Individual provider Active NPI

Alenka Maria Ravnik-List, MS, RD, CDN, CDE

  • Metabolic Nutrition Registered Dietitian
  • New York, NY
National Provider Identifier
1184727042
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
License
005783 Issued in NY
Practice address
One Gustave Levy Place, Box 1067
New York, NY 10029-6574
Phone
(212) 241-6162
Fax
(212) 426-7730
NPI assigned
Sep 6, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Metabolic Nutrition Registered Dietitian 133VN1006X 005783 NY Primary

Addresses

Primary practice location

One Gustave Levy Place, Box 1067
New York, NY 10029-6574

Mailing address

42 Omni Parc Dr
Nanuet, NY 10954-5947
Phone (845) 425-6573

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090218000046 NY Practitioner - Registered Dietitian Or Nutrition Professional 8325103856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1989
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9 Violet Dr
Pearl River, NY 10965-1209
Phone (845) 893-7036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
005783NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Alenka Ravnik List RDN PLLC CurrentSince May 16, 2018 Accepting new patients

Locations

1 Blue Hill Plz
Ste 1509
Pearl River, NY 10965
Phone (201) 914-0063

Organizations & group practices 1

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": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184727042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 OMNI PARC DR",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109545947",
            "telephone_number": "845-425-6573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE GUSTAVE LEVY PLACE, BOX 1067",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296574",
            "telephone_number": "212-241-6162",
            "fax_number": "212-426-7730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVNIK-LIST",
        "first_name": "ALENKA",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "MS, RD, CDN, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "NY",
            "license": "005783",
            "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 Jul 8, 2007; 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.