Individual provider Active NPI

Elizabeth Ann Hartz, M.S., R.D.N., C.D.N

  • Registered Dietitian
  • Lewiston, NY
National Provider Identifier
1861934465
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86052272 Issued in NY
Practice address
1870 Upper Mountain Rd
Lewiston, NY 14092-9742
Phone
(716) 531-5207
NPI assigned
Nov 14, 2016
Last updated
Oct 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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 86052272 NY Primary

Addresses

Primary practice location

1870 Upper Mountain Rd
Lewiston, NY 14092-9742

Mailing address

352 Brentwood Dr
Youngstown, NY 14174-1404
Phone (716) 531-5207

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
86052272NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Nutrition of Western New York, PLLC Current Accepting new patients
Inclusive Nutrition Counseling, PLLC Dietitian, Registered PastSince Nov 21, 2021 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1861934465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 BRENTWOOD DR",
            "city": "YOUNGSTOWN",
            "state": "NY",
            "postal_code": "141741404",
            "telephone_number": "716-531-5207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 UPPER MOUNTAIN RD",
            "city": "LEWISTON",
            "state": "NY",
            "postal_code": "140929742",
            "telephone_number": "716-531-5207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTZ",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.S., R.D.N., C.D.N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-14",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "86052272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.