Active NPI
Marissa Donofrio, MS, RD
- Registered Dietitian
- Austin, TX
National Provider Identifier
1558079202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 3724 Jefferson St Ste 104
Austin, TX 78731-6204 - Phone
- (512) 693-7045
- NPI assigned
- Nov 11, 2022
- Sex
- Female
- Sole proprietor
- No
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 | Primary |
Addresses
Primary practice location
3724 Jefferson St Ste 104
Austin, TX 78731-6204
Mailing address
2717 Bellevue Ave Ste 6
Syracuse, NY 13219-3233
Phone (315) 460-0802
Other practice location 1
2717 Bellevue Ave Ste 6
Syracuse, NY 13219-3233
Phone (315) 460-0802
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
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sarah Lynn Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736208000000",
"number": "1558079202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2717 BELLEVUE AVE STE 6",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132193233",
"telephone_number": "315-460-0802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3724 JEFFERSON ST STE 104",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787316204",
"telephone_number": "512-693-7045"
}
],
"practiceLocations": [
{
"address_1": "2717 Bellevue Ave Ste 6",
"address_purpose": "LOCATION",
"city": "Syracuse",
"state": "NY",
"postal_code": "132193233",
"country_code": "US",
"telephone_number": "315-460-0802",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DONOFRIO",
"first_name": "MARISSA",
"credential": "MS, RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-11",
"last_updated": "2025-01-07",
"certification_date": "2025-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.