Nicole Sun Cirilli, MS, RD, CDN
Individual provider Active NPI Registered Dietitian · Old Lyme, CT
NPI 1154948990 · NPPES record last updated Aug 15, 2024
Key facts
- NPI
- 1154948990
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 86089376 (NY)
- Practice address
- 251-1 Mile Creek Rd
Old Lyme, CT 06371-1889 - Phone
- (860) 629-0022
- NPI assigned
- Jun 27, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- MHS Primary Care, Inc.
Practice addresses (Care Compare)
520 Saybrook Rd
Suite 210
Middletown, CT 06457-4700
Phone (860) 358-2970
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211109001073 | CT | Practitioner - Registered Dietitian Or Nutrition Professional | 7214326487 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2086 | CT | MD | Behavioral Analyst |
| 86089376 | NY | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MHS Primary Care, Inc | Current | Accepting new patients | |
| MHS Primary Care Inc. | Dietitian, Registered | Current |
Accepting new patients |
| MHS Primary Care Inc | Current |
Accepting new patients | |
| Nicole Cirilli Nutrition LLC | Dietitian, Registered | Current |
Accepting new patients |
Locations
14 Jones Hollow Rd
Ste 2
Marlborough, CT 06447
28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000
410 Saybrook Rd
Middletown, CT 06457
Phone (615) 686-2262
520 Saybrook Rd
Ste 210
Middletown, CT 06457
Phone (860) 343-0380
540 Saybrook Rd
Middletown, CT 06457
Phone (860) 347-7491
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86089376 | NY | Yes |
Addresses
Primary practice location
251-1 Mile Creek Rd
Old Lyme, CT 06371-1889
Mailing address
28 Crescent St
Middletown, CT 06457-3654
Other practice location 1
520 Saybrook Rd Ste 210
Middletown, CT 06457-4700
Phone (860) 358-2970
Other providers in Old Lyme, CT
- Mercedes Maria Buckingham
- Gabriell Budoff
- Cambi Pediatrics, PLLC
- Kathryn M Cambi
- Circulatory Centers Connecticut, LLC
- Karen Ann Claise
- Elizabeth Jane Clark
- William Clinton
- Anthony Albert Corrao
- Mary Cummings Satti
All providers in Old Lyme, CT · Registered Dietitian in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.