Active NPI
Anisa Yasin, MS, RD, CD-N
- Registered Dietitian
- Brooklyn, NY
National Provider Identifier
1417366980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 007783-1
- Practice address
- 129 Sunnyside Ave
2A
Brooklyn, NY 11207-2010 - Phone
- (571) 234-7439
- NPI assigned
- Aug 8, 2014
- Last updated
- Aug 8, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 954661 | IL | |
| Registered Dietitian | 133V00000X | 007783-1 | NY | Primary |
Addresses
Primary practice location
129 Sunnyside Ave
2A
Brooklyn, NY 11207-2010
Mailing address
129 Sunnyside Avenue
2A
Brooklyn, NY 11207
Phone (571) 234-7439
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007783 | NY | MD | Mental Health Counselor |
| 954661 | IL | MD | Registered Dietitian |
| 007783-1 | NY | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
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": "1407456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407456000000",
"number": "1417366980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "129 SUNNYSIDE AVENUE",
"address_2": "2A",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11207",
"telephone_number": "571-234-7439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "129 SUNNYSIDE AVE",
"address_2": "2A",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112072010",
"telephone_number": "571-234-7439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YASIN",
"first_name": "ANISA",
"credential": "MS, RD, CD-N",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-08",
"last_updated": "2014-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "954661",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "007783-1",
"primary": true
}
],
"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 Aug 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.