Individual provider Active NPI

Suzanne M Oppedisano, RDN

  • Registered Dietitian
  • East Northport, NY
National Provider Identifier
1447014436
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
16 Furwood Dr
East Northport, NY 11731-3113
Phone
(516) 633-1808
NPI assigned
Feb 9, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

16 Furwood Dr
East Northport, NY 11731-3113

Mailing address

16 Furwood Dr
East Northport, NY 11731-3113
Phone (516) 633-1808

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250212003044 NY Practitioner - Registered Dietitian Or Nutrition Professional 4688104128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Dietetics and Nutrition PLLCGroup PAC ID 8224563929, 13 clinicians

Practice addresses (Care Compare)

358 Veterans Memorial Hwy
Suite 10
Commack, NY 11725-4326
Phone (516) 441-9013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012040NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
New York Dietetics and Nutrition PLLC Dietitian, Registered CurrentSince Dec 1, 2024 Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Locations

358 Veterans Memorial Hwy
Ste 10
Commack, NY 11725
Phone (516) 441-9013

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": "1707436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1447014436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 FURWOOD DR",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117313113",
            "telephone_number": "516-633-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 FURWOOD DR",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117313113",
            "telephone_number": "516-633-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPPEDISANO",
        "first_name": "SUZANNE",
        "middle_name": "M",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-09",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Northport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; 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.