Individual provider Active NPI

Fadhylla Nazareth Saballos Tercero, RD

  • Registered Dietitian
  • Bronx, NY
National Provider Identifier
1245711589
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1108586 Issued in NY
Practice address
871 Prospect Ave
Bronx, NY 10459-3913
Phone
(718) 991-0605
NPI assigned
Aug 24, 2018
Last updated
Sep 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1108586 NY Primary
Lactation Consultant (Non-RN) 174N00000X NU

Addresses

Primary practice location

871 Prospect Ave
Bronx, NY 10459-3913

Mailing address

871 Prospect Ave
Bronx, NY 10459-3913
Phone (718) 991-0605

Other practice location 1

890 Prospect Ave
Bronx, NY 10459-3978
Phone (718) 991-0605

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200206002021 NY Practitioner - Registered Dietitian Or Nutrition Professional 2466888656 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009675NYMDClinical Psychologist
1108586NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Dec 11, 2019 Accepting new patients
Montefiore Medical Center CurrentSince Dec 11, 2019 Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

871 Prospect Ave
Bronx, NY 10459
Phone (718) 991-0605

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 3

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": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1245711589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "871 PROSPECT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104593913",
            "telephone_number": "718-991-0605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 PROSPECT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104593913",
            "telephone_number": "718-991-0605"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "890 Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104593978",
            "country_code": "US",
            "telephone_number": "718-991-0605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SABALLOS TERCERO",
        "first_name": "FADHYLLA",
        "middle_name": "NAZARETH",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-24",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "1108586",
            "primary": true
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.