Individual provider Active NPI

Deanne H Lee, MS, RD, CDN

  • Registered Dietitian
  • Woodside, NY
National Provider Identifier
1215701883
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1108113 Issued in NY
Practice address
4131 51St St Apt 4M
Woodside, NY 11377-4446
Phone
(201) 615-0198
NPI assigned
Nov 14, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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 1108113 NY Primary

Addresses

Primary practice location

4131 51St St Apt 4M
Woodside, NY 11377-4446

Mailing address

4131 51St St Apt 4M
Woodside, NY 11377-4446
Phone (201) 615-0198

Other practice location 1

8900 Van Wyck Expy
Richmond Hill, NY 11418-2897
Phone (718) 206-6000 ext. 5019

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240102003288 NY Practitioner - Registered Dietitian Or Nutrition Professional 6002266194 Reassigns benefits to 1 organization
Practice locations: Woodside, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009564NYMDClinical Psychologist
1108113NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Jamaica Hospital CurrentSince Dec 1, 2023 Accepting new patients
Deanne H Lee Dietitian, Registered CurrentSince Mar 12, 2024 Accepting new patients
Jamaica Hospital CurrentSince Dec 1, 2023 Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Locations

3080 Atlantic Ave
Brooklyn, NY 11208
Phone (718) 647-0240

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088

Organizations & group practices 4

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": "1699920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1215701883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 51ST ST APT 4M",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113774446",
            "telephone_number": "201-615-0198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 51ST ST APT 4M",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113774446",
            "telephone_number": "201-615-0198"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8900 Van Wyck Expy",
            "address_purpose": "LOCATION",
            "city": "Richmond Hill",
            "state": "NY",
            "postal_code": "114182897",
            "country_code": "US",
            "telephone_number": "718-206-6000 x5019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "DEANNE",
        "middle_name": "H",
        "credential": "MS, RD, CDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-14",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "1108113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.