Active NPI
Ryan Robert Maciel, RDN
- Registered Dietitian
- Cambridge, MA
National Provider Identifier
1366944001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 4383
- Practice address
- 91 Sidney St
Cambridge, MA 02139-4277 - Phone
- (857) 242-3633
- NPI assigned
- Mar 7, 2018
- Sex
- Male
- 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 | 4383 | MA | Primary |
Addresses
Primary practice location
91 Sidney St
Cambridge, MA 02139-4277
Mailing address
112 Sherman Rd
Chestnut Hill, MA 02467-3179
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 |
|---|---|---|---|
| 4383 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521072000000",
"number": "1366944001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 SHERMAN RD",
"city": "CHESTNUT HILL",
"state": "MA",
"postal_code": "024673179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "91 SIDNEY ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021394277",
"telephone_number": "857-242-3633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACIEL",
"first_name": "RYAN",
"middle_name": "ROBERT",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-07",
"last_updated": "2018-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "4383",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.