Active NPI
Lorene Michelle Menichelli, RD; CDN
- Registered Dietitian
- Masonville, NY
National Provider Identifier
1396216180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 008351
- Practice address
- 15598 State Highway 8
Masonville, NY 13804 - Phone
- (607) 265-3322
- Fax
- (607) 265-3349
- NPI assigned
- Dec 6, 2018
- 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 | 008351 | NY | Primary |
Addresses
Primary practice location
15598 State Highway 8
Masonville, NY 13804
Mailing address
PO Box 352
Masonville, NY 13804-0352
Phone (607) 265-3322
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008351 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of New York Comptrollers Office | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Developmental Disabilities Clinic/Center
- Staten Island, NY
- NPI 1750469912
-
- Developmental Disabilities Clinic/Center
- Masonville, NY
- NPI 1447375324
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544054400000",
"number": "1396216180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 352",
"city": "MASONVILLE",
"state": "NY",
"postal_code": "138040352",
"telephone_number": "607-265-3322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15598 STATE HIGHWAY 8",
"city": "MASONVILLE",
"state": "NY",
"postal_code": "13804",
"telephone_number": "607-265-3322",
"fax_number": "607-265-3349"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENICHELLI",
"first_name": "LORENE",
"middle_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "RD; CDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-06",
"last_updated": "2018-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "008351",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Masonville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; 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.