Individual provider Active NPI

Melinda Dennis, MS, RD, LDN

  • Registered Dietitian
  • Boston, MA
National Provider Identifier
1508920034
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1983 Issued in MA
Practice address
330 Brookline Ave
Shapiro B04
Boston, MA 02215-5400
Phone
(617) 667-9326
Fax
(617) 975-5175
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1983 MA Primary

Addresses

Primary practice location

330 Brookline Ave
Shapiro B04
Boston, MA 02215-5400

Mailing address

330 Brookline Ave
Nutrition Services, Rabb B06
Boston, MA 02215-5400
Phone (617) 667-9326

Other identifiers 1

IdentifierTypeStateIssuer
1200151MedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050705000403 MA Practitioner - Registered Dietitian Or Nutrition Professional 1355387069 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1983MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jun 1, 2010 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jun 1, 2010 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Past Accepting new patients

Locations

330 Brookline Ave
#B4
Boston, MA 02215
Phone (617) 667-9326

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

330 Brookline Ave
#10
Boston, MA 02215
Phone (617) 667-2295

330 Brookline Ave
#B6
Boston, MA 02215
Phone (617) 667-2565

Organizations & group practices 3

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508920034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "NUTRITION SERVICES, RABB B06",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-9326",
            "fax_number": "617-975-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "SHAPIRO B04",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-9326",
            "fax_number": "617-975-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "MELINDA",
        "name_prefix": "Ms.",
        "credential": "MS, RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "1983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1200151",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.