Active NPI
Juan Pablo Chavez Salas, RDN
- Registered Dietitian
- New York, NY
National Provider Identifier
1164218012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86329875
- Practice address
- 462 1St Ave
New York, NY 10016-9196 - Phone
- (212) 562-2017
- NPI assigned
- Apr 17, 2025
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86329875 | NY | Primary |
Addresses
Primary practice location
462 1St Ave
New York, NY 10016-9196
Mailing address
657 W 183Rd St
New York, NY 10033-3807
Phone (917) 319-2916
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86329875 | NY | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
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": "1744848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746489600000",
"number": "1164218012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "657 W 183RD ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100333807",
"telephone_number": "917-319-2916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "462 1ST AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100169196",
"telephone_number": "212-562-2017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVEZ SALAS",
"first_name": "JUAN PABLO",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-04-17",
"last_updated": "2025-05-06",
"certification_date": "2025-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "86329875",
"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 May 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.