Active NPI
Sally Pechstein, R.D.N.
- Registered Dietitian
- Corrales, NM
National Provider Identifier
1609834332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT89872
- Practice address
- 295 Noble LN
Corrales, NM 87048-7703 - Phone
- (808) 866-8142
- NPI assigned
- May 2, 2006
- 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 | DT89872 | TX | Primary |
Addresses
Primary practice location
295 Noble LN
Corrales, NM 87048-7703
Mailing address
PO Box 2980
Corrales, NM 87048-2980
Phone (808) 866-8142
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0172935 | Other | WA | L&I PIN |
| 9723PE | Other | WA | REGENCE BLUE SHIELD |
| 8330169 | Medicaid | WA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT89872 | TX | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Cloud Health Medical Group, P.a. | 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.
-
- Internal Medicine Physician
- White Plains, NY
- NPI 1528744935
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711929600000",
"number": "1609834332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2980",
"city": "CORRALES",
"state": "NM",
"postal_code": "870482980",
"telephone_number": "808-866-8142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "295 NOBLE LN",
"city": "CORRALES",
"state": "NM",
"postal_code": "870487703",
"telephone_number": "808-866-8142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECHSTEIN",
"first_name": "SALLY",
"credential": "R.D.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-02",
"last_updated": "2024-04-01",
"certification_date": "2024-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT89872",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I PIN",
"identifier": "0172935",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "9723PE",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8330169",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Corrales, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.