Lisa Marie Gangemi, MS, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

100 Foster Rd
Staten Island, NY 10309-3011

Phone

(646) 460-7129

NPI assigned

Feb 5, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• LMG Nutrition PLLC

  dba LMG Nutrition

  • Registered Dietitian
  • Staten Island, NY
  • NPI 1598570756

  Dietitian, Registered

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1760074280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FOSTER RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093011",
            "telephone_number": "646-460-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FOSTER RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093011",
            "telephone_number": "646-460-7129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGEMI",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MS, RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-05",
        "last_updated": "2021-02-05",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gamzel Ny, Inc (Revival Home Health Care)
• Michelle Ganeles
• Arkady Ganelin, MD
• Esar Gangadin, BS
• Diana Gangal
• Tommi-Ann Gangi
• Trystan Gangi
• Aziz Ganiev, RN
• Gabrielle Gannon
• Jacqueline Gannon, CF

• Registered Dietitian in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; 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.