Jacqueline Cotumaccio, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86209519 Issued in NY

Practice address

55 Cuttermill Rd
Great Neck Plaza, NY 11021-3259

Phone

(516) 751-5736

NPI assigned

Dec 7, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678

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.

• Ms Nutritional Wellness PLLC

  • Registered Dietitian
  • Manhasset, NY
  • NPI 1003446709

  Dietitian, Registered

  Medicare reassignment NPD

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1487312351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 HIGHFIELD CT",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465713",
            "telephone_number": "516-512-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CUTTERMILL RD",
            "city": "GREAT NECK PLAZA",
            "state": "NY",
            "postal_code": "110213259",
            "telephone_number": "516-751-5736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1129 Northern Blvd Ste 404",
            "address_purpose": "LOCATION",
            "city": "Manhasset",
            "state": "NY",
            "postal_code": "110303022",
            "country_code": "US",
            "telephone_number": "516-751-5736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COTUMACCIO",
        "first_name": "JACQUELINE",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-07",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "86209519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susanna Cricchi
• Long Island Wellness Acupuncture, P.C.
• Nicholas A Serrano, MA

• Registered Dietitian in Great Neck Plaza, NY
• Providers in Great Neck Plaza, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.