Individual provider Active NPI

Deborah Ann Cardile, M.S., CDN

  • Nutritionist
  • New York, NY
National Provider Identifier
1699035402
Registry record updated Mar 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
002215-1 Issued in NY
Practice address
261 E 78TH St
6TH Floor
New York, NY 10075-1216
Phone
(646) 520-9751
NPI assigned
May 25, 2012
Last updated
Mar 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 002215-1 NY Primary

Addresses

Primary practice location

261 E 78TH St
6TH Floor
New York, NY 10075-1216

Mailing address

170 E 89TH St
Suite 4E
New York, NY 10128-2311
Phone (646) 520-9751

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121221000012 NY Practitioner - Registered Dietitian Or Nutrition Professional 8325290398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

170 E 89TH St
Apt 4E
New York, NY 10128-2335
Phone (646) 520-9751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Master of Science

State licenses

LicenseStateTypeSpecialty
002215-1NYMDNutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeways Nutrition, PLLC Nutritionist CurrentSince Jul 12, 2014 Accepting new patients

Locations

1370 Broadway
Fl 5
New York, NY 10018
Phone (212) 256-1071

261 E 78th St
Fl 6
New York, NY 10075
Phone (646) 386-7745

Networks

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

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, 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": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456790400000",
    "number": "1699035402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 E 89TH ST",
            "address_2": "SUITE 4E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101282311",
            "telephone_number": "646-520-9751",
            "fax_number": "212-876-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 E 78TH ST",
            "address_2": "6TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751216",
            "telephone_number": "646-520-9751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDILE",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "M.S., CDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-25",
        "last_updated": "2016-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NY",
            "license": "002215-1",
            "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 Mar 1, 2016; 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.