "telephone_number": "917-538-6588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 SHERIDAN PL",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074104205",
            "telephone_number": "551-996-5684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAKHTMAN",
        "first_name": "IRINA",
        "name_prefix": "Mrs.",
        "credential": "MS, RD, CDCES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "975348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.