Nicholas Albert Berretta, RDN, CD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

60863913 Issued in WA

Practice address

10634 E Riverside Dr Ste 250
Bothell, WA 98011-3759

Phone

(425) 949-7626

Fax

(425) 949-5413

NPI assigned

May 23, 2019

Last updated

Jun 11, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Puyallup Tribal Health AuthorityGroup PAC ID 9436047537, 35 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Puyallup Tribal Health Authority

  • Primary Care Clinic/Center
  • Tacoma, WA
  • NPI 1063455665
  Medicare reassignment Care Compare group NPD
• Emily Program PC

  dba The Emily Program

  • Community/Behavioral Health Agency
  • Seattle, WA
  • NPI 1154696698
  Medicare reassignment NPD
• Puyallup Tribal Health Authority

  • Adult Mental Health Clinic/Center
  • Tacoma, WA
  • NPI 1255378782
  NPD
• Emily Program P C

  dba The Emily Program

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
  • NPI 1528165065
  NPD
• Fay Nutrition

  • Registered Dietitian
  • San Francisco, CA
  • NPI 1104334465

  Dietitian, Registered

  NPD (past)
• Nourish, Inc.

  • Registered Dietitian
  • Austin, TX
  • NPI 1558097824

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1235796376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12242",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981020242",
            "telephone_number": "509-528-5011",
            "fax_number": "425-949-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10634 E RIVERSIDE DR STE 250",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113759",
            "telephone_number": "425-949-7626",
            "fax_number": "425-949-5413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRETTA",
        "first_name": "NICHOLAS",
        "middle_name": "ALBERT",
        "name_prefix": "Mr.",
        "credential": "RDN, CD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-23",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "60863913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033254115",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669938536",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891802146",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cindy Minh Bergmann, RPH
• Awet M Berhe, RN
• Rebecca Berndt
• Rebeca Victoria Berni, LMP
• Anna Klair Bernieri, ND
• Heather Berry-Cundy
• Jada Berry, M.A., CCC-SLP
• Craig Bertram
• Michael David Berven, M.D.
• Better Sleep Bothell

• Registered Dietitian in Bothell, WA
• Providers in Bothell, WA by specialty
• Registered Dietitian in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.