Active NPI
Stefania Medvedik, RD, RN, CDE
- Registered Dietitian
- Smithtown, NY
National Provider Identifier
1215428818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 01096652
- Practice address
- 34 Rowan St
Smithtown, NY 11787-1057 - Phone
- (631) 406-7768
- NPI assigned
- May 21, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 600088-1 | NY | |
| Diabetes Educator Registered Nurse | 163WD0400X | 21510265 | NY | |
| Registered Dietitian | 133V00000X | 01096652 | NY | Primary |
Addresses
Primary practice location
34 Rowan St
Smithtown, NY 11787-1057
Mailing address
34 Rowan St
Smithtown, NY 11787-1057
Phone (631) 406-7768
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01096652 | NY | MD | Registered Dietitian |
| 600088-1 | NY | MD | Registered Nurse |
| 21510265 | NY | MD | Diabetes Educator Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Simnutrition Inc. | Dietitian, Registered | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526860800000",
"number": "1215428818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 ROWAN ST",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117871057",
"telephone_number": "631-406-7768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 ROWAN ST",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117871057",
"telephone_number": "631-406-7768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDVEDIK",
"first_name": "STEFANIA",
"credential": "RD, RN, CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-21",
"last_updated": "2018-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "600088-1",
"primary": false
},
{
"code": "163WD0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Diabetes Educator",
"state": "NY",
"license": "21510265",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "01096652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smithtown, NY
- Meadows Nuclear Spect Imaging, PC
- Ashley J Meccariello, CNM
- Med Tech Medical Diagnostics PC
- Kylle Jean Medeiros, RN
- Medical Sales Consultants
- Christine Meehan, PTS
- Megan Resnick Nurse Practitioner in Psychiatry PC
- Michael Mehler, MA, CASAC-T
- Desiree Meier-Frost, MHC
- Maritza Mejia, NURSE PRACTITIONER
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.