Karissa Fuller, MS, RD, LND

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2108 Issued in PR

Practice address

1ER Piso, Centro Medico de Puerto Rico
Edif. Decanato de Estudiantes
San Juan, PR 00926

Phone

(787) 773-8283

NPI assigned

Nov 10, 2020

Sex

Female

Sole proprietor

Yes

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

Enrolled in PR

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

Centro de Investigacion Educacion Y Servicios Medicos Para la DiabetesGroup PAC ID 3577476936, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Centro de Investigacion Educacion Y Servicios Medicos Para la Diabetes

  • Specialist
  • San Juan, PR
  • NPI 1558456616

  Nutritionist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1821690256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 CALLE CESAR GONZALEZ APT 6",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009181423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1ER PISO, CENTRO MEDICO DE PUERTO RICO",
            "address_2": "EDIF. DECANATO DE ESTUDIANTES",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-773-8283"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "161 Calle Cesar Gonzalez Apt 6",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "009181423",
            "country_code": "US",
            "telephone_number": "503-508-8184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "KARISSA",
        "credential": "MS, RD, LND",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-10",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PR",
            "license": "2108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynette Fuentes, OTL
• Sol S Fuentes, RT
• Vilma Fuentes, MSW
• Mayeline Gisselle Fulcar Matos
• Patricia Fullana, M.S.
• Ileana Mercedes Fumero, M.D.
• Jose Roberto Fumero, MD
• Fundacion de Investigacion de Diego
• Fundacion Oncology Network LLC
• Fundacion Pediatrica de Diabetes

• Registered Dietitian in San Juan, PR
• Providers in San Juan, PR by specialty
• Registered Dietitian in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; 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.