Kristine Louise Bach, M.S., R.D., C.D.N.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

714025 Issued in NY

Practice address

1 Patty Ann CT
Port Jefferson Station, NY 11776-8031

Phone

(631) 474-8684

Fax

(631) 474-8684

NPI assigned

Apr 26, 2009

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24863/brand/1/csg/1/fhir/r4

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.

• Primary Partnercare Physicians PLLC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1891318168
  NPD (past)

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

{
    "created_epoch": "1240704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240704000000",
    "number": "1508000266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PATTY ANN CT",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117768031",
            "telephone_number": "631-474-8684",
            "fax_number": "631-474-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PATTY ANN CT",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117768031",
            "telephone_number": "631-474-8684",
            "fax_number": "631-474-8684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACH",
        "first_name": "KRISTINE",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "M.S., R.D., C.D.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-26",
        "last_updated": "2009-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "714025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Away From Home Senior Day Care
• Diane Jane Axelrod, D.D.S.
• Marissa T Ayasse, MD
• Aziz Chaudry
• Laura Babstock, LPN
• Nonna Badalova, MD,DO
• Riem Badr, M.D.
• Gianna Baialardo
• Nicholas Baialardo
• Alyza D Bailey, LCSW

• Registered Dietitian in Port Jefferson Station, NY
• Providers in Port Jefferson Station, 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 Apr 26, 2009; 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.