Betsy Rochelle Dubov, REGISTERED DIETITIAN
Individual provider Active NPI Renal Nutrition Registered Dietitian · South River, NJ
NPI 1386817856 · NPPES record last updated Nov 15, 2024
Key facts
- NPI
- 1386817856
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Renal Nutrition Registered Dietitian 133VN1005X
- License
- 634638 (IL)
- Practice address
- 8 Old Bridge Tpke Ste 7
South River, NJ 08882-2400 - Phone
- (732) 390-4888
- Fax
- (732) 390-0255
- NPI assigned
- Apr 7, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hackensack Meridian Health Medical Group - Specialty Care PC
Practice addresses (Care Compare)
30 Prospect Ave
Hackensack, NJ 07601-1915
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050726000531 | NJ | Practitioner - Registered Dietitian Or Nutrition Professional | 3577590074 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 634638 | IL | MD | Renal Nutrition Registered Dietitian |
| 634638 | NJ | MD | Renal Nutrition Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hackensack Meridian Health Medical Group - Specialty Care PC | Current |
Accepting new patients | |
| Wellness Consultation Services LLC | Current |
Accepting new patients | |
| Hackensack Meridian Health Medical Group - Specialty Care PC | Current |
Accepting new patients |
Locations
30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066
331 Newman Springs Rd
Ste 220
Red Bank, NJ 07701
Phone (732) 807-0514
8 Old Bridge Tpke
South River, NJ 08882
Phone (732) 390-4888
8 Old Bridge Tpke
Ste 7
South River, NJ 08882
Phone (732) 390-4888
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/IHJHBD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Renal Nutrition Registered Dietitian | 133VN1005X | 634638 | NJ | |
| Renal Nutrition Registered Dietitian | 133VN1005X | 634638 | IL | Yes |
Addresses
Primary practice location
8 Old Bridge Tpke Ste 7
South River, NJ 08882-2400
Mailing address
331 Newman Springs Rd Ste 220
Red Bank, NJ 07701-5792
Phone (732) 807-0877
Other practice location 1
901 W Main St Ste 363A
Freehold, NJ 07728-2537
Phone (732) 390-4888
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 053650 | Other | NJ | PROVIDER NUMBER |
Other providers in South River, NJ
- Thomas Anthony Debari
- Miche Dias
- Disability Service & Advocacy, LLC
- Diverse Support Counseling, LLC
- Thomas Edward Drabik
- Glenn Alan Dubov
- EMS Consultants of NJ, LLC
- Fase Health Care
- Aline Filipe
- Theresa Ann Gabler
All providers in South River, NJ · Renal Nutrition Registered Dietitian in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.