Active NPI
Leticia Gabriela Renkart, RD
- Registered Dietitian
- Lyndhurst, NJ
National Provider Identifier
1578156246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86197858
- Practice address
- 576 Valley Brook Ave Ste M1
Lyndhurst, NJ 07071-1919 - Phone
- (646) 389-9196
- NPI assigned
- Feb 14, 2021
- Last updated
- Nov 12, 2024
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86197858 | NJ | Primary |
| Metabolic Nutrition Registered Dietitian | 133VN1006X | 86197858 | NJ | |
| Obesity and Weight Management Nutrition Registered Dietitian | 133VN1201X | 86197858 | NJ |
Addresses
Primary practice location
576 Valley Brook Ave Ste M1
Lyndhurst, NJ 07071-1919
Mailing address
113 Rutherford PL
North Arlington, NJ 07031-6303
Phone (646) 389-9196
Other practice location 1
113 Rutherford Pl
North Arlington, NJ 07031-6303
Phone (646) 389-9196
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86197858 | NJ | MD | Obesity and Weight Management Nutrition Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Nutrition Sisters LLC | Dietitian, Registered | Current | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Locations
576 Valley Brook Ave
Ste M1
Lyndhurst, NJ 07071
Phone (646) 389-9196
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": "1613260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731369600000",
"number": "1578156246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113 RUTHERFORD PL",
"city": "NORTH ARLINGTON",
"state": "NJ",
"postal_code": "070316303",
"telephone_number": "646-389-9196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "576 VALLEY BROOK AVE STE M1",
"city": "LYNDHURST",
"state": "NJ",
"postal_code": "070711919",
"telephone_number": "646-389-9196"
}
],
"practiceLocations": [
{
"address_1": "113 Rutherford Pl",
"address_purpose": "LOCATION",
"city": "North Arlington",
"state": "NJ",
"postal_code": "070316303",
"country_code": "US",
"telephone_number": "646-389-9196",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RENKART",
"first_name": "LETICIA",
"middle_name": "GABRIELA",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-14",
"last_updated": "2024-11-12",
"certification_date": "2024-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NJ",
"license": "86197858",
"primary": true
},
{
"code": "133VN1006X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Metabolic",
"state": "NJ",
"license": "86197858",
"primary": false
},
{
"code": "133VN1201X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
"state": "NJ",
"license": "86197858",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lyndhurst, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.