Individual provider Active NPI

Negin Ebrahimifard, RD, CDCES

  • Registered Dietitian
  • Tucson, AZ
National Provider Identifier
1760024376
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86043491 Issued in AZ
Practice address
1500 N Wilmot Rd Ste B250
Tucson, AZ 85712-4416
Phone
(520) 420-2212
Fax
(520) 420-2222
NPI assigned
Oct 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 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 86043491 AZ Primary

Addresses

Primary practice location

1500 N Wilmot Rd Ste B250
Tucson, AZ 85712-4416

Mailing address

13003 20TH Ave NE
Seattle, WA 98125-4121
Phone (480) 254-1884

Other practice location 1

300 Lenora St # 1149
Seattle, WA 98121-2411
Phone (206) 409-8119

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250520000000 AZ Practitioner - Registered Dietitian Or Nutrition Professional 9739607110 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86043491AZMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Numena Nutrition PLLC Dietitian, Registered CurrentSince Aug 16, 2020 Accepting new patients
TMC Medical Network CurrentSince Mar 9, 2025 Accepting new patients

Locations

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

2380 N Ferguson Ave
Ste 104
Tucson, AZ 85712
Phone (520) 324-1010

1500 N Wilmot Rd
Ste B250
Tucson, AZ 85712
Phone (520) 324-7840

300 Lenora St
Seattle, WA 98121
Phone (206) 623-7671

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": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1760024376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13003 20TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981254121",
            "telephone_number": "480-254-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N WILMOT RD STE B250",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857124416",
            "telephone_number": "520-420-2212",
            "fax_number": "520-420-2222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Lenora St # 1149",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981212411",
            "country_code": "US",
            "telephone_number": "206-409-8119",
            "fax_number": "425-333-1886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EBRAHIMIFARD",
        "first_name": "NEGIN",
        "credential": "RD, CDCES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-15",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "86043491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.