Active NPI
Brandon Caraballosa, RDN
- Registered Dietitian
- Hartsdale, NY
National Provider Identifier
1770033482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86060332
- Practice address
- 80 Pinewood Rd Apt 1B
Hartsdale, NY 10530-1638 - Phone
- (914) 525-4711
- NPI assigned
- Oct 5, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86060332 | NY | Primary |
Addresses
Primary practice location
80 Pinewood Rd Apt 1B
Hartsdale, NY 10530-1638
Mailing address
80 Pinewood Rd Apt 1B
Hartsdale, NY 10530-1638
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86060332 | NY | MD | Registered Dietitian |
| 009187 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Interoperability endpoints
- brandon.caraballosa@692164750016516.direct.elationemr.com
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": "1475625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724976000000",
"number": "1770033482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 PINEWOOD RD APT 1B",
"city": "HARTSDALE",
"state": "NY",
"postal_code": "105301638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 PINEWOOD RD APT 1B",
"city": "HARTSDALE",
"state": "NY",
"postal_code": "105301638",
"telephone_number": "914-525-4711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARABALLOSA",
"first_name": "BRANDON",
"name_prefix": "Mr.",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-05",
"last_updated": "2024-08-30",
"certification_date": "2024-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "86060332",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hartsdale, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.