Individual provider Active NPI

Annette O'Neill, MS, RDN, CDN

  • Registered Dietitian
  • New York, NY
National Provider Identifier
1164040184
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
009457-1 Issued in NY
Practice address
215 W 10TH St Apt 5E
New York, NY 10014-2961
Phone
(201) 314-8929
NPI assigned
Jul 7, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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 009457-1 NY Primary

Addresses

Primary practice location

215 W 10TH St Apt 5E
New York, NY 10014-2961

Mailing address

215 W 10TH St Apt 5E
New York, NY 10014-2961
Phone (201) 314-8929

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251013003308 NY Practitioner - Registered Dietitian Or Nutrition Professional 6901393164 Practice locations: New York, NY

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

Practice addresses (Care Compare)

New York, NY 10014
Phone (201) 314-8929

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009457-1NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

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": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1164040184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 W 10TH ST APT 5E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100142961",
            "telephone_number": "201-314-8929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W 10TH ST APT 5E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100142961",
            "telephone_number": "201-314-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEILL",
        "first_name": "ANNETTE",
        "credential": "MS, RDN, CDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-07",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "009457-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; 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.