Individual provider Active NPI

Mariela Penalverty Morales, RD

  • Registered Dietitian
  • Bellevue, WA
National Provider Identifier
1922796713
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI61432855 Issued in WA
Practice address
3801 150TH Ave SE
Bellevue, WA 98006-1668
Phone
(425) 460-7140
NPI assigned
Apr 28, 2023
Last updated
May 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DI61432855 WA Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

3801 150TH Ave SE
Bellevue, WA 98006-1668

Mailing address

PO Box 34703
Seattle, WA 98124-1703

Other identifiers 1

IdentifierTypeStateIssuer
2251044MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231208000478 WA Practitioner - Registered Dietitian Or Nutrition Professional 4981053527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sea Mar Community Health CentersGroup PAC ID 7315831161, 235 clinicians

Practice addresses (Care Compare)

3801 150TH Ave SE
Bellevue, WA 98006-1668
Phone (425) 460-7140

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Mar Community Health Centers Dietitian, Registered Current Accepting new patients
Sea Mar Community Health Centers Dietitian, Registered CurrentSince Sep 25, 2023 Accepting new patients
Sea Mar Community Health Centers Dietitian, Registered CurrentSince Sep 25, 2023 Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients
Sea-Mar Community Health Center Past Accepting new patients

Locations

3801 150th Ave SE
Bellevue, WA 98006
Phone (425) 460-7140

8720 14th Ave S
Seattle, WA 98108
Phone (206) 762-3730

Organizations & group practices 5

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": "1682640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1922796713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 150TH AVE SE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061668",
            "telephone_number": "425-460-7140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENALVERTY MORALES",
        "first_name": "MARIELA",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-28",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI61432855",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2251044",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; 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.