Individual provider Active NPI

Noelle Fines, RDN LDN

  • Registered Dietitian
  • Camillus, NY
National Provider Identifier
1760940548
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164007677 Issued in IL
Practice address
5100 W Genesee St
Camillus, NY 13031-2354
Phone
(315) 401-0054
NPI assigned
Mar 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 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 164007677 IL Primary

Addresses

Primary practice location

5100 W Genesee St
Camillus, NY 13031-2354

Mailing address

194 E Cayuga Ave
Elmhurst, IL 60126-4420

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250207001640 NY Practitioner - Registered Dietitian Or Nutrition Professional 7517208069 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
164007677ILMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah Lynn Nutrition Dietitian, Registered CurrentSince Nov 7, 2024 Accepting new patients
Lindatroia,LCSW, P.C. PastSince Jun 30, 2024 Accepting new patients

Locations

5100 W Genesee St
Camillus, NY 13031
Phone (315) 401-0590

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": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1760940548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 E CAYUGA AVE",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601264420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W GENESEE ST",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130312354",
            "telephone_number": "315-401-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINES",
        "first_name": "NOELLE",
        "credential": "RDN LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-11",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164007677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camillus, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.