Elysa Dinzes Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

ELYSA DINZES NUTRITION LLC

Practice address

66 W Mount Pleasant Ave Ste 205
Livingston, NJ 07039-2930

Phone

(917) 837-0598

NPI assigned

Feb 5, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Elysa Faith Dinzes, RDNPI 1750317707

Title

Owner

Phone

(917) 837-0598

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elysa Faith Dinzes, R.D

  • Registered Dietitian
  • Livingston, NJ
  • NPI 1750317707
  Medicare reassignment Authorized official
• Tida Pradith Coralluzzo, RD

  • Registered Dietitian
  • Livingston, NJ
  • NPI 1073456422
  Medicare reassignment

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

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1659903870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 N HILLSIDE AVE",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070391110",
            "telephone_number": "917-837-0598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 W MOUNT PLEASANT AVE STE 205",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070392930",
            "telephone_number": "917-837-0598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELYSA DINZES NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-05",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "DINZES",
        "authorized_official_first_name": "ELYSA",
        "authorized_official_middle_name": "FAITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-837-0598",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Livingston, NJ
• Providers in Livingston, NJ by specialty
• Registered Dietitian in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.