Clarissa Padua, RD

Primary specialty

Sports Dietetics Nutrition Registered DietitianTaxonomy code 133VN1501X

License

86113915 Issued in IL

Practice address

193 Morris Ave
Springfield, NJ 07081-1211

Phone

(551) 258-9109

Fax

(201) 437-9653

NPI assigned

Aug 3, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Laparoscopic Edge, PCGroup PAC ID 1052591245, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Laparoscopic Edge, PC

  • Surgery Physician
  • Union, NJ
  • NPI 1992024095
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1689284978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 555",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070830555",
            "telephone_number": "551-258-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 MORRIS AVE",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070811211",
            "telephone_number": "551-258-9109",
            "fax_number": "201-437-9653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADUA",
        "first_name": "CLARISSA",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1501X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": "IL",
            "license": "86113915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpadua@njbcenter.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Springfield",
            "address_1": "193 Morris Ave",
            "city": "Springfield",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070811211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rachel Ostry, MD
• Johanna Victoria Otero, LSW
• Susanne Ottomanelli, OTR/L
• P&P Psychiatric and Recovery Center LLC.
• Sarah Pachner, PSY.D.
• Elizabeth Pais
• Jennifer Palko, L.AC.
• Ronald D Pallant, MD
• Kim Palmeri-Naman, PA
• David Fabian Palombi, D.C.

• Sports Dietetics Nutrition Registered Dietitian in Springfield, NJ
• Providers in Springfield, NJ by specialty
• Sports Dietetics Nutrition Registered Dietitian in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.