Individual provider Active NPI

Aneta Braam, RD

  • Metabolic Nutrition Registered Dietitian
  • Worcester, MA
National Provider Identifier
1578967063
Registry record updated Oct 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
License
3599 Issued in MA
Practice address
630 Plantation St
Worcester, MA 01605-2038
Phone
(508) 852-6175
Fax
(508) 595-2122
NPI assigned
Oct 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Metabolic Nutrition Registered Dietitian 133VN1006X 3599 MA Primary

Addresses

Primary practice location

630 Plantation St
Worcester, MA 01605-2038

Mailing address

630 Plantation St
Wot 12TH FL
Worcester, MA 01605-2038
Phone (508) 368-5532

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150102000685 MA Practitioner - Registered Dietitian Or Nutrition Professional 4183947906 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3599MAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Center, Inc. Current Accepting new patients
Umass Memorial Medical Center, Inc. CurrentSince Jun 15, 2019 Accepting new patients
Umass Memorial Medical Center, Inc Nutrition, Metabolic CurrentSince Jun 15, 2019 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413244800000",
    "number": "1578967063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 PLANTATION ST",
            "address_2": "WOT 12TH FL",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052038",
            "telephone_number": "508-368-5532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 PLANTATION ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052038",
            "telephone_number": "508-852-6175",
            "fax_number": "508-595-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAAM",
        "first_name": "ANETA",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-14",
        "last_updated": "2014-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "MA",
            "license": "3599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2014; 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.