Benedicte Disamb, RDN,LD
Individual provider Active NPI Registered Dietitian · Haslet, TX
NPI 1962380386 · NPPES record last updated Aug 25, 2025
Key facts
- NPI
- 1962380386
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 86098841 (TX)
- Practice address
- 11120 Boyne Ave
Haslet, TX 76052-1541 - Phone
- (703) 863-6284
- NPI assigned
- Aug 25, 2025
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Surely Health Inc
Practice addresses (Care Compare)
130 E Congress St
Suite 200 139
Tucson, AZ 85701-1708
Phone (724) 307-5926
6565 N Macarthur Blvd
Suite 225
Irving, TX 75039-2482
Phone (888) 807-4117
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (6 enrollments) in CO, TX, IL, NJ, AZ, DC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250929001872 | CO | Practitioner - Registered Dietitian Or Nutrition Professional | 7416453527 | Reassigns benefits to 1 organization |
| I20250929002211 | TX | Practitioner - Registered Dietitian Or Nutrition Professional | 7416453527 | Reassigns benefits to 2 organizations |
| I20250929002222 | IL | Practitioner - Registered Dietitian Or Nutrition Professional | 7416453527 | Reassigns benefits to 1 organization |
| I20250929002657 | NJ | Practitioner - Registered Dietitian Or Nutrition Professional | 7416453527 | Reassigns benefits to 1 organization |
| I20250929003104 | AZ | Practitioner - Registered Dietitian Or Nutrition Professional | 7416453527 | Reassigns benefits to 2 organizations |
| I20250929003160 | DC | Practitioner - Registered Dietitian Or Nutrition Professional | 7416453527 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86098841 | TX | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Season Clinical Care NJ PC | Dietitian, Registered | Current |
Accepting new patients |
| Surely Health, Inc. | Dietitian, Registered | Current |
Accepting new patients |
| Season Clinical Care P.a. | Dietitian, Registered | Current |
Accepting new patients |
| Vedic Nutrition LLC | Dietitian, Registered | Past |
Accepting new patients |
Locations
130 E Congress St
Ste 200139
Tucson, AZ 85701
Phone (724) 307-5926
130 E Congress St
Ste 213
Tucson, AZ 85701
102 S Tejon St
Ste 100
Colorado Springs, CO 80903
Phone (970) 319-2999
1719 Highway 10
Parsippany, NJ 07054
6565 N MacArthur Blvd
Ste 225
Irving, TX 75039
Phone (972) 635-0489
1710 Keller Pkwy
Keller, TX 76248
Phone (210) 201-2364
2800 Eisenhower Ave
Ste 220
Alexandria, VA 22314
Phone (540) 358-0423
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86098841 | TX | Yes |
Addresses
Primary practice location
11120 Boyne Ave
Haslet, TX 76052-1541
Mailing address
11120 Boyne Ave
Haslet, TX 76052-1541
Phone (703) 863-6284
Other providers in Haslet, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.