Active NPI
Rebecca Elbaum, MPH, RD, CDN, CDE
- Registered Dietitian
- Bronx, NY
National Provider Identifier
1710476346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 008466
- Practice address
- 1250 Waters PL FL 6
Bronx, NY 10461-2720 - Phone
- (929) 263-3519
- NPI assigned
- May 9, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 008466 | NY | Primary |
Addresses
Primary practice location
1250 Waters PL FL 6
Bronx, NY 10461-2720
Mailing address
1250 Waters PL FL 6
Bronx, NY 10461-2720
Phone (929) 263-3519
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1098511 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1710476346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 WATERS PL FL 6",
"city": "BRONX",
"state": "NY",
"postal_code": "104612720",
"telephone_number": "929-263-3519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 WATERS PL FL 6",
"city": "BRONX",
"state": "NY",
"postal_code": "104612720",
"telephone_number": "929-263-3519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELBAUM",
"first_name": "REBECCA",
"credential": "MPH, RD, CDN, CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-09",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "008466",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1098511",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.