Individual provider Active NPI

Alexandra Oksana Anderson, RDN

  • Registered Dietitian
  • New York, NY
National Provider Identifier
1710514575
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
420 E 61St St
New York, NY 10065-8763
Phone
(425) 281-6083
NPI assigned
Mar 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

420 E 61St St
New York, NY 10065-8763

Mailing address

1 Ford PL
Detroit, MI 48202-3450
Phone (313) 874-4806

Other practice location 1

71020 Weeks Rd
Richmond, MI 48062-4924
Phone (586) 291-9832

Other practice location 2

205 N East Ave
Jackson, MI 49201-1753
Phone (425) 281-6083

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240221000917 TX Practitioner - Registered Dietitian Or Nutrition Professional 8729422464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nourish, Inc.Group PAC ID 1557724937, 288 clinicians

Practice addresses (Care Compare)

3724 Jefferson St
Suite 104
Austin, TX 78731-6204
Phone (512) 693-7045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nourish, Inc. Dietitian, Registered CurrentSince Jan 30, 2024 Accepting new patients
Marjorie Nolan Cohn LLC Dietitian, Registered Past Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Locations

1390 Market St
Ste 200
San Francisco, CA 94102
Phone (415) 864-4482

500 Westover Dr
Sanford, NC 27330
Phone (478) 766-4000

3724 Jefferson St
Ste 104
Austin, TX 78731
Phone (512) 399-9039

Organizations & group practices 3

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": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1710514575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-874-4806",
            "fax_number": "313-876-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E 61ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100658763",
            "telephone_number": "425-281-6083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "71020 Weeks Rd",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "MI",
            "postal_code": "480624924",
            "country_code": "US",
            "telephone_number": "586-291-9832",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 N East Ave",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492011753",
            "country_code": "US",
            "telephone_number": "425-281-6083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ALEXANDRA",
        "middle_name": "OKSANA",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-23",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "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 Dec 3, 2024; 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.