Individual provider Active NPI

Shira Levine, R.D.

  • Registered Dietitian
  • Teaneck, NJ
National Provider Identifier
1174069298
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
002502-01 Issued in NY
Practice address
636 S Forest Dr
Teaneck, NJ 07666-2012
Phone
(201) 692-1569
NPI assigned
Jan 12, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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 002502-01 NY Primary

Addresses

Primary practice location

636 S Forest Dr
Teaneck, NJ 07666-2012

Mailing address

636 S Forest Dr
Teaneck, NJ 07666-2012
Phone (201) 692-1569

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171115002365 NJ Practitioner - Registered Dietitian Or Nutrition Professional 8527324037 Reassigns benefits to 1 organization
I20260604002964 NY Practitioner - Registered Dietitian Or Nutrition Professional 8527324037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

40 Robert Pitt Dr
Monsey, NY 10952-3333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002502-01NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Cloud Health Medical Group of California, P.C. Past Accepting new patients
Cloud Health Medical Group, P.a. Past Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1174069298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 S FOREST DR",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076662012",
            "telephone_number": "201-692-1569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 S FOREST DR",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076662012",
            "telephone_number": "201-692-1569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "SHIRA",
        "credential": "R.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-12",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "002502-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; 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.