Active NPI
Noelle Russomano, MS, RD
- Registered Dietitian
- Roseland, NJ
National Provider Identifier
1932924453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86331001
- Practice address
- 63 Roosevelt St
Roseland, NJ 07068-1258 - Phone
- (862) 754-8644
- NPI assigned
- Nov 19, 2024
- Last updated
- Nov 19, 2024
- 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 | 86331001 | NJ | Primary |
Addresses
Primary practice location
63 Roosevelt St
Roseland, NJ 07068-1258
Mailing address
63 Roosevelt St
Roseland, NJ 07068-1258
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VT
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86331001 | NJ | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| No Diet Dietitian, LLC | Dietitian, Registered | Current | Accepting new patients |
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, 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": "1731974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731974400000",
"number": "1932924453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "63 ROOSEVELT ST",
"city": "ROSELAND",
"state": "NJ",
"postal_code": "070681258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "63 ROOSEVELT ST",
"city": "ROSELAND",
"state": "NJ",
"postal_code": "070681258",
"telephone_number": "862-754-8644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSOMANO",
"first_name": "NOELLE",
"credential": "MS, RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-11-19",
"last_updated": "2024-11-19",
"certification_date": "2024-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NJ",
"license": "86331001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseland, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.