Active NPI
Anya Dissen, RDN, LD
- Registered Dietitian
- South Portland, ME
National Provider Identifier
1558071639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DI1621
- Practice address
- 41 Donald B Dean Dr Ste a
South Portland, ME 04106-3252 - Phone
- (207) 661-6064
- NPI assigned
- Nov 30, 2022
- Last updated
- Nov 30, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DI1621 | ME | Primary |
Addresses
Primary practice location
41 Donald B Dean Dr Ste a
South Portland, ME 04106-3252
Mailing address
240 Harvard St Apt 607
Portland, ME 04103-3536
Phone (410) 310-7343
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 97.93 of 100
- Quality
- 83.31
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Past | Accepting new patients |
Locations
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
41 Donald B Dean Dr
#A
South Portland, ME 04106
Phone (207) 661-6064
Interoperability endpoints
- anya.dissen@168064768409604.direct.elationemr.com
Organizations & group practices 4
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.
-
dba MaineHealth Pharmacy Brighton Ave
- Community/Retail Pharmacy
- Portland, ME
- NPI 1013868181
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669766400000",
"number": "1558071639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 HARVARD ST APT 607",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041033536",
"telephone_number": "410-310-7343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 DONALD B DEAN DR STE A",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041063252",
"telephone_number": "207-661-6064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DISSEN",
"first_name": "ANYA",
"credential": "RDN, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-30",
"last_updated": "2022-11-30",
"certification_date": "2022-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "ME",
"license": "DI1621",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.