Individual provider Active NPI

Alan W Lee, RD

  • Registered Dietitian
  • New York, NY
National Provider Identifier
1376844605
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
004974 Issued in NY
Practice address
1824 Madison Ave
New York, NY 10035-3832
Phone
(212) 423-4500
Fax
(212) 423-4577
NPI assigned
Nov 3, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 004974 NY Primary

Addresses

Primary practice location

1824 Madison Ave
New York, NY 10035-3832

Mailing address

279 Main St
Suite 204
New Paltz, NY 12561-1623
Phone (845) 255-3046

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110114000924 NY Practitioner - Registered Dietitian Or Nutrition Professional 9032308465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
New York University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Institute for Family HealthGroup PAC ID 9234048588, 188 clinicians

Practice addresses (Care Compare)

1 Family Practice Dr
Kingston, NY 12401-6449
Phone (845) 338-6400

11 Crum Elbow Rd
Hyde Park, NY 12538-2852
Phone (845) 229-1020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004974NYMDNeurorehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Institute for Family Health CurrentSince Jul 6, 2022 Accepting new patients
The Institute for Family Health Current Accepting new patients
The Institute for Family Health Past Accepting new patients

Locations

279 Main St
Ste 204
New Paltz, NY 12561
Phone (845) 255-3046

279 Main St
Ste 101
New Paltz, NY 12561
Phone (845) 255-2930

1824 Madison Ave
New York, NY 10035
Phone (212) 423-4200

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1376844605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 MAIN ST",
            "address_2": "SUITE 204",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611623",
            "telephone_number": "845-255-3046",
            "fax_number": "845-255-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353832",
            "telephone_number": "212-423-4500",
            "fax_number": "212-423-4577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ALAN",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-03",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "004974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; 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.

Verify at the official NPI Registry.