Individual provider Active NPI

Kelsy Camilo, RDN

  • Registered Dietitian
  • New York, NY
National Provider Identifier
1689326035
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
511 West 157TH Street
New York, NY 10032-5058
Phone
(212) 781-7979
Fax
(212) 781-7963
NPI assigned
Jan 26, 2022
Last updated
Jan 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

511 West 157TH Street
New York, NY 10032-5058

Mailing address

1063 Wheeler Ave
Bronx, NY 10472-5509
Phone (917) 645-7390

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220412000693 NY Practitioner - Registered Dietitian Or Nutrition Professional 4981090347 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Healthcare Network Inc Current Accepting new patients
Marjorie Nolan Cohn LLC Dietitian, Registered Past Accepting new patients

Locations

999 Blake Ave
Brooklyn, NY 11208
Phone (718) 277-8303

9704 Sutphin Blvd
Jamaica, NY 11435
Phone (718) 657-7088

511 W 157th St
New York, NY 10032
Phone (212) 781-7979

60 Madison Ave
Fl 5
New York, NY 10010
Phone (212) 545-2400

44 W 28th St
Fl 5
New York, NY 10001
Phone (212) 545-2439

81 W 115th St
New York, NY 10026
Phone (212) 426-0088

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1643155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1689326035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1063 WHEELER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104725509",
            "telephone_number": "917-645-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 WEST 157TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100325058",
            "telephone_number": "212-781-7979",
            "fax_number": "212-781-7963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMILO",
        "first_name": "KELSY",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-26",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; 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.