Individual provider Active NPI

Emma Glynn

  • Registered Dietitian
  • New Hyde Park, NY
National Provider Identifier
1699660860
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
012541 Issued in NY
Practice address
410 Lakeville Rd
New Hyde Park, NY 11042-1101
Phone
(631) 894-6256
NPI assigned
Jun 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 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 012541 NY Primary

Addresses

Primary practice location

410 Lakeville Rd
New Hyde Park, NY 11042-1101

Mailing address

30 Willow St
Babylon, NY 11702-3506

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250731003577 NY Practitioner - Registered Dietitian Or Nutrition Professional 7315455433 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jul 1, 2025 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jul 1, 2025 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

410 Lakeville Rd
Ste 108
New Hyde Park, NY 11042
Phone (516) 465-3270

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

410 Lakeville Rd
North New Hyde Park, NY 11042
Phone (516) 465-3270

300 Community Dr
Plandome, NY 11030

Networks

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1749513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1699660860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 WILLOW ST",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117023506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 LAKEVILLE RD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421101",
            "telephone_number": "631-894-6256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLYNN",
        "first_name": "EMMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-10",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "012541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; 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.