Active NPI
Nicolette Star Maggiolo, RDN, LDN
- Registered Dietitian
- Winthrop, MA
National Provider Identifier
1356899850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 4192
- Practice address
- 249 Winthrop Shore Dr Apt 5
Winthrop, MA 02152-1153 - Phone
- (201) 458-4065
- NPI assigned
- Sep 14, 2016
- 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 | 4192 | MA | Primary |
Addresses
Primary practice location
249 Winthrop Shore Dr Apt 5
Winthrop, MA 02152-1153
Mailing address
249 Winthrop Shore Dr Apt 5
Winthrop, MA 02152-1153
Phone (201) 458-4065
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nmaggiolo@mgh.harvard.edu | MGH |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4192 | MA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrive Health Holdings, Inc. | Dietitian, Registered | Current | Accepting new patients |
| Thrive Health Holdings, Inc. | Dietitian, Registered | Current | Accepting new patients |
| Secret Sauce Nutrition | Dietitian, Registered | Current | Accepting new patients |
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 and National Provider Directory roles.
-
- Registered Dietitian
- Wilmington, DE
- NPI 1356186522
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635552000000",
"number": "1356899850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "249 WINTHROP SHORE DR APT 5",
"city": "WINTHROP",
"state": "MA",
"postal_code": "021521153",
"telephone_number": "201-458-4065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "249 WINTHROP SHORE DR APT 5",
"city": "WINTHROP",
"state": "MA",
"postal_code": "021521153",
"telephone_number": "201-458-4065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAGGIOLO",
"first_name": "NICOLETTE",
"middle_name": "STAR",
"credential": "RDN, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-14",
"last_updated": "2021-10-30",
"certification_date": "2021-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "4192",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "nmaggiolo@mgh.harvard.edu",
"affiliation": "Y",
"affiliationName": "MGH",
"address_1": "249 Winthrop Shore Dr Apt 5",
"city": "Winthrop",
"state": "MA",
"country_code": "US",
"postal_code": "021521153",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Winthrop, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.