Individual provider Active NPI

Cassidy Iannello, RD

  • Registered Dietitian
  • Austin, TX
National Provider Identifier
1255980470
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
3432 Greystone Dr Ste 120
Austin, TX 78731-2371
Phone
(512) 967-3388
NPI assigned
Sep 10, 2019
Sex
Female
Sole proprietor
No

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 Primary

Addresses

Primary practice location

3432 Greystone Dr Ste 120
Austin, TX 78731-2371

Mailing address

5453 Burnet Rd Apt 229
Austin, TX 78756-1633
Phone (214) 491-9346

Other names 1

  • Cassidy Camiscione Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191121000376 TX Practitioner - Registered Dietitian Or Nutrition Professional 9335571868 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Maria Mendoza Rd, LLC Dietitian, Registered CurrentSince Dec 10, 2023 Accepting new patients

Locations

3432 Greystone Dr
Ste 120
Austin, TX 78731
Phone (512) 522-7793

Organizations & group practices 1

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": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1255980470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5453 BURNET RD APT 229",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787561633",
            "telephone_number": "214-491-9346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3432 GREYSTONE DR STE 120",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787312371",
            "telephone_number": "512-967-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANNELLO",
        "first_name": "CASSIDY",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSIDY",
            "last_name": "CAMISCIONE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Austin, TX

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.