Individual provider Active NPI

Scott Keatley, RD, CDN

  • Registered Dietitian
  • New York, NY
National Provider Identifier
1619327129
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
596 Broadway
Ste 302
New York, NY 10012-3396
Phone
(800) 571-8276
Fax
(888) 974-0289
NPI assigned
Jun 15, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Metabolic Nutrition Registered Dietitian 133VN1006X 009107 NY
Registered Dietitian 133V00000X Primary
Nutritionist 133N00000X 009107 NY
Renal Nutrition Registered Dietitian 133VN1005X 009107 NY

Addresses

Primary practice location

596 Broadway
Ste 302
New York, NY 10012-3396

Mailing address

869 Park Ave Apt 2a
Brooklyn, NY 11206-7334
Phone (800) 571-8276

Other identifiers 5

IdentifierTypeStateIssuer
NU009107OtherNYHEALTHFIRST
6004111OtherNYAETNA
75762436OtherNYCIGNA
06090442OtherNYBLUE CROSS BLUE SHIELD
009107OtherNYNYS REGISTRATION

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170921001687 NY Practitioner - Registered Dietitian Or Nutrition Professional 1557635018 Practice locations: New York, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Openloop Healthcare Partners PC Dietitian, Registered CurrentSince Aug 1, 2025 Accepting new patients
Openloop Healthcare Partners California PC Dietitian, Registered Past Accepting new patients
Keatley MNT Dietitian, Registered Past Accepting new patients

Locations

3707 E Southern Ave
#1
Mesa, AZ 85206
Phone (424) 387-6806

8270 Woodland Center Blvd
#110112
Tampa, FL 33614
Phone (804) 200-7348

317 6th Ave
Ste 400
Des Moines, IA 50309
Phone (515) 612-9097

3200 Greenfield Rd
Ste 300
Dearborn, MI 48120
Phone (313) 318-8208

101 Hudson St
Jersey City, NJ 07302
Phone (516) 432-3800

80 Broad St
Fl 5
New York, NY 10004
Phone (201) 286-1122

28 Liberty St
New York, NY 10005
Phone (415) 205-1229

18 Campus Blvd
Ste 100
Newtown Square, PA 19073
Phone (484) 680-7575

4500 Mercantile Plaza Dr
Ste 300
Ft Worth, TX 76137
Phone (469) 688-9501

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Organizations & group practices 3

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": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1619327129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "869 PARK AVE APT 2A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112067334",
            "telephone_number": "800-571-8276",
            "fax_number": "888-974-0289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "596 BROADWAY",
            "address_2": "STE 302",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100123396",
            "telephone_number": "800-571-8276",
            "fax_number": "888-974-0289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEATLEY",
        "first_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "RD, CDN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-15",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "NY",
            "license": "009107",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NY",
            "license": "009107",
            "primary": false
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "NY",
            "license": "009107",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHFIRST",
            "identifier": "NU009107",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "6004111",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "75762436",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "06090442",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS REGISTRATION",
            "identifier": "009107",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.