Individual provider Active NPI

Brandon Caraballosa, RDN

  • Registered Dietitian
  • Hartsdale, NY
National Provider Identifier
1770033482
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86060332 Issued in NY
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

Updated by the provider on Aug 30, 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 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

LicenseStateTypeSpecialty
86060332NYMDRegistered Dietitian
009187NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

Verify at the official NPI Registry.