Active NPI
Regina Bakshiyev, RD, CDN
- Registered Dietitian
- Fair Lawn, NJ
National Provider Identifier
1366617276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 984541
- Practice address
- 13-51 River Rd Ste B
Fair Lawn, NJ 07410 - Phone
- (201) 398-0020
- NPI assigned
- Apr 23, 2008
- 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 | 984541 | NJ | Primary |
Addresses
Primary practice location
13-51 River Rd Ste B
Fair Lawn, NJ 07410
Mailing address
6 McGuire CT
Old Bridge, NJ 08857-4400
Phone (732) 910-5862
Other practice location 1
1810 Park Ave
South Plainfield, NJ 07080-5522
Phone (908) 226-1810
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 006657-1 | Other | NY | THE UNIVERSITY OF THE STATE OF NEW YORK, OFFICE OF THE PROFESSIONS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 984541 | NJ | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mindful Eating Company LLC | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544400000000",
"number": "1366617276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 MCGUIRE CT",
"city": "OLD BRIDGE",
"state": "NJ",
"postal_code": "088574400",
"telephone_number": "732-910-5862"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13-51 RIVER RD STE B",
"city": "FAIR LAWN",
"state": "NJ",
"postal_code": "07410",
"telephone_number": "201-398-0020"
}
],
"practiceLocations": [
{
"address_1": "1810 Park Ave",
"address_purpose": "LOCATION",
"city": "South Plainfield",
"state": "NJ",
"postal_code": "070805522",
"country_code": "US",
"telephone_number": "908-226-1810",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BAKSHIYEV",
"first_name": "REGINA",
"name_prefix": "Mrs.",
"credential": "RD, CDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-23",
"last_updated": "2018-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": "NJ",
"license": "984541",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THE UNIVERSITY OF THE STATE OF NEW YORK, OFFICE OF THE PROFESSIONS",
"identifier": "006657-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fair Lawn, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.