Active NPI
Mary Raffetto
- Registered Dietitian
- Altoona, PA
National Provider Identifier
1174070700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN005135
- Practice address
- 2907 Pleasant Valley Blvd.
Altoona, PA 16602 - Phone
- (814) 943-8164
- NPI assigned
- Sep 1, 2016
- Sex
- Female
- 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 | DN005135 | PA | Primary |
Addresses
Primary practice location
2907 Pleasant Valley Blvd.
Altoona, PA 16602
Mailing address
933 W Whitehall Rd Apt 2
State College, PA 16801-2904
Other practice location 1
143 Hospital Dr Ste 201
State College, PA 16803-5500
Phone (814) 231-6824
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
143 Hospital Dr
Suite 201
State College, PA 16803-5500
Phone (814) 234-8800
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN005135 | PA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | 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.
-
- Internal Medicine Physician
- State College, PA
- NPI 1598992554
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775520000000",
"number": "1174070700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "933 W WHITEHALL RD APT 2",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "168012904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2907 PLEASANT VALLEY BLVD.",
"city": "ALTOONA",
"state": "PA",
"postal_code": "16602",
"telephone_number": "814-943-8164"
}
],
"practiceLocations": [
{
"address_1": "143 Hospital Dr Ste 201",
"address_purpose": "LOCATION",
"city": "State College",
"state": "PA",
"postal_code": "168035500",
"country_code": "US",
"telephone_number": "814-231-6824",
"fax_number": "814-231-7544",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RAFFETTO",
"first_name": "MARY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-01",
"last_updated": "2026-04-07",
"certification_date": "2026-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN005135",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Altoona, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; 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.