Individual provider Active NPI

Stephanie Chen, RDN

  • Registered Dietitian
  • Quincy, MA
National Provider Identifier
1962092924
Registry record updated Jan 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
4970 Issued in MA
Practice address
95 W Squantum St Apt 1219
Quincy, MA 02171-2136
Phone
(913) 980-1952
NPI assigned
Jan 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 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 4970 MA Primary

Addresses

Primary practice location

95 W Squantum St Apt 1219
Quincy, MA 02171-2136

Mailing address

95 W Squantum St Apt 1219
Quincy, MA 02171-2136
Phone (913) 980-1952

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210325000565 MA Practitioner - Registered Dietitian Or Nutrition Professional 6901211952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lori Lieberman and Associates LLCGroup PAC ID 9436186988, 4 clinicians

Practice addresses (Care Compare)

111 Willard St
Suite 2F
Quincy, MA 02169-1274
Phone (781) 335-7559

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4970MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lori Lieberman & Associates LLC Dietitian, Registered CurrentSince Mar 1, 2021 Accepting new patients
Doctors Foot Care Group PastSince Mar 1, 2021 Accepting new patients

Locations

111 Willard St
Ste 2F
Quincy, MA 02169
Phone (617) 773-2313

6 Washington Pl
Sharon, MA 02067
Phone (781) 335-7559

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": "1611446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611446400000",
    "number": "1962092924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 W SQUANTUM ST APT 1219",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021712136",
            "telephone_number": "913-980-1952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 W SQUANTUM ST APT 1219",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021712136",
            "telephone_number": "913-980-1952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "STEPHANIE",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-24",
        "last_updated": "2021-01-24",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "4970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2021; 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.