Individual provider Active NPI

In Kio Mac, RD, CDN

  • Registered Dietitian
  • New York, NY
National Provider Identifier
1720661622
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
009350-01 Issued in NY
Practice address
250 West 64TH Street
New York, NY 10023
Phone
(212) 769-6313
Fax
(212) 769-7825
NPI assigned
Apr 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1068495 NY
Registered Dietitian 133V00000X 009350-01 NY Primary

Addresses

Primary practice location

250 West 64TH Street
New York, NY 10023

Mailing address

250 West 64TH Street
New York, NY 10023
Phone (212) 769-6313

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240925002474 NY Practitioner - Registered Dietitian Or Nutrition Professional 0244771608 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
JGB Rehabilitation CorporationGroup PAC ID 5092606533, 13 clinicians

Practice addresses (Care Compare)

250 W 64TH St
New York, NY 10023-6402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009350-01NYMDRegistered Dietitian
1068495NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
JGB Rehabilitation Corporation CurrentSince Sep 16, 2024 Accepting new patients

Locations

250 W 64th St
New York, NY 10023
Phone (212) 769-6247

15 W 65th St
New York, NY 10023
Phone (212) 769-6200

250 W 64th St
Fl 3
New York, NY 10023
Phone (212) 769-6313

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1720661622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 WEST 64TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10023",
            "telephone_number": "212-769-6313",
            "fax_number": "212-769-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 WEST 64TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10023",
            "telephone_number": "212-769-6313",
            "fax_number": "212-769-7825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAC",
        "first_name": "IN KIO",
        "credential": "RD, CDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-29",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "1068495",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "009350-01",
            "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 Sep 9, 2025; 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.