Individual provider Active NPI

Mary Grace Leong, RD, CDE

  • Registered Dietitian
  • Redwood City, CA
National Provider Identifier
1437401031
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
706151
Practice address
2710 Middlefield Rd
Redwood City, CA 94063-3404
Phone
(650) 578-7141
Fax
(650) 366-4732
NPI assigned
Oct 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

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 706151 Primary

Addresses

Primary practice location

2710 Middlefield Rd
Redwood City, CA 94063-3404

Mailing address

2710 Middlefield Rd
Redwood City, CA 94063-3404
Phone (650) 578-7141

Other names 1

  • Ms. Mary Grace Jue Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160912000526 CA Practitioner - Registered Dietitian Or Nutrition Professional 1850687237 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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.

NPI Registry JSON

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

{
    "created_epoch": "1349395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1437401031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 MIDDLEFIELD RD",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940633404",
            "telephone_number": "650-578-7141",
            "fax_number": "650-366-4732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 MIDDLEFIELD RD",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940633404",
            "telephone_number": "650-578-7141",
            "fax_number": "650-366-4732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONG",
        "first_name": "MARY",
        "middle_name": "GRACE",
        "name_prefix": "Ms.",
        "credential": "RD, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-05",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "706151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "JUE",
            "middle_name": "GRACE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Redwood City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; 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.