Individual provider Active NPI

Laurie Wasserman

  • Registered Dietitian
  • Bridgewater, NJ
National Provider Identifier
1164950291
Registry record updated Mar 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
1170 US Highway 22 Ste 307
Bridgewater, NJ 08807-5940
Phone
(973) 896-3609
NPI assigned
Jun 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 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 Primary

Addresses

Primary practice location

1170 US Highway 22 Ste 307
Bridgewater, NJ 08807-5940

Mailing address

1170 US Highway 22 Ste 307
Bridgewater, NJ 08807-5940

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240503001489 NJ Practitioner - Registered Dietitian Or Nutrition Professional 0840630133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

101 Eisenhower Pkwy
Suite 300
Roseland, NJ 07068-1054
Phone (973) 896-3609

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Life Nutrition Project LLC Dietitian, Registered CurrentSince Mar 16, 2024 Accepting new patients
Absolute Nutrition Counseling LLC Dietitian, Registered PastSince Mar 29, 2020 Accepting new patients

Locations

101 Eisenhower Pkwy
Ste 300
Roseland, NJ 07068
Phone (201) 520-7221

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": "1496361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1164950291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 US HIGHWAY 22 STE 307",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088075940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 US HIGHWAY 22 STE 307",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088075940",
            "telephone_number": "973-896-3609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERMAN",
        "first_name": "LAURIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-02",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.