Individual provider Active NPI

Perla Mizrahi Nelson, RDN

  • Registered Dietitian
  • Totowa, NJ
National Provider Identifier
1467712828
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86023702 Issued in NJ
Practice address
137 Union Blvd
Totowa, NJ 07512-2767
Phone
(862) 257-1297
Fax
(862) 257-1299
NPI assigned
May 20, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X 86023702 NJ Primary

Addresses

Primary practice location

137 Union Blvd
Totowa, NJ 07512-2767

Mailing address

137 Union Blvd
Totowa, NJ 07512-2767
Phone (862) 257-1297

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL Totowa, Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210915001752 NJ Practitioner - Registered Dietitian Or Nutrition Professional 2860898921

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Dietitians LLC Dietitian, Registered Current Accepting new patients
My Weight Loss Center Nutrition, Education Past Accepting new patients

Locations

100 Enterprise Dr
Ste 301
Rockaway, NJ 07866
Phone (845) 800-9305

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": "1337472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1467712828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 UNION BLVD",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075122767",
            "telephone_number": "862-257-1297",
            "fax_number": "862-264-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 UNION BLVD",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075122767",
            "telephone_number": "862-257-1297",
            "fax_number": "862-257-1299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "PERLA",
        "middle_name": "MIZRAHI",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-20",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "NJ",
            "license": "86023702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Totowa,",
            "affiliation": "N",
            "endpointDescription": "Practice Fusion",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Totowa,",
            "address_1": "137 Union Blvd",
            "city": "Totowa",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "075122767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Totowa, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; 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.