Individual provider Active NPI

Anna Burrowes-Mulvey, RDN, CDCES

  • Registered Dietitian
  • Port Jefferson, NY
National Provider Identifier
1669239703
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1020834 Issued in NY
Practice address
70 N Country Rd Ste 303
Port Jefferson, NY 11777-2161
Phone
(631) 621-4093
NPI assigned
Mar 5, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1020834 NY Primary

Addresses

Primary practice location

70 N Country Rd Ste 303
Port Jefferson, NY 11777-2161

Mailing address

1297 Hiram Ave
Holbrook, NY 11741-3911

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250124001119 NY Practitioner - Registered Dietitian Or Nutrition Professional 9436688108 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harbor View Medical Services PCGroup PAC ID 5092865873, shared by 3 NPIs, 58 clinicians

Practice addresses (Care Compare)

125 Oakland Ave
Suite 203
Port Jefferson, NY 11777-2130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1020834NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor View Medical Services PC CurrentSince Nov 15, 2024 Accepting new patients
Harbor View Medical Services PC CurrentSince Mar 12, 2024 Accepting new patients
Harbor View Medical Services PC CurrentSince Nov 15, 2024 Accepting new patients

Locations

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

70 N Country Rd
Ste 303
Port Jefferson, NY 11777
Phone (631) 621-4093

125 Oakland Ave
Ste 205
Port Jefferson, NY 11777
Phone (631) 686-2523

125 Oakland Ave
Ste 203
Prt Jefferson, NY 11777
Phone (631) 686-2551

75 N Country Rd
Ste 201
Prt Jefferson, NY 11777
Phone (631) 686-2575

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

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": "1709596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1669239703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1297 HIRAM AVE",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117413911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 N COUNTRY RD STE 303",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772161",
            "telephone_number": "631-621-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURROWES-MULVEY",
        "first_name": "ANNA",
        "credential": "RDN, CDCES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-05",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "1020834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; 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.

Verify at the official NPI Registry.