Active NPI
Katherine Bortin, RD
- Registered Dietitian
- Saint James, NY
National Provider Identifier
1285067678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1095379
- Practice address
- 257 Northern Blvd
Saint James, NY 11780-1813 - Phone
- (631) 766-2747
- NPI assigned
- Aug 21, 2013
- Last updated
- Jun 7, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1095379 | NU | Primary |
Addresses
Primary practice location
257 Northern Blvd
Saint James, NY 11780-1813
Mailing address
257 Northern Blvd
Saint James, NY 11780-1813
Phone (631) 766-2747
Other practice location 1
17505 N 79th Ave
Suite 110
Glendale, AZ 85308-8725
Phone (623) 399-6825
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Am Nutrition Services | Dietitian, Registered | Past | Accepting new patients |
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, 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": "1377043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559865600000",
"number": "1285067678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "257 NORTHERN BLVD",
"city": "SAINT JAMES",
"state": "NY",
"postal_code": "117801813",
"telephone_number": "631-766-2747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "257 NORTHERN BLVD",
"city": "SAINT JAMES",
"state": "NY",
"postal_code": "117801813",
"telephone_number": "631-766-2747"
}
],
"practiceLocations": [
{
"address_1": "17505 N 79th Ave",
"address_2": "Suite 110",
"address_purpose": "LOCATION",
"city": "Glendale",
"state": "AZ",
"postal_code": "853088725",
"country_code": "US",
"telephone_number": "623-399-6825",
"fax_number": "623-505-3474",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BORTIN",
"first_name": "KATHERINE",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-21",
"last_updated": "2019-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NU",
"license": "1095379",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint James, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.