Individual provider Active NPI

Diana Rafailova, RD

  • Registered Dietitian
  • Brooklyn, NY
National Provider Identifier
1386022622
Registry record updated May 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86063482 Issued in NU
Practice address
2900 E 29TH St Apt 2F
Brooklyn, NY 11235-2272
Phone
(917) 498-4211
Fax
(718) 676-5589
NPI assigned
May 6, 2015
Last updated
May 6, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86063482 NU Primary
Metabolic Nutrition Registered Dietitian 133VN1006X 86063482 NU

Addresses

Primary practice location

2900 E 29TH St Apt 2F
Brooklyn, NY 11235-2272

Mailing address

2900 E 29TH St Apt 2F
Brooklyn, NY 11235-2272
Phone (917) 498-4211

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150824002001 NY Practitioner - Registered Dietitian Or Nutrition Professional 7517273311 Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008397NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nutrition Care P.C. Current Accepting new patients
Medical Supplies Near Me LLC Current Accepting new patients

Locations

1117 Brighton Beach Ave
Brooklyn, NY 11235
Phone (718) 998-9900

Networks

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

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430870400000",
    "number": "1386022622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 E 29TH ST APT 2F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112352272",
            "telephone_number": "917-498-4211",
            "fax_number": "718-676-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 E 29TH ST APT 2F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112352272",
            "telephone_number": "917-498-4211",
            "fax_number": "718-676-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFAILOVA",
        "first_name": "DIANA",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-06",
        "last_updated": "2015-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": "86063482",
            "primary": true
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "NU",
            "license": "86063482",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.