Shelly Dehaan, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

717426 Issued in IL

Practice address

707 East Main Street
Orange Regional Medical Center
Middletown, NY 10940

Phone

(845) 333-2705

NPI assigned

Jun 8, 2017

Last updated

Jun 8, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Middletown Medical PCGroup PAC ID 2567464308, 177 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

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

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.

• Middletown Medical PC

  • Emergency Medicine Physician
  • Middletown, NY
  • NPI 1902855828
  Medicare reassignment Care Compare group NPD
• Middletown Medical PC

  • Cardiac Rehabilitation Clinic/Center
  • Middletown, NY
  • NPI 1174201529
  NPD

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496880000000",
    "number": "1245769660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 EAST MAIN STREET",
            "address_2": "ORANGE REGIONAL MEDICAL CENTER",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "10940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 EAST MAIN STREET",
            "address_2": "ORANGE REGIONAL MEDICAL CENTER",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "10940",
            "telephone_number": "845-333-2705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHAAN",
        "first_name": "SHELLY",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2017-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "717426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aliza Curray Deen, LMSW
• Gianna Defabio, BS, MSED
• Defining Moments, LLC
• Kristen M Degeorge, BA
• Joyce Deghetto
• Julissa Dejesus, LPN
• Patricia Rena Dejesus
• Mana Dejhalla, M.D.
• Maria Delourdes Dallin, LMSW
• Ricky Demarse, LCSW

• Registered Dietitian in Middletown, NY
• Providers in Middletown, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2017; 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.