Individual provider Active NPI

Hermine Kessler Axelrod, RD CDE

  • Registered Dietitian
  • Fort Lee, NJ
National Provider Identifier
1669527693
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
00873077
Practice address
2100 Linwood Ave
Suite 15D
Fort Lee, NJ 07024-3141
Phone
(201) 461-9279
Fax
(201) 461-8262
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 00873077 Primary

Addresses

Primary practice location

2100 Linwood Ave
Suite 15D
Fort Lee, NJ 07024-3141

Mailing address

2100 Linwood Ave
Suite 15D
Fort Lee, NJ 07024-3141
Phone (201) 461-9279

Other identifiers 2

IdentifierTypeStateIssuer
22220261OtherCDE AM ASSOCIATION OF DIA
00873077OtherRD AM DIETETIC ASSOCIATIO

Other names 1

  • Ms. Hermine Kessler Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050726000182 NJ Practitioner - Registered Dietitian Or Nutrition Professional 6103853775 Reassigns benefits to 1 organization
Practice locations: Englewood Cliffs, NJ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Englewood, PC CurrentSince May 11, 2019 Accepting new patients

Locations

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

Organizations & group practices 1

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": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669527693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 LINWOOD AVE",
            "address_2": "SUITE 15D",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070243141",
            "telephone_number": "201-461-9279",
            "fax_number": "201-461-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 LINWOOD AVE",
            "address_2": "SUITE 15D",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070243141",
            "telephone_number": "201-461-9279",
            "fax_number": "201-461-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESSLER AXELROD",
        "first_name": "HERMINE",
        "name_prefix": "Ms.",
        "credential": "RD CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "00873077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDE AM ASSOCIATION OF DIA",
            "identifier": "22220261",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RD AM DIETETIC ASSOCIATIO",
            "identifier": "00873077",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HERMINE",
            "last_name": "KESSLER",
            "prefix": "MS.",
            "credential": "RD CDE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fort Lee, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.