Individual provider Active NPI

Kathy Ellen Kraus, RD

  • Registered Dietitian
  • Stamford, CT
National Provider Identifier
1487770145
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
000222 Issued in CT
Practice address
82 Akbar Rd
Stamford, CT 06902-1402
Phone
(203) 912-9449
Fax
(203) 324-1190
NPI assigned
Mar 22, 2007
Last updated
Nov 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 000222 CT Primary
Nutritionist 133N00000X 0063111 NY
Nutritionist 133N00000X 006311 NY

Addresses

Primary practice location

82 Akbar Rd
Stamford, CT 06902-1402

Mailing address

82 Akbar Rd
Stamford, CT 06902-1402
Phone (203) 912-9449

Other identifiers 3

IdentifierTypeStateIssuer
P2168469OtherCTOXFORD
270000222CT01OtherCTBC/BS
5455578OtherCTAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160401001198 NY Practitioner - Registered Dietitian Or Nutrition Professional 0446557680 Reassigns benefits to 1 organization
I20220325000437 CT Practitioner - Registered Dietitian Or Nutrition Professional 0446557680 Practice locations: Stamford, CT

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Vernon Neighborhood Health Center IncGroup PAC ID 0345139671, shared by 4 NPIs, 48 clinicians

Practice addresses (Care Compare)

107 W 4TH St
Mount Vernon, NY 10550-4002
Phone 9146997200660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0063111NYMDNutritionist
000222CTMDRegistered Dietitian
222CTMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Vernon Neighborhood Health Center Inc CurrentSince Jan 13, 2016 Accepting new patients
Mount Vernon Neighborhood Health Center, Inc. CurrentSince Jan 13, 2016 Accepting new patients

Locations

107 W 4th St
Mount Vernon, NY 10550
Phone (914) 699-0235

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71482

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, 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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1487770145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 AKBAR RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069021402",
            "telephone_number": "203-912-9449",
            "fax_number": "203-324-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 AKBAR RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069021402",
            "telephone_number": "203-912-9449",
            "fax_number": "203-324-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAUS",
        "first_name": "KATHY",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "000222",
            "primary": true
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NY",
            "license": "0063111",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NY",
            "license": "006311",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2168469",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "270000222CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5455578",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.