Individual provider Active NPI

Iris R Epstein, R.D.CDN

  • Nutritionist
  • Pomona, NY
National Provider Identifier
1538109780
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
003101-1 Issued in NY
Practice address
978 Route 45 Ste 107
Pomona, NY 10970-3512
Phone
(845) 362-1300
Fax
(914) 352-0325
NPI assigned
Jun 7, 2006
Last updated
Oct 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 003101-1 NY Primary

Addresses

Primary practice location

978 Route 45 Ste 107
Pomona, NY 10970-3512

Mailing address

978 Route 45 Ste 107
Pomona, NY 10970-3512
Phone (845) 362-1300

Other identifiers 1

IdentifierTypeStateIssuer
01421705MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041119000789 NY Practitioner - Registered Dietitian Or Nutrition Professional 9537124466 Practice locations: Pomona, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003101-1NYMDNutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
Iris Epstein & Associates LLC CurrentSince Oct 10, 2021 Accepting new patients
Nutrition Improvement Center PastSince Oct 10, 2021 Accepting new patients

Locations

978 Route 45
Ste 107
Pomona, NY 10970
Phone (845) 362-1300

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1538109780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "978 ROUTE 45 STE 107",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109703512",
            "telephone_number": "845-362-1300",
            "fax_number": "914-352-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "978 ROUTE 45 STE 107",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109703512",
            "telephone_number": "845-362-1300",
            "fax_number": "914-352-0325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPSTEIN",
        "first_name": "IRIS",
        "middle_name": "R",
        "credential": "R.D.CDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NY",
            "license": "003101-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01421705",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, NY

Sources for this page

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