Individual provider Active NPI

Nicole Marie Plaza, LND

  • Nutritionist
  • Caguas, PR
National Provider Identifier
1912440561
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
2001 Issued in PR
Practice address
Gatsby Plaza
Suite 212
Caguas, PR 00725
Phone
(787) 653-7555
NPI assigned
Nov 30, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 2001 PR Primary

Addresses

Primary practice location

Gatsby Plaza
Suite 212
Caguas, PR 00725

Mailing address

Gatsby Plaza
Suite 212
Caguas, PR 00725
Phone (787) 653-7555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190709000779 PR Practitioner - Registered Dietitian Or Nutrition Professional 4082949359 Practice locations: Caguas, PR

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Gatsby Plaza
212 Nutricion a Tu Medida
Caguas, PR 00725
Phone (787) 653-7555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2001PRMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Psyche Centro de Apoyo Psicologico Inc Nutritionist Past Accepting new patients
Lumar Consultoria Nutricional CSP PastSince Sep 24, 2013 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1480464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1912440561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GATSBY PLAZA",
            "address_2": "SUITE 212",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-653-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GATSBY PLAZA",
            "address_2": "SUITE 212",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-653-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLAZA",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "LND",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-30",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "PR",
            "license": "2001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; 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.