Organization Active NPI

Dietvana PLLC

  • Registered Dietitian
  • Boca Raton, FL
National Provider Identifier
1235714957
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
DIETVANA PLLC
Practice address
301 E Yamato Rd Ste 1240
Boca Raton, FL 33431-4931
Phone
(786) 203-9130
NPI assigned
Mar 15, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Authorized official

Name
Mrs. Monica L Capille, MHA, RD, LDNNPI 1952987935
Title
Registered Dietitian
Phone
(786) 203-9130

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

301 E Yamato Rd Ste 1240
Boca Raton, FL 33431-4931

Mailing address

301 E Yamato Rd Ste 1240
Boca Raton, FL 33431-4931
Phone (786) 203-9130

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210426000197 FL Part B Supplier - Clinic/Group Practice 0042628455 Receives reassigned benefits from 1 practitioner
Practice locations: Boca Raton, FL

National Provider Directory

National Provider Directory

Locations

301 E Yamato Rd
Ste 1240
Boca Raton, FL 33431
Phone (786) 203-9130

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616976000000",
    "number": "1235714957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E YAMATO RD STE 1240",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314931",
            "telephone_number": "786-203-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E YAMATO RD STE 1240",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314931",
            "telephone_number": "786-203-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIETVANA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A",
        "authorized_official_last_name": "CAPILLE",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "786-203-9130",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MHA, RD, LDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.