Individual provider Active NPI

Jane Boylan, RD

  • Registered Dietitian
  • Los Angeles, CA
National Provider Identifier
1679382584
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Phone
(818) 636-2025
NPI assigned
Jan 6, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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 Primary

Addresses

Primary practice location

4650 W Sunset Blvd
Los Angeles, CA 90027-6062

Mailing address

2550 Purvis Dr
Burbank, CA 91504-2211
Phone (818) 636-2025

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260102003220 MD Practitioner - Registered Dietitian Or Nutrition Professional 3971099557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 E Carroll St
Salisbury, MD 21801-5422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tidalhealth Primary Care, LLC CurrentSince Jan 20, 2026 Accepting new patients

Locations

400 Eastern Shore Dr
Salisbury, MD 21804
Phone (410) 543-2255

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": "1736121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1679382584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 PURVIS DR",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915042211",
            "telephone_number": "818-636-2025",
            "fax_number": "818-846-4813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "818-636-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLAN",
        "first_name": "JANE",
        "name_prefix": "Ms.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-06",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.