Individual provider Active NPI

Angela Bencivengo, MPH RD CDN

  • Registered Dietitian
  • White Plains, NY
National Provider Identifier
1679559561
Registry record updated Jan 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
005178-1 Issued in NY
Practice address
210 Westchester Ave
White Plains, NY 10604-2901
Phone
(914) 831-4154
Fax
(914) 457-1526
NPI assigned
Dec 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2021

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 005178-1 NY Primary

Addresses

Primary practice location

210 Westchester Ave
White Plains, NY 10604-2901

Mailing address

800 Westchester Ave Ste N715
Rye Brook, NY 10573-1376
Phone (914) 607-5730

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041210000726 NY Practitioner - Registered Dietitian Or Nutrition Professional 5698732683 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Westchester Medical Group, P.CGroup PAC ID 6406752963, 410 clinicians

Practice addresses (Care Compare)

210 Westchester Ave
White Plains, NY 10604-2901
Phone (914) 682-0700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005178-1NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Sharon Saka Associates Inc. Dietitian, Registered CurrentSince Apr 23, 2019 Accepting new patients
The Westchester Medical Group PC CurrentSince Dec 1, 2020 Accepting new patients
Westchester Medical Group, P.C. CurrentSince Dec 1, 2020 Accepting new patients
Sharon Saka Associates PastSince Apr 23, 2019 Accepting new patients

Locations

3030 Westchester Ave
Purchase, NY 10577
Phone (914) 682-6435

800 Westchester Ave
Ste N715
Rye Brook, NY 10573
Phone (914) 607-5730

2 Executive Blvd
Ste 203
Suffern, NY 10901
Phone (845) 357-0166

210 Westchester Ave
White Plains, NY 10604
Phone (914) 681-3100

1084 N Broadway
Yonkers, NY 10701
Phone (914) 848-8000

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: angela.bencivengo.1@21260.direct.athenahealth.com

Organizations & group practices 4

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": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610841600000",
    "number": "1679559561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WESTCHESTER AVE STE N715",
            "city": "RYE BROOK",
            "state": "NY",
            "postal_code": "105731376",
            "telephone_number": "914-607-5730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 WESTCHESTER AVE",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106042901",
            "telephone_number": "914-831-4154",
            "fax_number": "914-457-1526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENCIVENGO",
        "first_name": "ANGELA",
        "credential": "MPH RD CDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-21",
        "last_updated": "2021-01-17",
        "certification_date": "2021-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "005178-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2021; 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.