Active NPI
Theresa Lauren Gentile, RD
- Registered Dietitian
- Brooklyn, NY
National Provider Identifier
1598997041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 941637
- Practice address
- 136 83Rd St
Brooklyn, NY 11209-4310 - Phone
- (212) 920-7843
- NPI assigned
- Aug 18, 2009
- 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 | 941637 | NY | Primary |
Addresses
Primary practice location
136 83Rd St
Brooklyn, NY 11209-4310
Mailing address
136 83Rd St
Brooklyn, NY 11209-4310
Phone (212) 920-7843
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100810000603 | NY | Practitioner - Registered Dietitian Or Nutrition Professional | 1850425075 | Practice locations: Brooklyn, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
421 74TH St
Brooklyn, NY 11209-2601
Phone (212) 920-7843
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 941637 | NY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250553600000",
"number": "1598997041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "136 83RD ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112094310",
"telephone_number": "212-920-7843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 83RD ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112094310",
"telephone_number": "212-920-7843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENTILE",
"first_name": "THERESA",
"middle_name": "LAUREN",
"name_prefix": "Mr.",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-18",
"last_updated": "2009-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "941637",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; 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.