Active NPI
Ellen Thomson Bauersfeld, RD
- Registered Dietitian
- Tarzana, CA
National Provider Identifier
1881763472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 18372 Clark St
Suite 226
Tarzana, CA 91356-3508 - Phone
- (818) 881-9192
- Fax
- (818) 881-0261
- NPI assigned
- Nov 7, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | Primary |
Addresses
Primary practice location
18372 Clark St
Suite 226
Tarzana, CA 91356-3508
Mailing address
18372 Clark St
Suite 226
Tarzana, CA 91356-3508
Phone (818) 881-9192
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 1987
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
18372 Clark St
Suite 228
Tarzana, CA 91356-3555
Phone (818) 881-9192
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Nutrition Network LLC | Dietitian, Registered | Current | Accepting new patients |
Locations
18372 Clark St
Ste 228
Tarzana, CA 91356
Phone (818) 384-2886
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
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": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1881763472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18372 CLARK ST",
"address_2": "SUITE 226",
"city": "TARZANA",
"state": "CA",
"postal_code": "913563508",
"telephone_number": "818-881-9192",
"fax_number": "818-881-0261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18372 CLARK ST",
"address_2": "SUITE 226",
"city": "TARZANA",
"state": "CA",
"postal_code": "913563508",
"telephone_number": "818-881-9192",
"fax_number": "818-881-0261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUERSFELD",
"first_name": "ELLEN",
"middle_name": "THOMSON",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tarzana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.