Elyse Metelka, MS, RD, CDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

008966 Issued in NY

Practice address

200 W 57TH St Ste 204
New York, NY 10019-3211

Phone

(646) 883-6736

NPI assigned

Jan 24, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1174060487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W 86TH ST APT 7E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100243410",
            "telephone_number": "646-883-6736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W 57TH ST STE 204",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193211",
            "telephone_number": "646-883-6736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 W 86th St Apt 7E",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100243410",
            "country_code": "US",
            "telephone_number": "646-883-6736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "METELKA",
        "first_name": "ELYSE",
        "credential": "MS, RD, CDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-24",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "008966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in New York, NY
• Providers in New York, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.