Joelle B Porush

Primary specialty

NutritionistTaxonomy code 133N00000X

License

86066500 Issued in NY

Practice address

400 S Oyster Bay Rd Ste 300
Hicksville, NY 11801-3500

Phone

(215) 776-0389

NPI assigned

Sep 4, 2020

Last updated

Sep 4, 2020By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New York Dietetics and Nutrition PLLCGroup PAC ID 8224563929, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• New York Dietetics and Nutrition PLLC

  • Registered Dietitian
  • Commack, NY
  • NPI 1669299053
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1780298984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 WALTER CT",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253602",
            "telephone_number": "631-592-8415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S OYSTER BAY RD STE 300",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118013500",
            "telephone_number": "215-776-0389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORUSH",
        "first_name": "JOELLE",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NY",
            "license": "86066500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "86066500",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Pollicino, R.N.
• Carol Pollock, LMHC, CASAC-2, NCC
• Suma Sundersen Pondicherry Chandersen, PT
• Lisa Renee Pope
• Melissa Ann Poretsky, MS,SPED
• Shawn Jessica Potak
• Maryann J Pottanat, LICSW
• Alicia Camille Powell
• Tamara Prampin
• Precision Neurological Care PLLC

• Nutritionist in Hicksville, NY
• Providers in Hicksville, NY by specialty
• Nutritionist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; 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.