Individual provider Active NPI

Maral Misserian

  • Registered Dietitian
  • Dallas, TX
National Provider Identifier
1407440605
Registry record updated Feb 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
4424 Bobbitt Dr
Dallas, TX 75229-4237
Phone
(214) 632-4575
NPI assigned
Feb 27, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2021

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 Primary

Addresses

Primary practice location

4424 Bobbitt Dr
Dallas, TX 75229-4237

Mailing address

4424 Bobbitt Dr
Dallas, TX 75229-4237

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250402001612 TX Practitioner - Registered Dietitian Or Nutrition Professional 6305369174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2001 Inwood Rd
Dallas, TX 75390-7202
Phone (214) 645-7700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jan 19, 2025 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Jan 19, 2025 Accepting new patients

Locations

2001 Inwood Rd
Ut Southwest Medical Center, TX 75390
Phone (214) 645-8000

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

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": "1614384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614384000000",
    "number": "1407440605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4424 BOBBITT DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752294237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4424 BOBBITT DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752294237",
            "telephone_number": "214-632-4575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISSERIAN",
        "first_name": "MARAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-27",
        "last_updated": "2021-02-27",
        "certification_date": "2021-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2021; 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.