Stacey L Messe, RD, CDN, CNSC

Primary specialty

Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X

License

48-007255 Issued in NY

Practice address

725 Irving Ave
Suite 504
Syracuse, NY 13210-1603

Phone

(315) 464-4835

NPI assigned

Feb 23, 2015

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424649600000",
    "number": "1760874150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 WOODBINE AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132063325",
            "telephone_number": "404-295-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 IRVING AVE",
            "address_2": "SUITE 504",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101603",
            "telephone_number": "315-464-4835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESSE",
        "first_name": "STACEY",
        "middle_name": "L",
        "credential": "RD, CDN, CNSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-23",
        "last_updated": "2015-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "NY",
            "license": "48-007255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackqueline Anne Merulla, LCSW-R
• Mesa of N.Y., Inc.
• Michael Mesa, MHC-LP
• Jacob Mesches, MD, MS
• Alexis Rae Messak, NP
• Debora S Messur, RN
• Renee E Mestad, MD
• Diane Elliott Meszko, CNP
• Elizabeth E Metcalf, MSW
• Janice A Metcalf

• Pediatric Nutrition Registered Dietitian in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Pediatric Nutrition Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.