Active NPI
Linyue Kishi Peng, MS, RD, CDCES, LDN
- Registered Dietitian
- Broomall, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN006398
- Practice address
- 1991 Sproul Rd
Broomall, PA 19008-3512 - Phone
- (484) 476-6230
- NPI assigned
- Feb 17, 2019
- 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 | DN006398 | PA | Primary |
Addresses
Primary practice location
1991 Sproul Rd
Broomall, PA 19008-3512
Mailing address
1991 Sproul Rd
Broomall, PA 19008-3512
Phone (484) 476-6230
Other practice location 1
625 Clark Ave Ste 17A
King Of Prussia, PA 19406-1438
Phone (610) 768-7168
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211210002117 | PA | Practitioner - Registered Dietitian Or Nutrition Professional | 1052701786 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
625 Clark Ave
Suite 17a
King of Prussia, PA 19406-1438
Phone (484) 222-0224
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocare, LLC | Current | Accepting new patients | |
| Advocare , LLC | Current | Accepting new patients | |
| Advocare, LLC | Past | Accepting new patients |
Locations
401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033
515 Union Blvd
Ste 1
Totowa, NJ 07512
Phone (973) 595-0600
1100 Horizon Cir
Ste 101
Chalfont, PA 18914
Phone (215) 394-0400
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Manahawkin, NJ
- NPI 1912762162
-
- Pediatrics Physician
- Cherry Hill, NJ
- NPI 1780696732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759190400000",
"number": "1366908170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1991 SPROUL RD",
"city": "BROOMALL",
"state": "PA",
"postal_code": "190083512",
"telephone_number": "484-476-6230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1991 SPROUL RD",
"city": "BROOMALL",
"state": "PA",
"postal_code": "190083512",
"telephone_number": "484-476-6230"
}
],
"practiceLocations": [
{
"address_1": "625 Clark Ave Ste 17A",
"address_purpose": "LOCATION",
"city": "King Of Prussia",
"state": "PA",
"postal_code": "194061438",
"country_code": "US",
"telephone_number": "610-768-7168",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PENG",
"first_name": "LINYUE",
"middle_name": "KISHI",
"credential": "MS, RD, CDCES, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-17",
"last_updated": "2025-09-30",
"certification_date": "2025-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN006398",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Broomall, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.