Active NPI
Susan Peters Manez, MSRD
- Registered Dietitian
- Middletown, NY
National Provider Identifier
1326263302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 390 Crystal Run Rd
Suite 102
Middletown, NY 10941-4050 - Phone
- (845) 692-8780
- Fax
- (845) 692-3439
- NPI assigned
- Apr 16, 2007
- Sex
- Female
- Sole proprietor
- No
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 | Primary |
Addresses
Primary practice location
390 Crystal Run Rd
Suite 102
Middletown, NY 10941-4050
Mailing address
390 Crystal Run Rd
Suite 102
Middletown, NY 10941-4050
Phone (845) 692-8780
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- New York University Medical College - NLG, 2005
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
30 Walter CT
Commack, NY 11725-3602
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244678400000",
"number": "1326263302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "390 CRYSTAL RUN RD",
"address_2": "SUITE 102",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109414050",
"telephone_number": "845-692-8780",
"fax_number": "845-692-3439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "390 CRYSTAL RUN RD",
"address_2": "SUITE 102",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109414050",
"telephone_number": "845-692-8780",
"fax_number": "845-692-3439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS MANEZ",
"first_name": "SUSAN",
"credential": "MSRD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-16",
"last_updated": "2009-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.