Marta E Banuelos, MS, CNS

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

19289 Issued in MA

Practice address

504 Beacon St Ste 1
Boston, MA 02115-1042

Phone

(415) 999-8393

NPI assigned

Nov 9, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Marta E Oltarzewski Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1619633195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 BEACON ST STE 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021151042",
            "telephone_number": "617-615-9198",
            "fax_number": "617-616-0936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 BEACON ST STE 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021151042",
            "telephone_number": "415-999-8393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANUELOS",
        "first_name": "MARTA",
        "middle_name": "E",
        "credential": "MS, CNS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-09",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "19289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTA",
            "last_name": "OLTARZEWSKI",
            "middle_name": "E",
            "credential": "MS, CNS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michaela U Bannon
• Sarah M Bannon, MA
• Samridhi Banskota
• Lisa M Banta, M.D.
• Laura Louise Sanford Bantle, RD
• Tina Banzon, MD
• Bao Min Yee DMD PC of Boston
• Bo Bao, M.D.
• Chen Bao, MD
• Ting Bao, M.D.

• Registered Dietitian in Boston, MA
• Providers in Boston, MA by specialty
• Registered Dietitian in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.