Individual provider Active NPI

Mary Alexis Lupoli, R.D., CDN

  • Registered Dietitian
  • Catskill, NY
National Provider Identifier
1497009377
Registry record updated Oct 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
947105 Issued in NY
Practice address
159 Jefferson HTS
Suite D-303
Catskill, NY 12414-1237
Phone
(518) 821-7161
NPI assigned
Oct 31, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2012

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 947105 NY Primary

Addresses

Primary practice location

159 Jefferson HTS
Suite D-303
Catskill, NY 12414-1237

Mailing address

PO Box 386
South Cairo, NY 12482-0386
Phone (518) 821-7161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
947105NYMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351641600000",
    "number": "1497009377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 386",
            "city": "SOUTH CAIRO",
            "state": "NY",
            "postal_code": "124820386",
            "telephone_number": "518-821-7161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 JEFFERSON HTS",
            "address_2": "SUITE D-303",
            "city": "CATSKILL",
            "state": "NY",
            "postal_code": "124141237",
            "telephone_number": "518-821-7161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUPOLI",
        "first_name": "MARY",
        "middle_name": "ALEXIS",
        "name_prefix": "Mrs.",
        "credential": "R.D., CDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-31",
        "last_updated": "2012-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "947105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Catskill, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.